Gout is a common form of inflammatory arthritis caused by excess uric acid deposits, especially in the joints and the tissues around the joints. Gout tends to affect more men than women, and is commonly misunderstood. Despite being among the most effectively treated of all rheumatic diseases, where “cure” is achievable for the vast majority of people who stay on medication, gout is one of the worst managed rheumatic conditions long term. Why do people often think that gout flares cannot be prevented? Why do they believe that diet changes alone will control gout?
Dr. Ted Fields, MD, Attending Physician, Hospital for Special Surgery & Professor of Clinical Medicine, Weill Cornell Medical College
Click on the video below to see the video from the webinar.
Dr. Ted Fields, MD, Attending Physician, Hospital for Special Surgery & Professor of Clinical Medicine, Weill Cornell Medical College was joined by CreakyJoints’ patients and staff for a one-hour webinar to discuss this important topic. This webinar covered a range of issues around gout, including what causes this chronic disease, the role of uric acid in gout, the many facts and misconceptions about the role of diet in gout, facts and misconceptions about medications for gout and how to work with your doctor for long-term gout control.
Here are a few of our key learnings:
Gout is considered a periodic illness: when first diagnosed, patients get flares (attacks) followed by quiet periods with no pain in what are referred to as “intercritical periods”. This often makes people wrongly assume that their gout is gone once an attack has subsided. If left uncontrolled, however, gout attacks will almost always increase in number. The aim is to control gout before the number of attacks increases and the disease becomes more advanced. This is why gout is considered both a chronic and a progressive disease.
A key goal in controlling gout is to lower a patient’s blood uric acid (urate) level to below 6.0 mg/dL.
While diet can help control gout by mildly lowering the amount of uric acid in the blood, and helping to decrease flares, research has shown that diet alone cannot adequately reduce uric acid in with the great majority of people with gout. Research has shown that hereditary factors remain a more important cause than diet is of this chronic condition. While hydration is important, and dairy products may mildly lower urate level, effect of changes in diet are generally not sufficient to stop flares. Cherry juice, for example, has only a small effect on uric acid level in a study of people without gout. Interestingly, a small study of patients with gout actually showed no effect of cherry juice. However, an array of safe and readily available medications are highly effective in controlling gout.
In short, using a combination of approaches is the best way to manage and control gout. Approaches include monitoring blood uric acid levels with your doctor, making sure to take medication and following up with labs even if you feel good, and taking a “bridge” medication (e.g., colchicine) during the first 6 months that you are taking a medication, such as allopurinol, that lowers your urate level. Watching your diet also helps, especially early in your treatment, but is generally not sufficient, by itself, to achieve long term remission of gout.
The above are just a few takeaways from the one-hour event. Check out the embedded video, or head over to youtube.com/CreakyJoints to view the webinar in its entirety.
Autoimmune and Systemic Inflammatory Syndromes Collaborative Research Group (ASIS CRG)
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