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Make sure of the diagnosis (test for crystals)
Treat early with diet and medication
Lower serum urate to below six mg/dL
Be ready for gouty flares or "attacks"
Watch out for involvement of the kidneys
Aim for control (not cure) with regular doctor visits
Gout is not a minor problem affecting the big toe. It can be a very serious condition. It can destroy joints and even impair the kidneys. The key to a good result is careful, long-term management. Preventing gouty flares with early, more aggressive care is advised.
Dr. Simkin reviews medications often used for gout. Which drug to use, when to use it, what dose to give, and why are all discussed in detail. Flare-ups of the condition do not always mean the drug should be stopped.
The best approach is a program of treatment that gives consistent results over the long-term. Patients must be taught to report any break through or new symptoms and see their doctors right away.
The physician must also watch for kidney damage. At least half of all patients with gout have kidney involvement. Twenty per cent die from kidney failure. A simple urine test can help the physician track uric acid excretion and reduce the risk of renal damage in patients with gout.
Review of Strategies to Control Gout
In this review article, Dr. Peter A. Simkin, a professor of medicine in rheumatology at the University of Washington (Seattle) presents six goals in gout management. Specific ways to reach these goals are also discussed. The goals include:
Gout is not a minor problem affecting the big toe. It can be a very serious condition. It can destroy joints and even impair the kidneys. The key to a good result is careful, long-term management. Preventing gouty flares with early, more aggressive care is advised.
Dr. Simkin reviews medications often used for gout. Which drug to use, when to use it, what dose to give, and why are all discussed in detail. Flare-ups of the condition do not always mean the drug should be stopped.
The best approach is a program of treatment that gives consistent results over the long-term. Patients must be taught to report any break through or new symptoms and see their doctors right away.
The physician must also watch for kidney damage. At least half of all patients with gout have kidney involvement. Twenty per cent die from kidney failure. A simple urine test can help the physician track uric acid excretion and reduce the risk of renal damage in patients with gout.
References: Peter A. Simkin, MD. Addressing Problems in Gout and Hyperuricemia. In The Journal of Musculoskeletal Medicine. August 2006. Vol. 23. No. 8. Pp.538-553.
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