Medical Gout Treatment For Symptom And Pain Relief
There are several forms of medical gout treatment available today, some are now mainstream and some are quite new. This Q and A article will hopefully explain the benefits and potential side effects of some of the more common ones. While there are no known medically proven gout cures, there is still a lot you can do for gout pain relief and to ease the symptoms.
The Gout Remedy Report looks at how to treat gout using natural gout treatments. The author is an ex gout sufferer himself and goes into great detail about the different methods he tried for treating gout, and which ones finally worked for him. You can get access to his report on his website here.
Anyone with personal experience of gout knows that the first indication is an excruciatingly painful episode of ‘arthritis’, occurring without warning, and sometimes waking them in the early hours of the morning. Modem gout treatment for the first attack concentrates on these symptoms, and usually relieves the pain and swelling in a short time. Your doctor may prescribe a gout treatment of either colchicine or high doses of non-steroidal anti-inflammatory drugs (NSAIDs); if these don’t help enough, they can be followed by an injection of corticosteroids into the affected joint. Occasionally, when all else fails, it may be necessary to use corticosteroids by mouth in tablet form or even by injection into a muscle.
Colchicine – A Natural Gout Treatment
My aunt’s doctor has given her colchicine. I seem to have heard of it somewhere but not as a medicine. What is colchicine?
We can regard colchicine either as a vindication for ‘alternative’ medicine or as a triumph for pharmacology! It is an extract from the autumn crocus, Colchicum autumnale, which has pale purple flowers in the autumn. You may see the flowers growing in the grass on the Alps or in St James’s Park, London, in September. The UK National Collection of Colchicum plants is at the National Trust property, Felbrigg Hall, Norfolk. Colchicine has a number of useful effects, including treating gout – but can also be toxic in high doses. (The plants themselves are toxic to grazing animals.) In the controlled doses used for treatment of gout, it seems to prevent invasion of the joint by the inflammatory cells, thus also providing some effective gout relief. It should be given within the first 12 hours of the attack if it is to be effective in acute gout. This is only a temporary remedy because your aunt still has to get rid of the excess uric acid from her joints in the longer term.
My doctor gave me colchicine but I seem to be intolerant to it. Are there any alternatives?
When taken by mouth, colchicine causes diarrhoea in many people. It can also be given as a gout treatment by injection into the veins but this is hazardous because it may upset the heart rhythm. The alternative is to use NSAIDs, which generally do not cause diarrhoea.
Apart from diarrhoea, are there any other hazards connected with the use of colchicine – either as a treatment for gout or any other of its uses?
Colchicine should never be given to a woman who is or may be pregnant. The compound affects the multiplication of cells, so the developing baby could be affected. Small amounts of colchicine have been found in other herbal extracts; for example, in a formulation of gingko biloba, which has recently been shown to cause defects in babies whose mothers used it regularly during their pregnancy.
I have heard that colchicine can be used for treating gout between attacks as well as during an attack. Why is this?
As well as being effective against acute attacks, colchicine can be used at a low dose (0.25mg twice a day) over the longer term, even indefinitely, as a preventative (prophylactic) gout treatment. Of course, it does not help to reduce the amount of urate in the body and will not stop urate accumulating, so tophi will continue to enlarge. Thus colchicine is not a very efficient gout treatment, but it may be helpful in people who get side-effects with urate-lowering drugs or who do not wish to take them.
When I searched online, I saw a reference to colchicine being prescribed in a combined form with probenecid. Is it any good like this?
There are differences in gout treatments between countries and this is one example. Probenecid is a drug that increases the excretion of uric acid through the kidneys. It is now used less widely and it has not commonly been used in combination with colchicine.
The website you looked at may be out of date, or may be describing only one doctor’s preferred gout treatment. Remember that there is no guarantee that information gleaned from the internet is reliable unless it comes from a reputable source such as a government agency or a well-known institute.
Treating Gout To Relieve The Pain
Are there special drugs to treat the pain of gout?
Because the pain arises from inflammation around the joint, acute gouty arthritis responds either to colchicine or to one of the NSAIDs. These gout treatments relieve inflammation of any kind, being particularly effective in both acute and chronic forms of arthritis.
NSAIDs have been used world-wide for four decades. Of those in current use, naproxen, diclofenac and indometacin have been prescribed most frequently for use in treating gout. Aspirin should never be used as a treatment for gout, because at normal doses it slows the excretion of uric acid from the kidneys and so can actually tip the balance towards an acute gouty attack. Paradoxically, at very high doses (20 tablets a day – not recommended!) aspirin has a uricosuric action, helping the excretion of uric acid in the urine.
What are COX-2 inhibitors? The doctor who writes in my newspaper seems very enthusiastic about them for arthritis pain.
One of the unfortunate aspects of NSAIDs is their tendency to attack the stomach lining. This (unwanted) side-effect may result in irritation (‘gastritis’) or more serious complications such as ulceration (‘gastric ulceration’) or bleeding (‘haemorrhage’) in the stomach. This is because the principal effect of these drugs is to inhibit enzymes called cyclo-oxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2), which have a stomach-protecting action, so the price one pays for gout relief of the inflammation is the risk of gastric damage. The COX-2 inhibitors are a new type of NSAID treatment for gout that give less trouble in the stomach than the older inhibitors, and can give rapid relief in gouty arthritis.
I find that paracetamol is not strong enough for the pain and fever in an acute attack. What else can I take?
Paracetamol is a weak pain-killer (analgesic) that has the virtue of not irritating or ulcerating the stomach lining. For conditions in which inflammation plays an important part, such as gout, paracetamol (known as acetaminophen in North America) cannot help. You should be using one of the NSAID family of drugs if the pain is really severe, preferably a COX-2 inhibitor, as this kind is less likely to cause problems in the stomach.
I believe that some drugs can affect other drugs that people might also be taking. Are there any combinations of drugs that I should avoid when taking NSAIDs?
When two (or more) drugs are taken during the course of the same day they could react with one another to produce effects that may be harmful to the person taking them. This is called drug interaction, and some people may be very susceptible to the effects. For example, NSAIDs may interact with aspirin and other NSAIDs, anti-clotting agents, anti-epilepsy drugs, lithium (a drug used in some psychiatric conditions) and several other drugs. For these purposes, alcohol is regarded as a drug that may interfere with their action, sometimes with serious results.
If you are concerned about the possibility of your anti-gout medication reacting with another current medication, consult your doctor or pharmacist, who will understand the current gout treatment guidelines, and is best placed to answer your query.