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Feature Article

Beating gout: satisfaction for patient and doctor

Kevin D Pile

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Abstract

Gout can be frustrating and difficult to treat. Without satisfactory monitoring and treatment, patients may develop more severe disease, including joint destruction and renal damage. Careful monitoring of treatment, including the use of urate-lowering drugs for long-term disease, can allow patients to have symptom-free and productive lives.

Key Points

  • Gout is largely heritable but factors that trigger attacks include a diet high in meat and other purine-rich foods, obesity, increased alcohol consumption and diuretic use.
  • Asymptomatic hyperuricaemia is not associated with the development of gout in most people.
  • For acute gout, the goal of treatment is pain relief and reduction of inflammation.
  • The goal in the long-term treatment of chronic gout is an initial reduction in frequency and severity of attacks, leading to no further attacks or cure.
  • Urate-lowering agents should not be initiated, ceased or adjusted during acute gout attacks.
  • Patients with gout should have their diet and water intake reviewed periodically.

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