Therapy and natural remedies for gout There are two basic concepts for treating gout
The first step is the blockade of acute inflammation in the affected joints, and thereafter the long-term prevention of the disease to avoid recurrences of painful attacks. It is therefore necessary to reduce the deposition of uric acid crystals in the joints.
Treatment of this condition is different from the treatment of hyperuricemia.
Treatment of an acute attack of gouty arthritis consists of remedies and drugs that reduce inflammation.
To prevent gout, you should drink a lot, reduce weight, change your diet and drink less alcohol.
The doctor may recommend drugs that lower the level of uric acid in the blood, that is, reduce hyperuricemia.
Avoiding acute gout attacks is possible by drinking a lot. This also reduces the risk of kidney stones.
Alcohol is known for its diuretic effect, which can cause dehydration and a change in the metabolism of uric acid, potentially causing hyperuricemia.
Some natural remedies that can relieve the symptoms of acute gout include: immobilization and elevation of the inflamed joint.
Ice sheets can aggravate the inflammation because they promote the formation of uric acid crystals in the joints.
Patients should, if possible, avoid medications containing aspirin, because this drug prevents the excretion of uric acid from the organism.
What should you eat? Diet and nutrition for gout
A change in diet can help lower uric acid levels in the blood. Since purines are converted into uric acid in the organism, you should avoid foods that contain a lot of this substance.
Examples of foods rich in purines: crustaceans and meat, especially liver, brain and kidneys.
Researchers have discovered that eating meat and fish increases the risk of gout attacks, while consuming dairy products appears to reduce the frequency of seizures.
However, dairy products should be avoided for other reasons.
A diet rich in protein or plant purines does not affect this condition, while alcohol has a negative effect on it.
A healthy diet, consisting mainly of fruits, vegetables, legumes, nuts and seeds, rice and grains, is also digestible for gout.
Weight loss may be useful to reduce the risk of recurrent gout attacks.
For this purpose, it is necessary to reduce calorie intake and carry out a regular exercise program.
What not to eat?
Foods to avoid are meat, especially red meat, fish, alcoholic beverages and generally all foods containing animal protein.
Medication for gout
There are three types of medications used to treat gout.
In the first place are painkillers such as paracetamol (ben-u-ron) or stronger analgesics for pain treatment.
In second place are nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine and corticosteroids, which are used to reduce joint inflammation.
And finally, drugs are used to compensate for the metabolic imbalance that causes hyperuricemia.
They serve to reduce the high level of uric acid in the blood.
The NSAIDs, such as indomethacin (Indomet®) and naproxen (Proxene), are effective anti-inflammatory drugs used to treat acute gout attacks.
Common side effects of NSAIDs include irritation of the digestive system, stomach ulcer and intestinal bleeding.
People with an existing aspirin allergy or with nasal polyps should avoid NSAIDs due to the risk of allergic reactions.
Colchicine (Colchysate) is taken orally and is used to reduce inflammation and prevent attacks of gouty arthrosis, while hyperuricemia is treated with medications such as allopurinol (Zyloric) or febuxostat (Adenuric). In acute gout attacks, colchicine is taken every hour or every other hour until there is an improvement in pain or the patient develops side effects such as diarrhea.
Other undesirable effects of colchizine are nausea and vomiting.
Corticosteroids such as prednisone are powerful anti-inflammatories for gout treatment, but should only be used for a short period of time.
They can be administered orally or through infiltration directly into the inflamed joint.
Corticosteroids are prescribed to patients who have gastrointestinal problems or problems with the kidneys or liver.
Long-term use of corticosteroids is not recommended due to serious long-term side effects.
Probenecid and sulfinpyrazone are drugs used to reduce the level of uric acid in the blood and to increase urine excretion (uricosuric).
By lowering the level of uric acid in the blood, the risk of seizure recurrences of arthritis, kidney stones and kidney disease is reduced.
These drugs can also be taken for a long time.
Drugs aimed at lowering uric acid are allowed to be taken by the patient only after the acute inflammation has subsided, otherwise they can aggravate the situation.
You can also take them before an attack occurs.
In rare cases, these drugs can cause kidney stones, so they should not be given to patients with stone problems.
The uricosurics must be taken with plenty of water to allow rapid passage of uric acid through the urinary system and prevent kidney stone formation.
Allopurinol lowers uric acid in the blood by blocking its production.
In fact, the metabolic conversion of purines into uric acid is blocked.
This medication must be used with caution by patients with kidney problems because side effects may occur, including severe rashes and liver damage.
Febuxostat (adenuric) has been approved by the Food and Drug Administration in the United States for the treatment of chronic hyperuricemia.
This drug has been shown to be more effective than allopurinol in preventing acute attacks of gouty arthritis and is effective in reducing uric acid deposits in the fingers, elbows, and ears.
Since febuxostat does not cause side effects on the kidneys, it may be more suitable for patients with renal insufficiency than allopurinol.
Febuxostat and allopurinol are prescribed to patients only after the complete resolution of acute gout attacks.
In some patients, increasing the dose of this medication reduces gout attacks.
A new intravenous medication to lower blood uric acid levels in some patients with chronic gout is pegloticase (Krystexxa).
This drug (administered every two weeks) is prescribed only to patients who have not benefited from other medications.
Is gout dangerous? Complications
Gout causes joint stiffness and joint pain, it also leads to chronic and progressive damage to articular cartilage and bone. Over time, “nodules” can appear as deposits of uric acid in body tissues, causing local pain in the affected areas of the body.
Gout also causes kidney stones and arterial hypertension (high blood pressure).
In order to reduce recurrent gout attacks, one should eat properly, lose weight and drink a lot.
In addition, drugs such as thiazide diuretics, nicotinic acid, levodopa, aspirin, etc., which increase uric acid in the blood, should be reduced as much as possible.
However, a good diet is not enough to prevent gout attacks.
Medications that lower uric acid levels in the blood may be used to prevent gouty arthritis.
How long does the disease last? Healing time or recovery
In general, the attacks of gouty arthritis subside within a week with the use of anti-inflammatory drugs or physiotherapy equipment treatment to eliminate the swelling.
Recurrent gout is not only painful, it also causes permanent damage to cartilage and bones.
The best way to prevent further attacks of gout is to lower uric acid in the blood. The value should be below 6.0 mg/dl.
Therefore, regular studies of uric acid in the blood are necessary. A change in diet is the best prevention of gout.