Arthritis Health Center

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If you have previously had a gout attack, you are likely to have another, especially if you are not managing the disease with medicines or other treatment. The goal of treatment is to prevent future attacks, to reduce high levels of uric acid (hyperuricemia), and to identify and treat the causes of your hyperuricemia. Your doctor will review your health history and current health status to identify other medical conditions and medicines that could be causing the elevated uric acid levels. Factors such as alcohol consumption, diet, and body weight can be modified to lower your uric acid levels and reduce the risk of future gout attacks.

To reduce the pain, swelling, redness, and warmth of the affected joint(s) in an acute gout attack:

• Rest the affected joint(s).
• Take one or more of the following medicines at the first sign of a gout attack, as prescribed by your doctor:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or indomethacin. Avoid aspirin, because it may abruptly change uric acid levels in the blood.
  • Colchicine
  • Corticosteroids

To prevent recurrent attacks:

• Take a medicine that reduces uric acid levels in the blood, which reduces the risk of future attacks.
  • Uricosuric agents increase elimination of uric acid by the kidneys.
  • Drugs called xanthine oxidase inhibitors decrease production of uric acid by the body.
  • Colchicine is often prescribed to prevent flare-ups during the first months that you are taking medicines that lower uric acid.
• Take steps to reduce the risk of future attacks.
  • Control your weight. Being overweight increases your risk for gout. If you are overweight, a diet that is low in fat may help you lose weight. But very low-calorie diets increase the amount of uric acid produced by the body and may bring on a gout attack. For more information, see the topic Weight Management.
  • Limit alcohol, especially beer. Alcohol can reduce the release of uric acid by the kidneys into your urine, causing an increase of uric acid in your body. Beer, which is rich in purines, appears to be worse than some other beverages that contain alcohol.
  • Limit meat and seafood. Diets high in meat and seafood (high-purine foods) can raise uric acid levels.
  • Making changes in your diet may help with your gout. If you want to try an eating plan for gout, see:

    Gout: Changing Your Diet.

  • Talk to your doctor about the medicines you take. Certain medicines that are given for other conditions reduce the amount of uric acid eliminated by the kidneys. These include pills that reduce the amount of salt and water in the body (diuretics, or "water pills") and niacin. Regular use of low-dose aspirin may raise the uric acid level. Low-dose aspirin may be important for the prevention of stroke or heart attack, so your doctor may want you to continue to take it.
  • Follow a moderate exercise program.