Gout - Treatments
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There are two different groups of medicines to treat gout. They are known as relievers and preventers. Your doctor will prescribe the most suitable gout treatment for you.
Reliever medicines for Gout
For most people, non-steroidal anti-inflammatory drugs (NSAIDs) are the medicine of first choice. They work quickly to relieve the pain and inflammation of a gout attack.
Colchicine is another reliever medicine that is limited to second-line treatment for acute gout. Colchicine is especially useful for people who cannot take NSAIDs. Avoid taking asprin for pain relief as it can raise uric acid levels. If you are taking regular low dose asprin for blood thinning purposes, ask your doctor if you should continue taking this during an acute gout attack.
Preventer Medicines for Gout
These medicines are taken regularly for long term prevention. They lower the uric acid levels in the body and reduce the risk of crystals forming in the joints. During the early stages of treatment with a preventer medicine you will need to take regular low doses of a reliever as well. This is to prevent further attacks of gout while the uric level is reduced gradually.
During the early stages of treatment with a preventer medicine you will need to take regular low doses of a reliever as well. This is to prevent further attacks of gout while the uric level is reduced gradually.
Most treatments for gout aim to reduce the symptoms of pain and swelling. Based on your current health and treatment preference, your doctor chooses medicines that will suit you best.
Non-steroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs (NSAIDs) are used to reduce the pain and swelling associated with gout. When used for a short period of time, they cause few side effects. However, when taken in high doses over a longer duration, they can cause side effects such as stomach pain, bleeding and ulcers. If you have peptic ulcer or kidney disorders or have been using warfarin, you must consult your doctor before taking NSAIDs.
This drug is used for two purposes:
- To treat acute attacks of gouty arthritis
- To prevent recurring attacks
When used for treating acute attacks, colchicine is administered frequently, up to once every hour, till a maximum of 10 doses. By that time, the symptoms usually subside. The treatment is stopped if side effects begin to develop. Many people develop nausea, vomiting or diarrhoea. To prevent an attack of gout, colchicine can be given once or twice in a day. Side effects are less common at such doses.
In severe cases, when NSAIDs and colchicines are ineffective, corticosteroids are used to treat gout. They provide instant relief but long-term use can lead to weight gain, fluid retention, osteoporosis, bruising, muscle weakness, diabetes, and glaucoma.
Allopurinol decreases the formation of uric acid in the body. It is used to prevent gout attacks. Common side effects include stomach pain, headache, diarrhoea and rash. If you develop rash or fever, discontinue the use of the drug immediately and call a doctor.
This drug helps to eliminate excess uric acid from the body. To help prevent formation of uric acid kidney stones, it is advisable drink at least 2 litres of fluid a day while on probenecid. Several drugs are known to react with probenecid. So keep your doctor informed about all other drugs that you might be taking.
Nutritional Therapy for Gout
Diet changes can go a long way in helping to manage gout
Avoid purine rich foods: Uric acid is an end product of the metabolism of dietary elements known as purines. Foods rich in purines include meat (including organ meats and meat extracts) fish, seafood, yeast and yeast extracts, peas, beans, lentils, asparagus and mushrooms.
Cut down on alchohol: Consumption of alchohol has long been associated with high uric acid levels and gout.
Herbal Treatments for Gout
Once the acute gout attack has been dealt with, herbal treatments can play a role in helping to manage and prevent gout and can be used effectively alongside conventional gout treatments
Burdock root: Burdock is said to have 'blood cleansing' properties while research supports it's anti-inflammatory properties.
Celery Seed: Celery seed is another well known gout remedy with anti-inflammatory, diuretic and anti-arthritic actions.
Cherries: Cherries have been shown to reduce uric acid levels in the blood. Other fruits such as strawberries, cranberries, blackcurrants may be effective due to anti-inflammatory properties.