Introduction
Gout is a disease that expresses itself in acute joint pain, which is caused by inflammation and has several stages of manifestation. Patients with this diagnosis can avoid symptoms, successfully treat them, and control the course of the disease. This essay will analyze the main causes of gout, the stages of its development, anatomy, and pathophysiology, as well as the course of treatment with the pharmacological and non-pharmacological methods.
Main body
Gout is a metabolic disorder that causes inflammation in joints, most often of the big toe, but knees, elbows, or wrists can also be affected. The cause of inflammation are tiny needle-like crystals that accumulate in joints due to elevated uric acid levels (Institute for Quality, 2015; Kuo, Grainge, Zhang, & Doherty, 2015). The reason for the growth of uric level may be a decrease in renal secretion, excessive consumption of purine food, as well as a high speed of the production of uric acid because of cell death or an increase in the turnover of nucleoproteins (Edwards, 2018). Gout has four phases that are expressed in varying degrees of symptoms. The first phase is asymptomatic deposits in tissues, and the second is the acute phase of rapidly developing inflammation (Engel, Just, Bleckwenn, & Weckbecker, 2017). The third phase is intercritical periods in which symptoms do not appear for a long time between acute attacks, and the last one is a chronic stage, which is characterized by constant inflammation in joints (Engel et al. 2017). These stages can be alternated and delayed by timely prescribed therapy.
Standard treatment implies a diet, as well as taking medications that reduce uric acid levels with repeated attacks of gout. It is also necessary to take anesthetic and anti-inflammatory medicine to overcome bouts of pain. People suffering from gout should avoid eating fatty, salty, high-protein foods, and alcohol. According to research, a more active lifestyle combined with diet can lower uric acid levels by up to 18% (Engel et al. 2017). Drinking more fluids is also recommended as it reduces the risk of repeated attacks. The cardinal points of treatment are the elimination of pain by taking painkillers, lowering the level of uric acid during periods of exacerbation, as well as following a diet, and taking medications to prevent repeated attacks.
The most common drugs for treating gout are ibuprofen – “Advil,” “Motrin”; colchicine – “Colcrys”; “Mitigare”; oral prednisone – “Deltasone”; allopurinol.- “Zyloprim”; febuxostat – “Uloric”; and pegloticase – “Krystexxa” (Institute for Quality, 2015). The first phase of gout is hidden, so there is no medication for it. During the acute phase, no later than 24 hours after the onset, it has to be used anesthetics, colchicine, or prednisone. In intercritical periods and for treatment of chronic gout, the patient can take allopurinol, febuxostat, or pegloticase, as well as similar drugs that maintain an acceptable level of uric acid in the body.
NSAIDs cannot be prescribed for longer than one or two days, and patients need constant monitoring to detect possible side effects on time, especially if a patient has kidney failure. In addition, increased fluid intake is required. Colchicine is taken no later than 24 hours after the attack in small doses, and a doctor also has to monitor the patient’s condition, since the medicine can cause both gastric disorders and liver failure (Engel et al., 2017). The dose of Xanthine Oxidase Inhibitors should be regulated by the doctor on an ongoing basis, especially in the first days of using as many patients have an intolerance to certain drugs, but can be replaced with analogs from the same group.
Conclusion
In conclusion, the treatment of gout is an ordinary process; however, it requires the full involvement and education of the patient. Depending on the age and associated diseases, a person diagnosed with gout may demonstrate different responsiveness to treatment, and therefore, the dosage and use of medicines must be adjusted continuously. In addition, awareness of the patient in the rules of a healthy diet and habits that contribute to a decrease in uric acid levels largely helps to eliminate repeated attacks.
References
- Edwards, N. L. (2018). Gout. MSD Manual Professional Version. Web.
- Engel, B., Just, J., Bleckwenn, M., & Weckbecker, K. (2017). Treatment options for gout. Deutsches Aerzteblatt Online, 114(13), 215–222.
- Institute for Quality and Efficiency in Health Care. (2015).Gout: Overview. Web.
- Kuo, C.-F., Grainge, M. J., Zhang, W., & Doherty, M. (2015). Global epidemiology of gout: Prevalence, incidence and risk factors. Nature Reviews Rheumatology, 11(11), 649–662.