Treatment
The goals of treatment are to ease pain and inflammation and to reduce uric acid levels in order to minimize the potential for future attacks and the potential for joint and kidney damage.
During acute attacks, patients may be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen to relieve pain and inflammation and, if necessary, with corticosteroids like prednisone. If those do not help to control symptoms, colchicine may be useful within the first 12 hours of an attack. NSAIDs or oral colchicine may be prescribed in small daily doses to prevent future attacks as well.
People can make lifestyle changes to minimize gout attacks. Examples of changes include:
- Minimize alcohol consumption
- Eat a diet rich in low-fat dairy products and vegetables but avoid foods high in purines such as liver and kidney as well as high fructose corn syrup, and eat less beef, lamb, pork, shellfish, sardines, anchovies and table sugar and salt (see Gout Diet from the Gout & Uric Acid Education Society)
- Exercise regularly
- Increase fluid intake to help the kidneys flush out uric acid
If dietary changes are inadequate to improve signs and symptoms and lower uric acid levels, drug therapy may be needed. According to 2012 guidelines on the management of gout by the American College of Rheumatology, either of the drugs allopurinol or febuxostat can be used as a first-line urate-lowering therapy. Other drugs, such as probenecid, fenofibrate, or losartan, may also be prescribed if needed.
Always take any medications that your doctor prescribes as directed and tell your doctor about any other medicines or vitamins you are taking.
