Crystals of pain: navigating gout and its management

Authors

  • SD Vambe Sefako Makgatho Health Sciences University
  • CV Mchavi Sefako Makgatho Health Sciences University
  • E Hough Sefako Makgatho Health Sciences University
  • E Bronkhorst Sefako Makgatho Health Sciences University

Keywords:

gout, urate-lowering therapy, allopurinol, colchicine

Abstract

Gout is a form of inflammatory arthritis, caused by the buildup of uric acid crystals in the joints, especially the big toe. If left untreated these tophi, or crystals can become extremely painful, and over time may result in damage to bone and soft tissue. It is important to get a correct diagnosis on gout and to differentiate with other diseases like septic arthritis, rheumatoid arthritis and even stress fractures.

Non-pharmacological treatment and prevention strategies include sufficient rest and adequate dietary and lifestyle modifications. The management of gout distinguishes between treatment for acute gout symptoms and the prevention of a gout attack or the lowering of uric acid in the serum. Urate-lowering therapy, like allopurinol and febuxostat, lowers blood urate levels, can prevent gout flare-ups and diminishes tophi over time. Treatment with one or more potent anti-inflammatory medication is necessary for the management of acute flares. Four categories of medicine are available for treatment of acute symptoms of pain and inflammation. They include nonsteroidal antiinflammatory medicine, corticosteroids, colchicine, and anti-IL-1β biologics. Efficacy between these agents is similar, thus focus should be on minimising individual risks. People with a tendency to develop gout must limit their consumption of red meat, fish, shellfish and alcohol, particularly those that have additional purines such as beer, wine and whiskey.

Author Biographies

SD Vambe, Sefako Makgatho Health Sciences University

School of Pharmacy, Sefako Makgatho Health Sciences University, South Africa

CV Mchavi, Sefako Makgatho Health Sciences University

School of Pharmacy, Sefako Makgatho Health Sciences University, South Africa

E Hough, Sefako Makgatho Health Sciences University

School of Pharmacy, Sefako Makgatho Health Sciences University, South Africa

E Bronkhorst, Sefako Makgatho Health Sciences University

School of Pharmacy, Sefako Makgatho Health Sciences University, South Africa

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Published

2024-08-22

Issue

Section

Review