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What
Is Gout?: Gout typically occurs when people have high uric acid levels in
their blood. Uric acid can precipitate into crystals in
peoples joints which leads to intense pain and inflammation.
In people without kidney disease or stomach ulcers, it is typically
treated with nonsteroidal anti-inflammatory (NSAID's) medications
such as Motrin (ibuprofen), Indocin (indomethacin), or Celebrex.
If NSAID's cannot be taken sometimes colchicine or steroids such as
prednisone are used. With very high uric acid levels or
recurrent gout attacks, a drug called allopurinol can also be used.
Allopurinol (Zyloprim) lowers uric acid levels.
What does this have to do with
stones?:
People with gout have a
predisposition to kidney stones. They can have either uric
acid stones or calcium stones. This is not necessarily due to
high uric acid levels in the urine. Often times the urine pH
is very low (i.e. acidic urine) causing uric acid to precipitate (even if the uric acid
levels in the urine are not very high). Uric acid crystals
form when the urine is acidic and dissove when it is alkaline/basic.
This is the basis for treatment. In order to prevent stones or
dissolve preexisting stones the urine must become more
alkaline/basic (i.e. a high urine pH).
How are kidney stones treated
with gout:
Treatment principles are similar as
for people without this disorder. Citrate will likely be
necessary, particulalry with uric acid stones. Most gout
patients with stones will also need allopurinol to lower uric acid
levels. This should help with both the kidney stones and the
arthritis attacks. A low purine diet will contribute to
decreased uric acid levels as well. |
