The treatment options of an ACUTE episode of gout, which is characterized by severe pain, swelling, and warmth of a joint include: NSAIDs (such as indomethacin), prednisone (oral), colchicine, or intra-articular injections of steroids. The choice of treatment depends on the individual. For example, patients with kidney problems cannot take NSAIDs. Oral prednisone may not be the best choice for a patient with diabetes, but an intra-articular injection may be sufficient. Allopurinol should never be started during an acute episode of gout. This is a uric acid lowering medication to be used in the long-term management of gout. However, if a patient is ON allopurinol already and has an acute flare, it can safely be continued.
Gout & Pseudogout Q & A
Gout is due to hyperuricemia or high uric acid levels in the blood. The cornerstone of treatment is to lower the uric acid levels. There are medications that can be helpful but avoiding purine rich foods (such as seafood and organ meats) and other triggers, such as alcohol, are also beneficial.
High purine foods should be avoided in individuals with gout. These include organ meets (kidneys, liver), seafoods (anchovies, sardines, shellfish), and some vegetables (asparagus, cauliflower, lentils, lima beans).
Gout is caused by hyperuricemia (high uric acid levels in the blood). Risk factors for hyperuricemia include obesity, medications, and certain medical conditions (kidney disease). However, there is also a genetic predisposition as well. The management of gout is focused on decreasing uric acid levels. Medication can be effect at doing this, but also avoiding anything that may increase uric acid levels (or the body’s ability to excrete uric acid) can be helpful as well. Carbohydrates such as bread, pizza, and pasta do not increase uric acid levels. Alcohol (but beer in particular more so than other types of alcohol), organ meets (liver, kidney, etc), and seafood (notably shellfish) can increase uric acid levels.
Gout is indeed very painful but the good news is that there are ways to prevent it. Changes in your diet can help (search our website for ‘gout’ and you can read more about diet). Also, medications such as colchicine and allopurinol can prevent further attacks and outstanding ways to prevent further attacks. Weight loss for those who are overweight or obese, reduction in alcohol intake (especially beer), and staying hydrated are other manuevers that can help avoid gout attacks.
Excessive alcohol use is a definite risk factor for gout, especially beer. In fact, excessive alcohol use has many potential bad effects on the liver, heart, nerves, and other organs. Best to try to get your intake down or eliminated completely to protect your health !! Good luck !!