Gout Treatments and Gout Attack Prevention
How Do I Treat Gout?
Once you start to treat gout, you are usually a few hours away from noticeable pain relief, and 5 to 8 days away from being symptom free. Medication will be your weapon for your current fight with gout, while prevention may reduce the risk of a future gout attack.
Treatments for Acute Gout Attacks
In most cases, your primary care provider will treat your gout. To treat an acute attack, he or she will probably prescribe non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen, indomethacin, and suldinac. This is to help reduce the inflammation.
Another anti-inflammatory, colchicine, is also effective against gout. However, due to common side effects, it is still not used as frequently as traditional NSAIDs.
Oral steroids are also an option if you do not tolerate NSAIDs or colchicine.
We have an entire article on gout medications; read it for more information.
If you live with other types of arthritis in addition to gout, your primary care provider may refer you to a rheumatologist, a physician who specializes in treating arthritis and other joint conditions.
If you see specialists for other health conditions, make sure they are aware of your gout and the details of your treatment plan, since there are known interactions and contraindications with some medicines.
Preventing Further Gout Attacks with Lifestyle Changes and Medications
Gout is one of the most manageable types of arthritis. The goal of the various gout treatments is to hold uric acid levels down to a point where they do not cause flare-ups.
If you follow prevention guidelines, you will likely stop new uric acid crystals from forming, and experience fewer gout attacks. Some people prevent them for years with persistent self-care.
If you've recently been diagnosed with gout, the best things you can do to reduce the risk of future flare-ups include:
- reducing the amount of red meat and seafood you eat to 4 to 6 ounces per day
- eating more low-fat dairy products
- eliminating alcoholic beverages, such as beer and liquor, or at least limiting them to 1 drink 3 times per week. (Wine consumption does not appear to affect gout.) Learn more about what to eat (and not eat) when you have gout.
- maintaining or working toward a healthy weight
Even if you've lived with gout for a few years, you would likely benefit from these lifestyle modifications.
Your gout prevention plan may include medication to lower uric acid levels in your blood. The medications your doctor prescribes will depend on the reason your body stores extra uric acid.
Do I Produce Too Much Uric Acid or Are My Kidneys Bad at Getting Rid of It?
Your doctor will perform some tests to find out why you have too much uric acid in your system. About 80% of gout sufferers can attribute their pain to underperforming kidneys that do not filter out enough uric acid. These "underexcretors" benefit from uricosurics, a class of medication that helps the kidneys expel more uric acid, along with a daily dose of two liters of water or fluid.
The other 20% of people living with gout simply produce too much uric acid. Doctors often prescribe the uricosurics and water mentioned above.
In addition, they have traditionally added a medication from the xanthine oxidase inhibitor class, which lowers uric acid levels in the blood. Newer medications for treating patients who produce too much uric acid include the intravenously infused medication Krystexxa (pegloticase), as well as Uloric (febuxostat).
Most people living with gout can thrive by taking advantage of treatments such as medications to lower uric acid levels, as well as lifestyle changes to reduce the risk of future attacks. Maintaining low uric acid levels can greatly reduce the threat of a gout attack.