This disease is due to genetic factors leading to a high uric acid due to overproduction or inability to excrete through the kidneys.
Environmental factors:
- High purine diet- beer, red meat, fructose in soda or food, shellfish
- Routine use of diuretics for leg swelling or heart failure
- Kidney disease – this leads to inability to remove uric acid from blood
- Obesity leads to high levels of inflammation which causes more attacks
New studies indicate that gout is associated with higher risk of high cholesterol and heart disease. A Mediterranean diet will help reduce this risk and also helps treat gout.
All vegetables are OK, since vegetable purines do not raise uric acid.
- Attacks: Painful swollen and tender joints
- Treat: NSAIDS like naproxen, ibuprofen, or indomethacin for 1- 2 weeks daily
- Steroids: Prednisone 5mg taking 4 pills per day for 3 days, then 3 pills per day for 3 days, then 2 pills per day for 3 days, then one per day for 3 days, then stop.
- Prevention: Using a pill daily to prevent attacks from starting. Colchicine or Colcrys 0.6 mg one each day. This is very important when starting allopurinol, which causes more attacks during the first 6 to 12 months of use.Decreasing uric acid levels long term – this is extremely important. If the uric acid stays high, then painful lumps of gout crystal will form that destroy bone and joints. Allopurinol must be taken every day indefinitely. Common side effects are rash or high liver tests.
Go to WebMD, Johns Hopkins Arthritis Center, or www.Mayoclinic.com to learn more.