Gout Treatment

There are two chief reasons to treat gout:

  1. To reduce the acute inflammation of the affected joints
  2. To manage the disease in the long run in order to prevent gout arthritis attacks and to shrink the tophi crystal deposits in the tissues.

Gout treatment mainly comprises measures and medication that help to reduce joint inflammation. Some of the ways in which gout can be treated are discussed below:

Adequate fluid intake: In order to prevent recurrent gout attacks, it is very important to consume adequate fluids. Fluid intake also prevents the development of kidney stones, especially in patients suffering from gout. Alcohol has a diuretic effect which can cause dehydration and lead to precipitating of gout. Additionally, alcohol may also affect the metabolism of uric acid and cause hyperuricemia. Therefore, it should be completely avoided by patients who suffer from this condition.

Diet: Gout can be treated by making a few changes in the patient's diet. It is a known fact that gout is caused by food items that are rich in purine, which in turn gets converted into detrimental uric acid. Therefore, patients suffering from gout are strongly advised to stay away from food items that are rich in purine. These include shellfish and organ meats such as liver, brains, kidneys, and sweetbreads. Daily food, on the other hand should be whole-heartedly enjoyed since they help to reduce the risk of gout. As mentioned before, alcohol in the form of beer or any other liquor should be completely subtracted. So should soft drinks that contain fructose from corn syrup. Both increase the risk of gout. Patients should also reduce the amount of dietary fat and calories they consume.

Exercises: Obesity is one of the reasons causing gout. Therefore, exercises that help to reduce weight should be practiced to lower the risks of recurrent gout attacks. An aerobics program is a great way to stay fit and avoid undesirable gout attacks.

Medication: There are basically three reasons why medication is prescribed to patients suffering from gout.

  • To help reduce and manage pain
  • To decrease joint inflammation
  • To decrease elevated levels of uric acid in the blood

Pain killers such as acetaminophen (Tylenol) or other more potent analgesics help to reduce and manage pain.

Anti-inflammatory chemicals as nonsteroidal anti-inflammatory drugs or NSAIDS, colchicine and corticosteroids help to decrease joint inflammation.

  • Medications for elevated levels of uric acid in the blood.

  • Medications for pain relief include over the counter anti-inflammatory drugs and analgesic painkillers such as Aleve® (Naproxen) and Ultram® (Tramadol). These can be used without a doctor's prescription.

  • Medications for inflammation include nonsteroidal anti-inflammatory drugs or NSAIDs, specifically indomethacin. Other NSAIDS such as Mobic® (Meloxicam), Naprelan® (Naproxen Sodium), and Naprosyn® (Naproxen) can be equally effective in treating inflammation caused due to gout. NSAIDs are initially prescribed at maximum dosage and reduced as the symptoms subside. NSAIDs which are COX-2 inhibitors, such as Celebrex®, may be useful for patients with gastrointestinal concerns. Corticosteroids such as prednisone and deflazacort can be used for patients who cannot take NSAIDs.

  • Medications for controlling uric acid levels include Allopurinol (Zyloprim) and Probenecid (Benemid, Probalan). However, they are only used to prevent gout attacks, not to treat them once they occur.

  • Losartan, (Cozaar, Hyzaar), is not specifically a gout medication but is an angiotensin II receptor antagonist, antihypertensive drug that may help to control uric acid levels. Fenofibrate (Tricor) is also not a specific gout medication but it is a lipid-lowering drug that may help to control uric acid levels.

In addition to medications for acute gout attacks, patients can be administered other drugs over prolonged periods to lower the levels of uric acid in the blood and consequently reduce the risk of recurrent arthritis attacks, kidney stones and kidney disease and to dissolve the hard tophi deposits slowly.

These medicines should be started only after the inflammation from acute gout arthritis has subsided as they can worsen the attack. However, if they are already being administered prior to the attack, they can be continued and adjusted after the attack has subsided.

Home remedies: Resting and elevating the inflamed joint are the two best home remedies to alleviate the symptoms of gout. Ice pack applications should be avoided as they may flare up the symptoms by crystallizing uric acid. Patients should also avoid aspirin-containing medications since aspirin impedes the excretion of uric acid from the kidneys.