Treatment of Gout
Treatments for a sudden attack or flare-up of gout:
* Your doctor will recommend that you take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or indomethacin as soon as your symptoms begin. You will need to take prescription-strength medicines for 4 – 10 days.
* Your health care provider may occasionally prescribe strong painkillers such as codeine, hydrocodone, and oxycodone.
* A prescription medicine called colchicine helps reduce pain, swelling, and inflammation.
* Corticosteroids can also be very effective. Your doctor may inject the inflamed joint with steroids to relieve the pain.
* The pain often goes away within 12 hours of starting treatment, and is completely relieved in 48 hours.
Daily use of allopurinol or probenecid decrease uric acid levels in your blood. Your doctor may prescribe these medicines if:
* You have several attacks during the same year
* You have signs of gouty arthritis
* You have uric acid kidney stones
Some diet and lifestyle changes may help prevent gouty attacks:
* Avoid alcohol, anchovies, sardines, oils, herring, organ meat (liver, kidney, and sweetbreads), legumes (dried beans and peas), gravies, mushrooms, spinach, asparagus, cauliflower, consommé, and baking or brewer’s yeast.
* Limit how much meat you eat at each meal.
* Avoid fatty foods such as salad dressings, ice cream, and fried foods.
* Eat enough carbohydrates.
* If you are losing weight, lose it slowly. Quick weight loss may cause uric acid kidney stones to form.
Prognosis (Expectations)
Proper treatment of acute attacks allows people to live a normal life. However, the acute form of the disease may progress to chronic gout.
Complications
* Chronic gouty arthritis
* Kidney stones
* Deposits in the kidneys, leading to chronic kidney failure
Calling Your Health Care Provider
Call for an appointment with your health care provider if you have symptoms of acute gouty arthritis.
Prevention
The disorder itself may not be preventable, but you may be able to avoid things that trigger your symptoms. Limit alcohol consumption and follow a low-purine diet.
References
Keith MP, Gilliland WR. Updates in the management of gout. Am J Med. 2007;120:221-224.
Cameron MA, Sakhaee K. Uric acid nephrolithiasis. Urol Clin North Am. 2007;34:335-346.
Reviewed By : Mark James Borigini, MD, Rheumatologist in the Washington, DC Metro area. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
