People with gout are either producing too much uric acid or their kidneys are not excreting the uric acid. The uric acid, in the form of urate crystals, then deposits into the tissues, especially in and near the joints, causing inflammation. Rheumatoid arthritis is an inflammatory disease which affects the whole system, but primarily the joints.
Treatment of Gout Attacks
The treatment of gout attacks can include the use of nonsteroidal anti-inflammatory drugs, corticosteroids and colchicine, writes Daniel McCarty, M.D., Emeritus Professor of Medicine of the Medical College of Wisconsin in the "The Merck Manual for Healthcare Professionals." Nonsteroidal anti-inflammatory drugs, or NSAIDs, fight inflammation by interfering with a protein that increases the production of substances which are part of the inflammatory process. Corticosteroids are manufactured, or synthetic, steroid hormones. Both corticosteroids and colchicine are used to treat gout because they are also anti-inflammatory.
Management Between Gout Attacks
Managing between attacks includes decreasing the amount of urate crystals deposited into the tissues, and decreasing the number of gout attacks and their severity. Eating a lot of meat and seafood, and drinking a lot of beer increases the risk of gout attacks, according to David Hellmann, M.D., Chairman of the Department of Medicine at John Hopkins Bayview Medical Center in "Current Medical Diagnosis & Treatment." Those who are obese will have less attacks if they lose weight. A physician may decide to prescribe medication as part of the management, choosing from colchicine, allopurinol, probenecid or sulfinpyrazone.
Prognosis of Treatment of Gout
Dr. Hellmann writes in "Current Medical Diagnosis & Treatment," that gout attacks can last anywhere from a few days to as long as several weeks for those who do not get any treatment. The time between attacks will vary and may initially be as long as a few years. As gout progresses, the interval between each attack will get shorter. Allopurinol will decrease the amount of uric acid produced, while both probenecid and sulfinpyrazone will interfere with the reabsorption of uric acid in the kidneys.
Supportive Treatment of Arthritis
Pain medications, heat therapy, exercise, orthopedic and athletic shoes, joint splints and good nutrition are all examples of the supportive treatments of arthritis, as explained by Roy Altman, M.D., Professor of Medicine at the University of California in "The Merck Manual for Healthcare Professionals." Exercises done in warm water help because the heat will decrease the muscle spasms and stiffness. Orthopedic and athletic shoes will provide good arch support. Joint splints may lower the severe arthritic symptoms and inflammation, while good nutritious meals are encouraged.
Medical Treatments for Arthritis
NSAIDs and corticosteroids are used because they fight inflammation. COX-2 inhibitors may be useful because they interfere with cyclooxygenase-2, a protein that speeds up the production of substances that are part of inflammation. Disease modifying anti-rheumatic drugs, or DMARDs, may lower the destruction caused by arthritis, writes Peter Lipsky, M.D., Chief at the National Institutes of Health in "Harrison's Principles of Internal Medicine." Medications referred to as biologics are very beneficial in decreasing symptoms and damage. Cytotoxics and immunosuppressive medications, which suppress an overactive immune system, lower the symptoms for some.
References
- "Current Medical Diagnosis and Treatment 2011"; Stephen McPhee, M.D., Maxine Papadakis, M.D.; 2011
- "Harrison's Principles of Internal Medicine;" Anthony Fauci, M.D., Dennis Kasper, M.D., Dan Longo, M.D. et al.; 2008
- The Merck Manual for Healthcare Professionals: Gout
- The Merck Manual for Healthcare Professionals: Rheumatoid Arthritis
