Gout is a disease that can flare without warning. Asking your doctor these 10 questions can help you better manage the condition.
- Why do I have gout?
Gout is caused by deposits of sharp, needle-like crystals of uric
Gout is a disease that can flare without warning. Asking your doctor these 10 questions can help you better manage the condition.
- Why do I have gout?
Gout is caused by deposits of sharp, needle-like crystals of uric acid in the joints that create inflammation, redness, and heat around the joint, along with extreme pain. Uric acid comes from two main sources: internally from the destruction of old or damaged body cells and externally from foods, such as red meat and seafood, that contain a lot of a substance called purines.
A number of factors can increase your chances of getting gout, including genetics, gender, age, weight, and medical conditions, including hypertension. Some medications, like diuretics, can also cause gouts.
Your doctor may feel that some combination of these factors has put you at high risk, or that your diet has contributed to the problem.
- What other medical conditions are linked to gout?
- How long will a gout attack last and how often will I get one?
An acute gout attack may last from three to 10 days, with or without medication. Some people have only one attack in their lifetime, but without treatment or a drastic change in your diet and risk factors, attacks may eventually happen several times a year.
- What are my gout medication options?
For an acute gout attack, medications are given simply to reduce pain and inflammation; they do not affect uric acid levels. The options include non-steroidal anti-inflammatory drugs (NSAIDs), oral corticosteroids, and colchicine, depending on what is tolerated best. If only one joint is affected, a corticosteroid may be directly injected into the joint to reduce inflammation and pain.
After the attack subsides, many (but not all) people will need ongoing treatment designed to keep uric acid levels in a normal range to prevent further attacks.
“The guide to treating someone,” says Chaim Putterman, MD, chief of rheumatology at Albert Einstein College of Medicine, New York City, “is the number and severity of attacks.” This means you may not need long-term medication if you’ve only had one attack. Long-term treatment either lowers the body’s production of uric acid or speeds up its excretion. Either approach can level out uric acid concentrations in the body.
- Why do I have to continue to take my medication if my gout is better?
There can be low-lying inflammation between attacks, and crystal deposits can increase in size and eventually become hard and damage the joint. The medications help prevent this. “It’s important to know that gout is a disease of uric acid, so you need to maintain low levels by taking medication every day,” says Dr. Putterman.
- Are there side effects to my gout medications?
Medications for both acute gout attacks and long-term control of uric acid control can have side effects. Medications that abruptly change uric acid levels can actually bring on a gout attack (or make a current attack worse) while uric acid levels are fluctuating. For this reason, attempts to lower uric acid levels are often postponed until the painful, acute attack has subsided.
NSAIDs can ca