What Are the Treatments for Polyarticular Gout?

Gout is a painful form of arthritis triggered by the irritating presence of uric acid crystals. Polyarticular gout is the term used for gout that is simultaneously present in more than one joint. While gout most frequently makes its initial appearance in one joint, polyarticular gout accounts for 10 to 20 percent of first-time cases. The condition is typically treated with medications, although additional relief may be gained from certain lifestyle modifications.

Understanding Polyarticular Gout

• The symptoms of gout can arise suddenly, with effects including inflammation, redness and intense joint pain. Joints afflicted with gout can also be very tender, and even something as light as a bed sheet may aggravate gout pain. However, sufferers of polyarticular gout generally experience a more gradual onset of symptoms, and individual flare-ups may happen less frequently than in other gout cases. If you experience polyarticular gout, it will most likely strike on one side of your body in the foot, ankle or lower leg. See your doctor for an accurate diagnosis of your condition.

Medications

• If polyarticular gout is diagnosed, your treatment will be similar to that for gout limited to one joint (monoarticular gout). Typically, the first goal in gout treatment is relief from any flare-ups that may be in progress. These acute attacks may be dealt with through use of non-steroidal anti-inflammatory (NSAID) medications or corticosteroids. While these compounds will not address the uric acid imbalance that triggers the presence of inflammatory crystals, they will help diminish the inflammation itself.

  The most commonly used NSAIDs for gout are naproxen (Naprosyn, Anaprox) and indomethacin (Indocin), given in daily doses. If you use these compounds, be aware that long-term NSAID use is associated with complications including stomach bleeding and kidney and liver damage. While acute cases of gout typically last for no more than a week, you will still want to exercise caution when using these products.

  The corticosteroid prednisone is also commonly administered, either orally or through injections made directly in gout-afflicted joints. Relief from corticosteroid treatment can begin within hours of treatment, with effects lasting throughout the entire course of a flare-up. However, these compounds can also lead to diminished immune system performance and increased susceptibility to infection.

Preventive Treatments

• To help control or prevent future polyarticular gout flare-ups, your doctor may also prescribe low doses of NSAIDs or of colchicine, a natural alkaloid with anti-inflammatory properties. Additional preventive benefits may be gained from medicines designed to reduce the excess uric acid that initiates the gout process. Options here include compounds that block uric acid production including allopurinal (Aloprim, Zyloprim), as well as compounds like probenecid (Benemid) that improve your body's ability to eliminate uric acid. If you already take the high blood pressure medication losartan (Cozaar), or the triglyceride medication fenofibrate (Tricor), you may find that they also help in preventing episodes of gout.

Lifestyle Alterations

• While no particular diet is reliably associated with gout relief, you may obtain relief by avoiding foods rich in purines, such as liver, mushrooms, sardines, asparagus and dried beans and peas. You may also benefit from regular exercise and a healthy body weight.