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Gout

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Treatment

The goals of treatment are to reduce inflammation and the pain by controlling uric acid levels. This will minimize future attacks and the potential for joint and kidney damage.

During acute attacks, someone 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. In some patients, anti-interleukin-1 therapy (anti-IL-1) has shown to be very effective in treating acute gout flare-ups.

People can make lifestyle changes to minimize gout attacks. Examples of changes include:

  • Decreasing alcohol consumption, especially beer
  • Eating a diet rich in low-fat dairy products and vegetables but avoiding foods high in purines (such as liver and kidney) and high fructose corn syrup. Eating less beef, lamb, pork, shellfish, sardines, anchovies, and sugar and salt (see Gout Diet from the Gout & Uric Acid Education Society)
  • Exercising regularly and lowering their body mass index (BMI)
  • Increasing 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, the drugs allopurinol or febuxostat can be used as a first-line urate-lowering therapy. Other drugs, such as probenecid, pegloticase, 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.

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