Gout cannot be cured, but it can be very successfully treated. The main goal of treating gout is to reduce the amount of urate in your blood. Joint crystals will not dissolve or go away unless the serum urate concentration is below six mg/dL.
Doctors prescribe medicines called colchicines, certain nonsteroidal anti-inflammatory drugs and corticosteroids to decrease swelling and relieve pain. All of these drugs work quickly and are very effective. The sooner they are given after an attack starts, the faster the pain goes away.
These drugs may be given by mouth, through an intravenous line into your bloodstream, or injected directly into the joint.
Your doctor may also decompress the affected joint. Aspiration of synovial fluid immediately decreases the pressure in the joint.
And the needle leaves a pathway or track that acts as a vent for continued drainage after the needle is removed. Lifestyle changes can help you manage intermittent gout without using drugs every day.
Your doctor may ask you to do the following:
• Change your diet. Diets that are lower in meat and some other foods can help decrease the amount of uric acid in your body.
• Quit taking drugs such as diuretics.
• Lose weight.
• Quit drinking alcohol.
• Avoid activities that stress your joints.
• Drink plenty of fluids to help your kidneys work more efficiently.
If your gout is severe, you may need to take daily medication to reduce your uric acid levels. Your doctor will put you on the lowest dose possible of medications such as uricosuric drugs.
For patients who have difficulty getting rid of uric acid through the kidneys, medications to help the kidneys remove more uric acid from the blood may be prescribed as well. Probenecid is one of the commonly prescribed drugs that increase the removal of uric acid in the urine.
A program to control uric acid levels and manage symptoms often includes daily colchicine and allopurinol or probenecid (usually both are not taken at the same time) along with dietary restrictions.
Regular follow-up with your physician and blood tests to detect serum uric acid concentration that are above the six mg/dL target level are important in maintaining good control and preventing joint erosion.