A common cause of gout is the accumulation of a chemical called uric acid. Uric acid is a normal breakdown product of another chemical called purines. The treatment involves controlling the inflammation, which causes the pain and swelling and ultimately damage to joints. Also, lowering the uric acid level is a logical means to controlling gout.
There is some benefit to avoiding foods that cause gout but most people who get gout will need medication to prevent joint damage and also prevent future attacks which often happen sooner and are more severe. They can also cause permanent damage to the kidney and joints. The crystals can also deposit on the skin and are then called tophi.
Most of the time the symptom can be controlled by anti-inflammatory medications like naproxen or indomethacin. In severe cases steroids like prednisone may be needed. Some people even need injections into the joints. Fluid from the swollen joints can be removed and analyzed for the uric acid crystals.
The treatment includes medicines like allopurinol, which decrease the level of uric acid, or there are other medicines like colchicine, which decrease inflammation. Also there are medicines called uricosuric agents that increase the removal of uric acid in urine. Colchicine works best if taken really early in the attack and sometimes repeat does may need to be taken periodically such as every two hours or so till there is pain relief or a maximum dose is reached or there are side effects like gastrointestinal upset.
The specific dose and the manner of taking these medicines are best discussed with your healthcare provider.
Common side effects of these drugs include stomach upset and ulcers from prednisone and ibuprofen type of medications, diarrhea from colchicine and sometimes gout can get worse from allopurinol especially if the person is not on colchicine first during an acute attack.
