It is critical to stop the acute inflammation and address the long-term management. Initial treatments will involve medications to reduce inflammation and pain. Often times non-steroidal anti-inflammatory medications are taken orally for three to four days. At this time indomethacin is the treatment of choice. Corticosteroids may be used if the individual is unable to tolerate non-steroidal anti-inflammatory medications.
Long-term treatment is also initiated once the acute stage is over. Prevention of further attacks involves maintaining adequate fluid, reducing weight, dietary changes, reduction in alcohol consumption and medications to lower the uric acid level in the blood. Uric acid is a metabolic byproduct of purines. These are chemicals which are in high concentration in red meat, shellfish and organ meats. (2)
Research has reported that meat in general increases the risk of a subsequent attack of gout while dairy products appear to reduce the risk. Total amount of alcohol intake is also strongly associated with an increased risk as our soft drinks are high in fructose. Maintaining an adequate fluid intake will also help to prevent the risk of kidney stone formation in patients who are at high risk for Gout. Because alcohol has a diuretic effect it has two major pathways that worsen Gout – by slowing the excretion of uric acid as well as causing dehydration.
Medications may also be used to block the production of uric acid in the body if all else is not successful. Allopurinol is the drug of choice used for long-term treatment in older patients and those who have high levels of excreted uric acid.
Long-term treatment and prevention for Gout is essential for the long-term health of the individual. Over time gout will cause permanent damage to the joints it affects resulting in decreased motion, increased pain and impaired function.
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