If you have an acute attack of gout, you will want to start treatment as soon as possible, in order to alleviate the pain and prevent complications in the future. Let’s take a closer look at how to deal with gout.
Lifestyle and dietary changes to help prevent gout
In conjunction with any medication prescribed to you by a doctor, you should look at your diet and lifestyle, to make sure they’re as healthy as they can be, to prevent attacks of gout happening.
Lifestyle changes you can make include:
- Losing weight if you are overweight or obese
- Quitting smoking if you are a smoker
- Checking with your doctor that any medications you’re on do not cause gout
- Having your blood pressure checked annually
- Getting regular exercise
- Drinking less alcohol
Dietary changes you can make include:
- Eating less foods that contain high levels of purine, which causes your body to produce uric acid, which can lead to gout - this includes red meat, offal (hearts, lungs etc.) and seafood (herring, sardines etc.)
- Avoiding sugary snacks and drinks that contain fructose
- Eating fewer full fat dairy products and opting for things like skimmed milk instead
- Eating more fruit and vegetables and maintaining a balanced diet
- Eating more cereals, potatoes and whole grain breads
- Drinking more water to keep hydrated
- Consuming more vitamin C - you can take these as supplements, but speak to a doctor first
How is a gout attack treated?
Gout usually needs to be treated in a number of ways - medication to alleviate the pain and lifestyle changes to try and help prevent it returning. You may also be put on long-term medication to help you maintain lower levels of uric acid in your bloodstream.
As well as taking any medication you’re prescribed, you should:
- Rest the affected area and keep it raised
- Use an ice pack on it to help keep it cool
- Avoid knocking the joint, as this will be extremely painful and don’t walk on it (if applicable)
- Drink plenty of fluids - water is best
- Try to relax, as stress can aggravate the condition
Anti-inflammatory medication should be taken as soon as possible after the attack starts. A doctor can recommend which is the best for you, but it can include ibuprofen (read more below). This is often enough to start the ease the pain within 12 to 48 hours, but take them for as long as your doctor recommends.
Gout medications that the doctor may recommend include:
- NSAIDS - Non steroidal anti-inflammatory drugs may be prescribed for treating the pain of sudden gout attacks. This range of drugs includes ibuprofen, naproxen and diclofenac. If prescribed, these medicines should be taken as soon as possible and be continued for a few days after the symptoms have been relieved.
- Colchicine - derived from a plant that has been used to treat gout for thousands of years, this medication is prescribed less often that NSAIDs, because it may upset your stomach, causing nausea, vomiting and diarrhoea if taken in a high dose. It is, however, an effective treatment for acute attacks of gout, particularly if you’re not able to take NSAIDs or if they’re ineffective.
- Corticosteroids - if anti inflammatory drugs NSAIDs or colchicine do not alleviate your gout symptoms because it is severe, or you’re unable to take them for some reason, then corticosteroids may be used. They are usually taken in tablet form but can also be administered by injection into either the joints, an arm muscle or the buttocks.
Medication to prevent repeated attacks of gout
In cases where repeated gout attacks occur, and when uric acid levels remain high, the doctor may prescribe you drugs designed to reduce uric acid in the blood. These medicines will usually have to be taken for the rest of your life and include:
- Allopurinol - it takes 2 to 3 months to be effective and is taken daily.
- Febuxostat - this has side effects, so is only usually prescribed if you cannot take allopurinol.
What happens if gout is left untreated?
If gout is left untreated then you may experience repeat attacks. This can lead to permanent and irreversible damage to your joints and long-term (chronic) pain. You may also develop tophi, which are little lumps under your skin - underneath are the crystals of uric acid and these can be painful.
If you do not reduce the levels of uric acid in your blood stream it can also lead to complications like kidney stones.