Treating Gout - Dr Stephanie Barrett – Rheumatologist London

 

 

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The treatment of gout is a two-stage process

Two different elements of the disease need to be considered in their own right and it may be you treat both at the same time or individually, dependent on your circumstances. Treating gout combines lifestyle changes and medical treatment and the two separate approaches you need to consider for your treatment are:

  • Treating the actual attacks of gout
  • Treating the high levels of uric acid in the body

Treating Gout Attacks

To instantly manage and control the pain that comes with a gout attack you should make all efforts to take an anti-inflammatory medication as soon as possible. You should also elevate the effected joint and drink plenty of plain fluids, water is the best choice. An acute attack should also mean you make a doctor’s appointment to discuss your circumstances and where possible get help with daily tasks so you can relax and manage the pain effectively.

Gout attacks begin with a sudden and often chronic onset of pain and may last for as long as 10 days, with high and low points. Medications which may be used to treat an acute gout attack include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): they can shorten the attack and bring down swelling quickly
  • Corticosteroids: either in injection or oral form, corticosteroids will reduce pain and swelling and usually begin to work within 24 hours of taking them.
  • Cochicine: this plant-based medication has been used to treat gout for over 2000 years. It can relieve the pain of an acute attack but it does have some unpleasant side effects such as cramps, diarrhoea and nausea. It needs to be taken as soon as possible after an attack starts for the best results.

Reducing Uric Acid Levels

Medications which aim to lower the body’s uric acid levels should help to prevent gout attacks and will also keep the condition under control. These medications are usually started once a gout attack is over as they should not be taken during an attack as they can make the symptoms worse. Below are some of the drug treatments you may be prescribed to manage your uric acid levels.

  • Allopurinol: this is the first choice for most doctors treating gout. It directly reduces the production of uric acid.
  • Febuxostat: in the case that allopurinol isn’t suitable, you may be prescribed febuxotat which again will reduce the amount of uric acid your body makes.
  • Probenecid: this medication works directly on the kidneys to help with the elimination of uric acid.

These are just some examples of how gout may be treated. It is also important to be hyperaware of your body and recognise the onset of an attack so it can be controlled. Taking a proactive role in self-managing your own treatment is very successful for many gout patients, so if you want to look at other treatments or are concerned about any aspect of your care, just ask.

Have some questions about gout?

Contact Dr Stephanie Barrett to discuss gout and see what options there are to help.