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Gout Treatment Options For Pain of Uric Acid Crystals

Gout is a metabolic disease also referred to as arthritis urica; hyperuricemia, niggles. It is caused by an increased uric acid content in the blood ( hyperuricemia ). As a result of hyperuricemia, uric acid crystals deposit in various body tissues, and especially in the joints, which can lead to very painful inflammations in the form of attacks of gout.

In industrialized countries, many people have elevated uric acid levels. Men are affected more frequently than women. Elevated uric acid levels alone usually do not cause any discomfort and are therefore usually only detected by chance during a medical examination. The higher the uric acid level increases, the greater the risk of an acute attack of gout.

Acute Gout Attack

The first attack often occurs at night or early in the morning. The metatarsophalangeal joint (sometimes including the knee joint, the spine or the metacarpophalangeal joint) is often affected, which swells within a few hours and causes severe pain. The skin above it turns red and hot, in addition it can come to fever . The doctor calls this thing Podagra. It is often preceded by lavish fat food or excessive consumption of alcohol.

After several days to a few weeks, the pain has usually subsided and everything seems normal again. But do not take such an attack lightly. There is a danger of recurrent attacks of gout, which occur at ever shorter intervals and can last longer. Finally, it comes to permanent joint damage. In addition, kidney function disorders (so-called gout kidney) as well as the formation of kidney stones may occur. The uric acid can be deposited in the tissue and there are so-called tophi (gout nodules), for example on the auricles, on the big toe or heel. Also on the bones can lead to defects.

Causes

Uric acid is the end product of the breakdown of purines in the body. Purines are precursors of carriers of genetic information in cell nuclei.

We also take purines via the diet. Intestines, meat and fish are especially rich in purines. The uric acid excretes the body for the most part via the kidneys. However, since it is poorly soluble in water, it crystallizes easily at too high a concentration. These crystals are deposited in the body tissue, especially in joints, but also in the kidneys or in the skin of the auricles. Uric acid crystals exert a strong attraction on phagocytes . These absorb the indigestible crystals and thereby release inflammatory substances. This leads to the acute, very painful gout attacks.

Too much uric acid (hyperuricemia) is a congenital metabolic disorder in the majority of patients in which the body excretes too little uric acid. In the other patients, hyperuricemia is the result of other diseases, such as kidney damage, tumor disease, anemia , or ill-treated diabetes mellitus. Also, diseases that are associated with increased cell degradation lead to excess uric acid. These diseases include primarily tumors, hemolytic anemia (a special form of anemia) and leukemia (blood cancers).

Unfavorable eating habits (especially fatty food) and high alcohol consumption (alcohol reduces uric acid excretion) additionally burden the metabolism with purines. In addition, various medications (for example, dehydrator) or extreme fasting can trigger a gout attack.

Self Treatment

People with gout disease should switch their diet to a low-purine diet with as few as possible offal, sardines, anchovies, sprats, mussels, crabs and herring, as well as very little meat and fish. For fried fish and poultry dishes always remove the skin if possible.

Obese people should try to reduce the weight slowly. Avoid radical cures and independent fasting treatments. During fasting, fat loss causes increased uric acid. This can result in severe and very painful gout attacks. Get better advice from dieticians.

Avoid alcohol altogether if possible. Drink at least two liters of fluid daily to prevent kidney build-up. Not suitable are naturally cloudy juices or non-alcoholic beer, especially Hefeweizen (because of its cloudy ingredients).

In many cases, these general measures are sufficient to limit the risk of gout attacks. You save medicines. Some patients may even refrain completely from medicines.

In case of an acute attack of gout, you should primarily immobilize and cool the affected joint. After every gout attack a doctor’s visit should be made. For information on how to deal with over-the-counter drugs such as ibuprofen and indomethacin (both non-steroidal anti-inflammatory drugs ).

The over-the-counter gout therapies also include, for example, medicinal extracts of Ibuprofen Heisteriarinde. Plants to which a supportive effect in the treatment of gout are attributed are, for example, horsetail, birch, yellow gentian, yaw, fall-time lotus, celery and barberry.

When to Consult a Doctor?

If more gout occurs among relatives, the uric acid level should be checked as a precaution by the doctor. Some pharmacies also offer various blood tests, which can be there to determine the uric acid level in the blood. An increased uric acid content should be checked again by the doctor.

See the doctor immediately if the symptoms of an acute gout attack described in the description appear. The doctor will prescribe medications that will quickly and reliably relieve the pain.

Medicines for Gout

Gout medicines work by lowering uric acid levels. This is done in two ways, Either reduce gout formation of uric acid, are called such means uricostatics . Or the active ingredients increase the excretion of uric acid and they are called uricosuric . Both ways can be used preventively and in acute gout attacks.The preventive treatment with gout medicines should reduce the excessive uric acid levels in the long term. This is important as it becomes more and more likely that acute attacks of gout will occur from a specific uric acid concentration. The target uric acid level is 5.5 to 7 milligrams per deciliter of blood.Available preventive agents are allopurinol , benzbromarone , febuxostat and probenecid .Allopurinol and febuxostat reduce the body’s uric acid production. At the beginning of treatment, however, the uric acid concentration in the blood may initially increase because deposits in the tissue are dissolved. So sometimes acute gout attacks occur. Therefore, Allopurinol and Febuxostat are only used after the acute symptoms subsided and to prevent a gout attack.In contrast, benzbromarone and probenecid are uricosuric agents that promote kidney uric acid excretion. Due to the increased excretion of uric acid crystals, however, stones can form in the kidney. Therefore, patients with kidney stones should not use these drugs.

In an acute attack of gout, fast-acting agents are needed to quickly rid the patient of his pain. The classic remedy for the acute gout attack is colchicine , an ingredient of the seed of the autumn timeless. Colchicine is actually a poison that leads to serious side effects in too high doses. In low dose, however, it is used profitably.

Anti-inflammatory non-steroidal anti-inflammatory drugs such as indomethacin , acemetacin , diclofenac and ibuprofen are also useful in effectively relieving the pain of an acute gout attack. In very severe cases, the doctor may also prescribe glucocorticoids such as prednisolone .

Over The Counter

Indomethacin

It’s used as it;

  • Inhibit inflammation
  • Relieve pain in joint disorders
  • Treat gout
  • Alleviate inflammation in ankylosing spondylitis
  • Reduce inflammatory pain in rheumatic complaints
  • Treat painful swelling and inflammation after injury and surgery
  • Alleviate eye inflammation after surgery
  • Relieve pain (mild to moderate)
  • Relieve pain (strong to very strong)
  • Relieve menstrual pain
  • relieve inflammatory rheumatic diseases
  • Relieve pain in fibromyalgia
  • Relieve pain in gout and osteoarthritis
  • Treat soft tissue rheumatism.

Prescription Drugs

The following table provides an overview of active ingredients that can be used in the “Gout” application area.

For each active ingredient, you can view the prescription drugs that contain each active ingredient. Below each drug name you will also be shown information about the effects and areas of use of the drug.

Triamcinolone

It’s used as it;

  • Inhibit inflammation in rheumatic and joint diseases
  • inhibit allergic reactions in allergies
  • Reduce symptoms of asthma and COPD
  • Inhibit inflammation of the skin, mucous membranes and skeletal system
  • Treat kidney disease and diseases of the blood and lymphatic system
  • Relieve symptoms of eczema, psoriasis and eczema
  • Reduce inflammatory skin reactions such as itching and hair loss
  • Treat first-degree burns such as sunburn and burns, burns, scalds and insect bites
  • Reduce inflammation of the oropharynx and in the area of ​​the external auditory canal (otitis externa)
  • treat acute relapses of multiple sclerosis

Benzbromarone

It’s used as it;

  • Prevent acute gout attacks
  • Lower uric acid concentration in the blood
  • Accelerate uric acid excretion via the kidneys

Diclofenac

It’s used as it;

  • Relieve inflammation and inflammatory rheumatic diseases
  • Lower fever
  • For example, mild to severe pain relieves headache, migraine, gout, osteoarthritis, fibromyalgia, menstrual pain, ophthalmia, conjunctivitis, venous disease, cancer
  • Fight swelling and inflammation after operations and injuries

Ibuprofen

Effects and applications of the active substance:

  • Relieve pain (severe to very severe), especially in inflammatory rheumatic diseases such as gout, joint erosion (arthritis) or rheumatoid arthritis (rheumatoid arthritis)
  • Mild to moderate pain relieve such as headache, migraine, menstrual pain or toothache
  • Lower fever
  • Treating arthritis in gout, rheumatoid arthritis, osteoarthritis, chronic polyarthritis
  • Reduce inflammation such as ankylosing spondylitis
  • Short-term pain inhibition in non-inflammatory pain on muscles, tendons and ligaments such as in fibromyalgia
  • Treat sports injuries such as compressions or bruises

Colchicine

It’s used as it;

  • interrupt acute attacks of gout
  • Prevent acute gout attacks

Allopurinol

It’s used as it;

  • Lower uric acid concentration in hyperuricemia and gout
  • Prevent acute gout attacks
  • Prevent kidney damage in hyperuricemia
  • Prevent kidney damage in leukemia therapy
  • treat congenital enzyme deficiency diseases

Probenecid

It’s used as it;

  • Accelerate uric acid excretion via the kidneys
  • Prevent acute gout attacks
  • Lower uric acid concentration in hyperuricemia

Allopurinol + Benzbromarone

It’s used as it;

  • Prevent acute gout attacks
  • Lower uric acid concentration in hyperuricemia and gout

Phenylbutazone

It’s used as it;

  • Relieve pain in chronic polyarthritis, ankylosing spondylitis and acute attacks of gout.

Acemetacin

It’s used as it;

  • reduce pain
  • Lower fever
  • Inhibit inflammation
  • Improve mobility
  • Reduce swelling

Oxaceprol

It’s used as it;

  • Relieve inflammation of the musculoskeletal system
  • Reduce joint pain
  • Dampen tension pain
  • reduce painful and inflammatory joint disease
  • Positively influence joint inflammation
  • Alleviate bursitis
  • Inflores tendon inflammation and tendonitis in a positive way
  • treat inflammatory connective tissue diseases successfully

Etoricoxib

It’s used as it;

  • Inhibit joint inflammation
  • Breastfeeding pain
  • Protect gastric mucosa

Piroxicam

Effects and applications of the active substance:

  • Relieve inflammation on bones
  • Alleviate inflammation of joints

Ketoprofen

It’s used as it;

  • Delay blood clotting
  • reduce pain
  • Inhibit inflammation
  • Lower fever
  • Reduce swelling

Naproxen

It’s used as it;

  • Relieve pain (mild to moderate)
  • Lower fever
  • Inhibit inflammation
  • Relieve menstrual pain
  • Treat fibromyalgia and gout
  • treat inflammatory rheumatic diseases
  • Alleviate cycle disorders and symptoms.

Proglumetacin

It’s used as it;

  • Inhibit inflammation
  • Lower fever
  • reduce pain

Tiaprofenic

It’s used as it;

  • Inhibit inflammation
  • reduce pain

Febuxostat

It’s used as it;

  • Impede the formation of uric acid
  • Lower uric acid content of the blood
  • Inhibit uric acid-forming enzyme

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