Gout is Forever

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Health Editor’s Note: Several years ago I wrote an article about recognizing and treating gout. That article is located at:

https://www.veteranstodayarchives.com/2008/06/24/a-veterans-guide-to-recognizing-and-treating-gout/ 

Since the numbers of those who are diagnosed with gout are rising exponentially, I thought it would be a valuable health lesson to once again look at this disease.

Supposedly, Henry the VIII greatly suffered from gout. Gout has been plaguing mankind for centuries and the numbers of gout sufferers has steadily risen as the human diet has become richer. Gout is a disease found in developed countries who have the resources to grow/produce food which are rich in purines. Gout is one of the forms of arthritis and thus becomes a chronic ailment with occasional flare-ups from time to time…..Carol

Gout: A Chronic, Not Just Dietary, Disease

Growing number of older adults expected to boost the need for appropriate care

by Jack Cush MD

Gout gets a bad rap as a dietary disease rather than the complex, chronic inflammatory disorder that is ineffectively treated in many, according to a perspective article in the Journal of the American Medical Association.

The author and experts interviewed believe that the pipeline of new drugs for gout will fuel the future of evidence-based care and more informed lifestyle instruction.

Gout affects about 4% of adults in the U.S. The growing number of older adults, who are more likely to have gout, is expected to increase the need for gout care.

“The disease of kings” is clearly a misnomer as gluttony and excess seldom stand in the way of better care. Sadly, many with gout fail to recognize it as a form of arthritis, A 2016 online survey showed that 71% of patients didn’t know gout, and that half with gout were embarrassed by their condition.

Although diet is often implicated, evidence proving the benefits of strict avoidance are limited. While red meat, alcohol, sugar-sweetened soft drinks, and seafood have been implicated, the American College of Rheumatology (ACR) guideline suggests that avoidance of purine-rich organ meats (liver), shellfish, and sardines may only improve serum uric acid levels by 10% to 18%.

Many experts have noted the limitations and pitfalls found with a dietary approach to gout.

A real problem are the differing treatment approaches and understanding of gout by primary care physicians (PCPs) and rheumatologists, exemplified by their contrasting guidelines. The 2012 ACR focuses on a a treat-to-target approach with the goal of a uric acid levels below 6 mg/dL, and the use of urate-lowering medications long-term with frequent monitoring.

Yet the 2016 American College of Physicians (ACP) guideline only has a treat-to-symptoms approach emphasizing the use of anti-inflammatory medications to control flares and reserving uric acid-lowering therapy for patients with frequent flares.

Discrepancies between the guidelines may be hampering patient care, and hopefully upcoming meetings between the ACR and ACP may resolve these differences. The ACR’s gout guideline is scheduled for release in 2020.

Emerging evidence suggests that a chronic disease care model for gout, which simultaneously addresses uric acid levels, lifestyle, and dietary factors, may improve management and outcomes for patients with gout.

Jack Cush, MD, is the director of clinical rheumatology at the Baylor Research Institute and a professor of medicine and rheumatology at Baylor University Medical Center in Dallas. He is the executive editor of RheumNow.com. A version of this article first appeared on RheumNow, a news, information and commentary site dedicated to the field of rheumatology. Register to receive their free rheumatology newsletter.

Cush disclosed no relevant relationships with industry.

Primary Source

Journal of the American Medical Association

Source Reference: Kuehn BM “Chronic Disease Approaches Needed to Curb Gout’s Growing Burden” JAMA 2018; DOI:10.1001/jama.2018.0547.

Biography
Carol graduated from Riverside White Cross School of Nursing in Columbus, Ohio and received her diploma as a registered nurse. She attended Bowling Green State University where she received a Bachelor of Arts Degree in History and Literature. She attended the University of Toledo, College of Nursing, and received a Master’s of Nursing Science Degree as an Educator.

She has traveled extensively, is a photographer, and writes on medical issues. Carol has three children RJ, Katherine, and Stephen – one daughter-in-law; Katie – two granddaughters; Isabella Marianna and Zoe Olivia – and one grandson, Alexander Paul. She also shares her life with husband Gordon Duff, many cats, and two rescue pups.

Carol’s Archives 2009-2013
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1 COMMENT

  1. gout visited me about 15 years ago ,i went to the doctor, gave me some pills. took them and it went away.about 4 years ago this painful disease showed up again and decided to stick around. i went to see the doctor again, and she prescribed COLCRYS 0.6 MG for 10 days to make it go away, and ALL0PURINOL 300 MG once a day every day to keep it away. well, first medication made it go away,but exactly one week later would come back. even though i was taking the allopurinol daily as doctor had advised. my wife seeing me in so much pain, and going to doctor every other week decided to search on the net and see if she can find some kind of home remedy. she found one. i call it KILLER LEMONADE. IT IS: 1 TBS OF GLYCERIN OIL(the sweetened kind, not the rubbing kind.) and 1TBS OF LEMONE JUICE MIX THEM IN HALF CUP OF WATER and drink it once a dad in the morning. it tastes like lemonade. i drank that probably for 2 to 3 month every day. since i was not in pain for a while, i got lazy and started missing days drinking the lemonade and after a short while stopped drinking it all together. it has been about two and half years now i am gout free. 3 of my co workers had the same problem and used this remedy and it worked for them too. i hope it works for you as well. by the way, i did not change my diet, only cut down my drinking to a total of a six pack a week, not all at once.

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