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- $Unique_ID{BRK01273}
- $Pretitle{}
- $Title{The Workings of Gout}
- $Subject{arthritis gout metabolism connective tissue uric acid stone kidneys
- urine joints joint tophi kidney stones purines colchicine allopurinol
- probenecid sulfinpyrazone salicylates gouts}
- $Volume{C-17}
- $Log{
- Gout Affects the Elbow*0003801.scf
- Gout Affects the Kidneys*0003802.scf
- Gout Affects the Knee*0003803.scf
- Gout Affects the Ankle*0003804.scf
- Gout Affects the Toes*0003805.scf
- Gout Affects the Instep*0003806.scf
- Gout Affects the Hand*0003807.scf
- Gout and the Kidney*0016701.scf}
-
- Copyright (c) 1991-92,1993 Tribune Media Services, Inc.
-
-
- The Workings of Gout
-
-
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-
- QUESTION: It is time you devoted some space to your readers with gout. This
- is my problem which always strikes just when I think all is going well. Can
- you please explain the workings of this disease for me?
-
- ------------------------------------------------------------------------------
-
- ANSWER: Gout is a form of arthritis. It's caused by an excess of uric acid
- in the body. Everybody has some uric acid, but some people have too much.
- Either they make too much or their kidneys don't flush enough uric acid out
- with their urine. As a result, the excess acid forms crystals, which tend to
- collect in the joints, especially in the fingers and toes. A gout attack
- occurs when these crystals cause pain, redness and swelling in the joint.
- Generally, the first attack of gout will disappear by itself after no
- more than two weeks. Another attack may occur shortly thereafter, or it may
- not happen again for years. Left untreated, though, gout can cause
- complications. As the uric acid crystals build up in the joints, they form
- tophi (or deposits). The crystals can also lead to kidney damage and kidney
- stones. Therefore, it's important to seek medical attention for gout.
- Your doctor may check for gout via several techniques. For example, he
- or she may want to draw some fluid out of the affected joint to check for the
- presence of uric acid crystals. If that's not possible, you may be put on a
- trial course of medication. If the drug works, it rules out most causes of
- your joint pain other than gout. Finally, the level of uric acid in your
- urine may be tested. (If this is the case, for three days before the test
- you'll have to limit your intake of foods high in purines, substances that
- turn to uric acid in the body.)
- If a diagnosis of gout is confirmed, two types of medications can treat
- the disease. Colchicine or nonsteroidal anti-inflammatory drugs (NSAID) are
- often prescribed to relieve the pain and inflammation. These drugs will clear
- up an attack of gout; however, they have no effect on future attacks. NSAIDs
- take longer to relieve gout's symptoms, but they have fewer side effects than
- colchicine, which causes cramps, nausea, vomiting or diarrhea in 80 percent of
- the people who take a full dose of it.
- Other drugs go to work to lower the level of uric acid in your body,
- thereby preventing future attacks. Allopurinol does this by reducing the
- amount of uric acid you produce. Probenecid and sulfinpyrazone help your
- kidneys clear uric acid out of your bloodstream. These drugs will also
- dissolve any tophi you may have formed and prevent future complications such
- as kidney disease. Some doctors feel that gout patients must take drugs that
- lower uric acid levels indefinitely. However, other experts disagree. In
- mild cases, the risk of long-term use of the drugs may outweigh the risk of
- future gout attacks.
- Besides taking your medication, there are a few things you can do to help
- control your gout. Keep alcohol consumption to no more than one or two drinks
- a day, avoid large amounts of foods high in purine (anchovies, bacon, salmon,
- herring, turkey and veal, to name a few), cut back on red meat to no more than
- two to three times a week (it's also high in purines), drink at least two
- quarts of liquid a day and avoid aspirin and other drugs that contain
- salicylates, which can increase uric acid levels and reduce the effectiveness
- of gout medications. Remember, though, you can't cure gout with your diet;
- for that you need medication.
-
- ----------------
-
- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
-
-