A lot of people I see in the Emergency Room suffer from gout. Gout is an arthritis which causes attacks of painful inflammation in joints. Gout is caused by an excess of uric acid in the blood. Uric acid is produced in the body through the breakdown of purines, compounds that are found in high amounts in certain foods such as meat, poultry and seafood. Other risk factors for gout include:
- Gender: Men produce more uric acid than women, though women’s levels of uric acid approach those of men after the menopause
- Family History or genetics
- Chronic lead exposure has been linked to some cases of gout
- Certain medications, like diuretics and salicylate, can increase the levels of uric acid in the body
- Obesity: Being overweight increases the risk of gout as there is more turnover of body tissue, resulting in more production of uric acid as a metabolic waste product. Higher body fat also increase inflammation.
- Renal insufficiency and other kidney problems can reduce the body’s ability to efficiently remove waste products, such as uric acid.
- Lifestyle choices: alcohol consumption interferes with the removal of uric acid from the body and eating a high-purine diet . We will talk about how to make positive lifestyle changes for gout (below).(4)
Here are some common medications people are given for gout, with mechanism of action and side effects:
Allopurinol: reduces the production of uric acid by inhibiting the biochemical reactions immediately preceding its formation. The most common reactions are
- Gastrointestinal: diarrhea, nausea, or an increase in liver function enzymes
- Acute attacks of gout!
- Rashes
There are also a host of other possible side effects that are more rare.(2)
Colchicine: Exactly how colchicine works is not known. However, it may affect certain proteins in the body, which may relieve gout. Similar to allopurinol, common side effects are gastrointestinal such as nausea, vomiting and diarrhea. There are other possible side effects including acute renal failure. (3)
Indomethacin: Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID). Indomethacin reduces hormones that cause inflammation and pain in the body. Commonly reported side effects of indomethacin include headache. Other side effects include dizziness, dyspepsia, hyponatremia, and nausea. There are a lot of other possible side effects (similar to side effects of other NSAIDS) including gastrointestinal bleeding.(4)
Ray decided to forego all these medications and their possible side effects and opted for dietary changes, and he is without pain. Thank you, Ray for sharing your story to inspire others to make positive changes in their life.
(1) Mcintosh, James. “Gout: Causes, Symptoms, and Treatments.” MedicalNewsToday.com. MediLexicon International, Ltd. 24 July 2015. Web. Accessed 24 December 2015. <http://www.medicalnewstoday.com/articles/144827.php>.
(2) “Allopurinol” Drugs.com Web. Accessed 24 December 2015. <http://www.drugs.com/pro/allopurinol.html>
(3) “Colchicine.” Drugs.com. Web. Accessed 24 December 2015. <http://www.drugs.com/sfx/colchicine-side-effects.html>.
(4) “Indomethacin.” Drugs.com. Web. Accessed 24 December 2015. <http://www.drugs.com/mtm/indomethacin.html>.