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GoutGout – General InformationGout is considered a medical condition caused by a buildup of the uric acid and is also known as metabolic arthritis. This type of disease manifests by monosodium urate or uric acid crystals that are deposited in the articular cartilage of the patient’s joints, tendons or nearby tissues because of the increased concentrations of uric acid in the blood stream. This process leads to the appearance of an inflammatory reaction of the inside parts of these tissues. Gout is a kind of disease that is more encountered in male patients or in individuals who consume important amounts alcohol. The disease is closely related to hyperuricemia which can be caused by overproduction or underexcretion of serum uric acid or the breakdown production of circulating purines. It is a medical condition that can easily recur or progress to a more severe form called tophaceous which usually appears also if the disease is left untreated. Early pain and joint swelling disappear over a few days with rest, and the intake of nonsteroidal anti inflammatory drugs and proper hygiene of the patient’s overlying skin are considered to be the main treatment options. The disease can also develop after taking medicines that interfere with uric acid excretion. Gout can also be caused by a disorder of purine or pyrimidine metabolism called inflammatory arthritis. There are some particular cases in which the disease is left untreated or treated improperly and the patients can also develop other uncomfortable diseases such as diabetes, kidney disease, obesity or even sickle cell anemia.Gout – SymptomsIn almost all the cases, the signs and symptoms of Gout are acute, occurring suddenly, often during the night, and are experienced without any warning. The main signs and symptoms of the Gout disease are excruciating, sudden, unexpected, burning pain, swelling, redness, warmness and stiffness in the joint, but there are also some cases in which the patient can experience low grade fever. Generally, the patient suffers from two sources of pain. The crystals inside the joint usually cause intense pain when the affected area is moved just a little. The inflammation of the tissues surrounding the joint can also causes the skin to become swollen, tender and sore only if it is a little touched or moved. Even a blanket or the lightest sheet draping over the affected part of the patient’s body can lead to experiencing extreme pain. Gout attacks the patient’s big toe in more than half of the cases of first attacks and can also spread to the surrounding parts of the joint including the ankle, heel, instep, knee, wrist, elbow, fingers, and spine. In some particular cases, the disease can occur on the joints of small toes which can become immobile because to an impact injury earlier in the patient’s life, leading to a poor blood circulation that leads to the appearance of the condition. Usually, the patients experience the second attack after six months to two years, but there are cases in which this second attack does not appear before five to even ten years.Gout – TreatmentThe treatment for Gout, in most cases, consists in administrating medications. These medications are prescribed depending on the overall medical status of the patient and his preferences. The most common medications used to treat the disease can include nonsteroidal anti inflammatory drugs, colchicines and steroids. There are cases in which the doctor can use indomethacin, oral glucocorticoids, or intra articular glucocorticoids, which are administered through a joint injection, to treat Gout. Colchicine was considered the main drug of choice by specialists in the attacks provoked by the disease. This medicine has the effect of impairing the motility of granulocytes and preventing the inflammatory phenomena that triggers the attack. This kind of drug has to be administered in the first 12 hours of the attack and has the greatest effect of relieving the present signs and symptoms in 48 hours. However, gastrointestinal disorders such as diarrhea and nausea are considered common side effects of this medicine. The nonsteroidal anti inflammatory drugs are now chosen by the doctor to relieve the symptoms of pain caused by Gout. Such medical products and oral glucocorticoids are considered to have the same effects as Colchicine, with less adverse reactions. The nonsteroidal anti inflammatory medicines are, in most cases, administered to each patient in doses of 75 mg of diclofenac intramuscularly, indomethacin in 50 mg dose orally, and acetaminophen in 1 g dose also orally. In cases in which the patient who receives a five days of indomethacin in 50 mg dose orally, every eight hours for two days, in combination with indomethacin in 25 mg dose every eight hours for three days, has to receive an adjacent treatment trial with acetaminophen in 1 g doses every six hours. There are cases in which the patient receives a treatment trial with glucocorticoids, which usually consists in prednisolone in 30 mg dose orally, and acetaminophen in 1 g dose, also orally and then has to take prednisolone in 30 mg dose once a day for five days. The doctor can also apply other over the counter medications that can provide pain and swelling relief and can include ibuprofen, which has the effect of reducing the pain and inflammation slightly. Aspirin is not considered adequate to treat Gout because it can easily worsen the condition. There are cases in which a mixture of H hemorrhoidal ointment can be also applied on the swollen skin to reduce the swelling for a short time. Ice can also be applied for twenty to thirty minutes a day and that is why many clinical studies found that patients who used the ice pack treatment trials had better improvement in pain relieving without experiencing many side effects. There are cases in which the patients who suffer from Gout can suffer from an aggravation of the disease in the knees and toes areas. This is associated with prolonged periods of immobility, for example when sitting at a computer desk for several hours. |
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