Tests then will be conducted to determine the amount of uric acid your body produces. These tests are particularly helpful because some people with gout produce and eliminate a large amount of uric acid. These people may be more likely to develop kidney stones. People with gout also may have high blood pressure or kidney infections. Since these problems can cause kidney damage, your doctor will check for signs of these problems and treat them if they occur. Almost all people with gout have too much uric acid in their blood, a condition called hyperuricemia.
However, there are many people who have hyperuricemia but not gout. Hyperuricemia is caused by one or both of the following:.
Hyperuricemia often is caused by using diuretic medications "water pills". Diuretics are used to get rid of excess body fluid and to lower high blood pressure. However, diuretics can hamper the kidneys' ability to remove uric acid, thus raising uric acid levels in the blood. Other factors such as inherited traits and environmental factors such as weight, alcohol use and diet also can play an important role in causing gout.
To diagnose gout, your doctor will examine you and ask you to describe your symptoms. Your doctor may take blood tests to measure the amount of uric acid in your blood.
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Remember: A high level of uric acid in your blood doesn't necessarily mean you have gout nor does a normal level mean you don't have gout. Your doctor may check for other types of arthritis such as CPPD deposition disease and infectious arthritis. These conditions resemble gout but are not caused by uric acid crystals. To determine which type of arthritis you might have, your doctor may have to remove fluid from an affected joint and examine it for crystals. The goals of treatment are to relieve pain, shorten the duration of inflammation during an acute attack, prevent future attacks and prevent joint damage.
You can drink coffee and tea. However, talk to your doctor about drinking alcohol. Too much alcohol may raise your uric acid level and bring on a gout episode. Drink at least eight-ounce glasses of non-alcoholic fluids daily, especially if you have had kidney stones. This will help flush the uric acid crystals out of your body. Using medications for gout can be complicated. The treatment needs to be tailored for each person and may have to be changed from time to time. People who have hyperuricemia, but no other problems, usually do not require medications.
All of these drugs are powerful so you need to understand why you are taking them, what side effects may occur and what to do if you have any problems. Colchicine has been used to treat gout for over 2, years. It relieves the pain and swelling of acute attacks. It usually is taken by mouth in several small doses every day.
It works best if taken during the first two days of an attack. When taken by mouth, colchicine can cause diarrhea, nausea and abdominal cramps. If side effects occur, stop taking the drug and notify your doctor. To prevent future episodes, you may have to continue taking a small dose of colchicine after the attack has cleared. Nonsteroidal anti-inflammatory drugs NSAIDs are sometimes used to relieve the pain and swelling of an acute attack.
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They usually begin working within 24 hours after you start taking them. These medications are as effective as colchicine but may have less frequent side effects. However, side effects from NSAIDs may include stomach upset, headache, skin rashes and sometimes ulcers. Doctors teach many people with gout how to begin treatment on their own.
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When a gout episode begins, call your doctor and begin taking your medication. Your doctor may suggest that you keep a supply of medication on hand to take at the first sign of trouble. The medications listed below are used to treat or prevent tophi and to prevent future gout episodes. In addition, allopurinol is used to prevent kidney stone formation. However, these medications do not relieve the pain and inflammation of an acute attack. These medicines start working slowly over many months. They may cause you to have more gout episodes when you first start taking them, so you may have to take colchicine or an NSAID at the same time for the first three to six months to prevent such attacks.
Many people with gout do not require these medicines. If you must take them, however, you'll probably have to do so for the rest of your life in order to prevent future problems. Allopurinol Lopurin, Zurinol, Zyloprim reduces the amount of uric acid in your blood and urine by slowing the rate at which the body makes uric acid. It is the best medicine for people who have kidney problems or kidney stones caused by uric acid. Occasional side effects include skin rash and stomach upset. Stomach problems usually go away as your body adjusts to the drug. In rare cases, this drug can cause a severe allergic reaction.
If you have a skin rash along with hives, itching, fever, nausea or muscle pain, contact your doctor right away. This drug also may make some people drowsy or less alert. Make sure you know how you react to this medicine before you drive or operate machinery. Some drugs lower the uric acid level in your blood by increasing the amount of uric acid passed in your urine. They help dissolve tophi and prevent uric acid deposits in joints. The drugs commonly used to lower uric acid levels in gout are probenecid Benemid, Parbenem, Probalan and sulfinpyrazone Anturane.
They usually are taken by mouth on a daily basis. Your doctor will adjust the amount of medication you take based on your blood uric acid level. When a normal level of uric acid is reached, no more crystals will be deposited in your joint s. Those already present will start dissolving. While the skin rash sometimes can be serious, other side effects usually are not serious and may go away as your body gets used to the medicine.
If any side effects continue to bother you, contact your doctor. Take these medications with plenty of liquids. Do not take aspirin with these drugs because it blocks their effects on the kidneys. Read the labels of any prescription or over-the-counter medicines you take to be sure they don't contain aspirin.
At first, probenecid or sulfinpyrazone may increase your risk for kidney stones by increasing the uric acid content of the urine. To prevent this problem, keep your urine diluted by drinking eight ounce glasses of fluid every day. Probenecid, sulfinpyrazone and allopurinol also may cause you to have more frequent gout episodes at first. During this time, you may have to take colchicine or an NSAID for the first three to six months to prevent an episode. Take your medicine exactly as your doctor instructs.
In order to be effective, these medicines must be taken continuously. This will help your body get rid of excess uric acid and will keep the uric acid level from rising again.
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Do not take double doses of your medicine. At present, only are in practice across the country. The goal is to increase that number substantially and deliver effective care to an estimated additional , Canadians. Incentives such as new scholarships and career training programs will be funded to address this vital need.
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The Society is about to change that. Community Central — Using a combination of social and digital tools, The Arthritis Society is creating one home for Canadians living with arthritis that can serve as a combined online community centre, referral board and resource library.
Being able to share stories, resources and access to credible information will make this portal a vital component of self-management strategies employed by Canadians with arthritis. Too many people accept arthritis in silence. I hope Canadians respond to the call to drag arthritis out of the shadows and work with The Arthritis Society to help erase the pain. Share Article. Five Signature Initiatives Designed to Support 4. Share article on social media or email:.