Gout And Stones

Topics:

   

Symptoms and Diagnosis

Types of Stones

Dietary Prevention

Xray/ CT Scan/ Ultrasound/ IVP

Surgical Removal/ Lithotripsy

Causes of Stones

Genetic Causes

Medical Diseases

Infections

Passing A Stone

 

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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.