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Rheumatic Diseases

A list of the most common we treat.

Gout

Condition & Description

Gout is a form of arthritis caused by too much uric  acid build-up in your body. Gout often causes sudden pain and swelling in one joint, often the big toe or other joints in the feet. Uric acid is a natural substance that’s in your blood. Your kidneys filter uric acid, but if levels get too high or the kidneys can’t remove enough of it, urate crystals can form and settle into a joint. This clump of crystals causes pain, swelling, and redness. Gout affects men more often than women. 

Foods rich in purines, high alcohol intake, and drugs like  immunosuppressants and diuretics can raise your risk of gout. 

• Shellfish, gravies, red meat, soups and organ meats,  such as liver, are high in purines. 

• Sugary drinks and alcoholic beverages are also  linked to gout. 

• Diet, weight loss, and regular exercise help manage  gout and reduce flare risk. 

• Gout usually strikes the toes or feet, but can occur  in other joints

Signs/Symptoms

Gout’s main signs are sudden, intense pain and  swelling in one or two joints. At first, gout attacks may start at night. Severe attacks are typically followed by periods of no symptoms. In addition to being located in the joints, crystals can form tophi, or swollen growths, under the skin, often located over a joint or on the outer ear. Urate crystals and tophi can damage the joints over time. A rheumatologist can diagnose gout and make sure symptoms are not due to some other type of arthritis or an injury. 

Diagnosis is based on symptoms, medical history and  lifestyle, and laboratory tests. 

• Blood tests can measure uric acid, although high  levels don’t always mean gout. 

• Some people with gout may have low uric acid levels  at times, even during flares. 

• A needle can be used to withdraw fluid from the  swollen joint. The fluid obtained can be examined by the physician or sent for laboratory analysis. 

• Patients with long-standing gout may need x-rays  or other scans to show joint damage.

Common Treatments

Gout treatments include drugs to ease inflammation,  lower or break down uric acid in the blood, or help the kidneys flush excess uric acid. Colchicine can ease a gout flare or help prevent attacks, but has some side effects. Nonsteroidal anti-inflammatory drugs (NSAIDs) can ease pain and swelling. Glucocorticoid pills or shots can ease a gout flare. Allopurinol (Lopurin, Zyloprim) lowers uric acid levels in the blood and also blocks its production. Febuxostat (Uloric), a newer drug, also blocks uric acid. Probenecid (Benemid) and Lesinurad (Zurampic) help the kidneys remove uric acid, and pegloticase (Krystexxa) infusions help break down uric acid. 

Each person with gout needs a unique treatment plan.  A rheumatologist can prescribe the right treatment for gout and manage it over time. 

• Gout treatment aims for a uric acid level of 6 mg/dL  or lower to dissolve or prevent crystals. 

• Kidney function and uric acid levels may affect  choice of treatment. 

• People with severe gout may benefit from a short  treatment course of anakinra (Kineret), a biologic drug, though this medication is not FDA-approved for the treatment of gout. 

• Low-dose colchicine and NSAIDs may prevent gout flares.

Care/Management Tips

Diet and lifestyle can help manage gout and prevent  flares. It’s important to watch your diet and maintain a healthy weight. Gout is often associated with high blood pressure, heart and kidney disease, so your primary care provider or rheumatologist may test for or watch for signs of these health problems. 

• Excess alcohol, especially beer, can trigger gout.  Cut back on alcohol drinking. 

• People with gout should be safe to eat purine-rich  vegetables like spinach or mushrooms. 

• Low-fat dairy foods may lower uric acid levels and  help manage gout. 

• Avoid drinks high in sugar or fructose, like  concentrated juices or sodas.

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820 Jordan St, Ste 201         
Shreveport, LA 71101

Contacts

Phone: (318) 221.0399
Fax: (318) 221.1940