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Video:Treating Gout

with Dr. Pamela Rosenthal

Gout can be a painful and debilitating condition, but there are a number of ways of treating it. This video from About.com will explain the basics of treating gout.See Transcript

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Transcript:Treating Gout

Hi, I'm Dr. Pamela Rosenthal, Rheumotologist at the NYU Langone Medical Center for About.com. In this video, I'll be discussing about the varied goals of gout therapy.

Treatments for Acute Gout Attacks

Gout is caused by uric acid crystals precipitating in a joint. It's excruciatingly painful and intensely inflammatory. As such, our first line of defense is to use anti-inflammatory drugs. Typically, we start with non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, or indomethacin.

Also Treat Gout With Colchicine

In addition, even in the context of acute gout, we may use a medication such as colchicine, which is also used to suppress gout attacks. So, colchicine is an agent that we can use in two different ways. In addition, since gout is such a fully inflammatory type of arthritis, it is possible to use powerful anti-inflammatory medication such as prednisone. Depending on who you are, and what underlying medical conditions you may have, there are a variety of therapeutic options for an acute gout attack.

Suppressive Therapies for Gout

Depending on the frequency and severity of the gout attacks, a patient might be in need of chronic suppressive therapy. Those patients tend to be folks who get gout several times a year, and are incapacitated by their gout for periods of two to three days at a time. In this case, we would look at the patient's blood levels of serum uric acid and we would check the patient's kidney and liver functions as we consider a medication to prescribe. We might start out by using colchicine, one tablet a day, which seems to do an extremely effective job of suppressing recurring gout attacks. Or if the serum uric acid level is particularly high, we might recommend a uric acid lowering agent such as allopurinol, or febuxostat, a newer medication.

Diet Modifications Can Affect Gout

In addition, even before we try therapeutic pharmacologic interventions, we might actually make suggestions about diet modifications. Uric acid is actually a byproduct of protein metabolism of purines and pyrimidines, and of purines in particular. Protein-based animal products are rich in purines. So reducing the amount of animal proteins in people's diet seems to help lower uric acid levels and decrease the severity and frequency of gout attacks. In addition, epidemiological studies have determined that dairy products seem to be protective against gout. So there are, in fact, dietary interventions that you can make.

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