Gout Prevention and Treatment

Medications Help Prevent Recurring Gout Attacks

doctor checking woman's weight
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Gout is a form of arthritis characterized by inflammation in a joint. The touch of a bedsheet or the sensation of a passing breeze on an affected joint can provoke excruciating pain for people suffering with gout. Gout can be intensely painful.

The most common joint affected by a gout attack is the big toe. However, other joints can also be affected. Unlike other arthritic diseases, the cause of gout is a consequence of body metabolism rather than the immune system.

An Overview of Gout

What Causes Gout?

Gout is often related to an inherited abnormality in the body to process uric acid. Uric acid levels can become elevated by eating a lot of purine-rich foods, by the overproduction of uric acid by the body, or if the kidneys do not eliminate excess uric acid. When uric acid reaches a certain level in the blood it precipitates out in the form of monosodium urate crystals. In gout, the crystals are deposited in connective tissue and joint spaces causing intense inflammation.

People with high levels of uric acid in the blood (hyperuricemia) do not always develop gout. Actually most people with hyperuricemia do not develop gout. Therefore, it is not necessarily the high level of uric acid causing gout but perhaps a rapid change in its level. Gout attacks can be precipitated by dehydration, injury, fever, heavy eating, heavy drinking of alcohol, and recent surgery.

Other contributory factors include obesity, weight gain, high blood pressure, abnormal kidney function, and certain medications.

Gout Risk Factors

What Are Gout Attacks?

Gout usually attacks a single joint suddenly and intensely. Gouty joints show the most visible signs of inflammation of any type of arthritis.

An initial attack of gout may last several days and disappear even if untreated. Subsequent attacks may not occur for weeks, months, years, or may not occur at all. In severe cases, repeated attacks occurring over a long period may cause damage to the joints and loss of mobility.

A definitive diagnosis of gout can be made by examination of aspirated joint fluid with a polarizing light microscope for evidence of crystals. Approximately one million people in the United States suffer from gout. It is nine times more common in men than women, predominantly after puberty with a peak age of 75. Gout attacks in women usually occur after menopause.

Gout Prevention

Prevention of acute gout involves:

  • maintaining adequate fluid intake
  • weight reduction
  • dietary changes
  • reduction in alcohol consumption
  • medications to reduce hyperuricemia

How to Treat Gout With Diet And Medication

Gout Medications

Medication treatment of gout includes:

  • Acetaminophen (Tylenol) or other analgesic painkillers - helps to manage pain​​
  • NSAIDs (nonsteroidal anti-inflammatory drugs), more specifically Indocin (indomethacin) - helps to control inflammation
  • Colchicine - prevents or relieves gout attacks by suppressing inflammation
  • Corticosteroids - provokes a quick anti-inflammatory response
  • Probenecid (Benemid, Probalan) - decreases uric acid blood levels by increasing the excretion of uric acid into the urine
  • ColBenemid (other brand names are Col-Probenecid and Proben-C) - contains Probenecid, a uricosuric agent, and ​Colchicine, which has anti-gout properties
  • Allopurinol (Zyloprim) - lowers blood uric acid by preventing uric acid production; blocks the conversion of purines to uric acid by xanthine oxidase
  • Febuxostat (Uloric) - lowers serum uric acid levels by blocking xanthine oxidase (similar to allopurinol)
  • Losartan (Cozaar and Hyzaar) - not specifically ​a gout medication but it is an angiotensin II receptor antagonist, antihypertensive drug which may help control uric acid levels
  • Fenofibrate (brand name - Tricor) - not a specific gout medication but it a lipid-lowering drug that may help uric acid levels
  • Krystexxa (pegloticase) - biologic drug works by breaking down uric acid

The Bottom Line

While there is no cure for gout, it is possible to prevent or reduce the frequency of future gout attacks by taking medication, making dietary changes, and lifestyle changes as well. Develop a plan with your doctor and be compliant with your treatment plan. It is important to stop the recurrence of gout attacks, in order to prevent permanent damage.


Kelley's Textbook of Rheumatology. Elsevier. Ninth edition.