People with gout are no longer condemned to live with a recurring painful condition and ultimately with permanent disability.
Biochemists have investigated the metabolic pathways through which uric acid passes as it is manufactured in the body, and several effective drugs and home remedies for gout now allow us to control the production of uric acid (allopurinol) and its excretion from the kidneys (probenecid, sutfinpyrazone, benzbromarone) so most people with gout can now lead a reasonably normal life. Remember that part of the remedy is up to you – equally vital factors in controlling uric acid levels are weight loss or maintenance of an already healthy weight, avoidance of purine-rich foods and beverages, and rigorous control of your blood pressure.
For people with the inherited disorders like gout in young people, the important first step is accurate diagnosis. Modem molecular genetic techniques can identify the tiny changes in our genes that may lead to both small and large changes in the concentrations of the essential chemicals in our blood. With this knowledge, parents can discuss the likelihood of having another affected child, and the options for treatment of existing affected children.
Can Gout Be Cured?
After All These Centuries, Why Can’t Gout Be Properly Cured?
Classic primary gout in men is the result of an inherited defect or difference that appears at puberty, and means that their kidneys reabsorb less uric acid from their urine than do women’s. It is a fact of life! In adult men, urate already circulates at levels close to the maximum before crystals will form. When levels of urate in the blood reach saturation point (around 420 micromoles per liter, 7mg/100ml) excess uric acid from the diet will then just tip the scales towards gouty arthritis. In other words, it is part of the human condition, and perhaps will never be ‘cured’ in the way that infectious diseases are eliminated.
We can certainly look for good management of the symptoms using drugs and modem advice on ‘healthy eating‘, without repeating the stringent food rationing that caused the disappearance of this type of gout during the two world wars in the 20th century.
The possibility of gene manipulation is sometimes mentioned as a possible answer to some disorders but, in the case of classic gout, such efforts can be difficult to justify when most cases are managed well through a combination of a low-purine diet, regular allopurinol and the control of weight and blood pressure.
