Question: My son, who is 47, has suddenly developed gout. It started in his knees, but has now moved to his ankles and fingers. We know the cause is from uric acid, but is there a cure, or at least a pain reliever, that is not harmful?
Dr. Hibberd's Answer:
Unfortunately, we have no cure for gout. Gout is a condition resulting from the body's accumulation of uric acid that's deposited in tissue and joints and causes painful inflammation. Uncontrolled or recurrent gout has elevated risks for development of uric acid kidney stones and also elevates cardiovascular risk as well as wreaking devastation with bone and joint health. It can even lead to resistant and deforming collections of uric acid in soft tissue and tendon areas called tophi.
We manage gout by reducing dietary purine intake and treating acute attacks with anti-inflammatory medications. Do avoid excessive alcohol and red meat. Usually, the anti-inflammatories (NSAID meds and several days of cortisone-type medications are most often used) are needed for a short time only and are very effective. Toxic drugs such as colchicine are old-style medication options most of us avoid due to concern about side effects and potential bone-marrow toxicity.
Strategies intended to lower uric acid lowering are often used, but remember that levels of uric acid in the blood are not elevated in all cases of gout.
Ask your doctor for a list of medications and foods known to worsen gout. Follow a purine-free diet as closely as possible.
Though long-term medications like allopurinol are available, they are not needed by all patients, and their use is not always free of side effects. So, if preventive gout medications are proposed, use them under the guidance of your physician. Be aware that medications, such as selected diuretics, can actually exacerbate gout, so be sure to consult your medical professional regarding gout management and control.
Also, gout increases your cardiovascular risk, so seek professional guidance for further advice on reducing your cardiovascular risk factors.
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