Gout treatment guidelines

[Admin]

The Malaysian Rheumatology Association have released their Guidelines for the management of gout (attached)

[Admin]

Gout--current diagnosis and treatment.
Tausche AK, Jansen TL, Schröder HE, Bornstein SR, Aringer M, Müller-Ladner U.
Dtsch Arztebl Int. 2009 Aug;106(34-35):549-55. (http://www.ncbi.nlm.nih.gov/pubmed/19795010?dopt=Abstract)
BACKGROUND: Because of the changing dietary habits of an aging population, hyperuricemia is frequently found in combination with other metabolic disorders. Longstanding elevation of the serum uric acid level can lead to the deposition of monosodium urate crystals, causing gout (arthritis, urate nephropathy, tophi). In Germany, the prevalence of gouty arthritis is estimated at 1.4%, higher than that of rheumatoid arthritis. There are no German guidelines to date for the treatment of gout. Its current treatment is based largely on expert opinion. METHODS: Selective literature review on the diagnosis and treatment of gout. RESULTS AND CONCLUSIONS: Asymptomatic hyperuricemia is generally not an indication for pharmacological intervention to lower the uric acid level. When gout is clinically manifest, however, acute treatment of gouty arthritis should be followed by determination of the cause of hyperuricemia, and long-term treatment to lower the uric acid level is usually necessary. The goal of treatment is to diminish the body's stores of uric acid crystal deposits (the intrinsic uric acid pool) and thereby to prevent the inflammatory processes that they cause, which lead to structural alterations. In the long term, serum uric acid levels should be kept below 360 micromol/L (6 mg/dL). The available medications for this purpose are allopurinol and various uricosuric agents, e.g., benzbromarone. There is good evidence to support the treatment of gouty attacks by the timely, short-term use of non-steroidal anti-inflammatory drugs (NSAID), colchicine, and glucocorticosteroids.

[Gout-hero]

I’ve been suffering from Gout for the last about 2 months. My doc prescribed me to have half of Allopurinol (150mg) and also Indomethacin (25mg each) (1 or 2) to take at the same time after dinner. My question is, do these two medicines go together? I asked my Doc & he replied that there is no problem to take both of the medicines at the same time as soon as I’ve pain on my foot. I’ve been suffering from Gout pain on my left feet. At the moment my Uric acid level is about 0.32 mmol/L. It used to be 0.61 mmol/L few months ago. But still I’m having pain on the right side of my biggest toe of the left feet with light red colour & the pain get increased during middle of the night! Please advise me regarding the above matter. I appreciate it. Thanks.

[ella14]

Alternative therapies are popular among people with gout. However, if they are used, they should complement and not replace conventional care. There is very little evidence right now that shows alternative therapies (http://instantgoutrelief.com/main-gout-remedies/) are effective for gout. Here are some natural remedies that are commonly used: Vitamin C, Cherries, diet, etc.