A distinction must be made here between the therapy of acute attacks of gout and the therapy of increased uric acid (hyperuricemia). The aim of the treatment of the acute attack of gout is to relieve pain and contain the inflammatory reaction. In the past, colchicine, the poison of the autumn timeless people, was mostly used to treat an acute attack of gout.
Today, due to the many side effects (especially diarrhea and vomiting), a non-steroidal anti-rheumatic drug (NSAID, e.g. indomethacin, diclofenac) is mostly used, which makes the pain of the gout attack just as manageable. Under certain circumstances, therapy with a steroid (cortisone) may also be useful. In pregnancy, phenylbutazone (Butazolidin®) is the drug of choice.
The aim of treatment of chronic gout is to prevent acute attacks of gout, kidney stones, damage to the kidney, further damage to the joints and the recovery (regeneration) of damaged joints. To achieve this, it is necessary to reduce the uric acid level to normal values. There are three starting points for the treatment of hyperuricemia:
- Reduction of the purine intake by a low-purine diet and abstention from alcohol.
If the uric acid levels do not exceed a certain concentration, a purely dietary treatment with the aim of permanently lowering the uric acid level through a change in diet can be sufficient and no drug treatment is necessary. With a low-purine diet, it is important to ensure that meat consumption is reduced. Meat, fish and sausage should be on the menu no more than once a day.
Beans, lentils and other legumes are also rich in purine. Milk and dairy products, as well as eggs, on the other hand, are low-purine foods. The consumption of alcohol influences the uric acid content in the blood on several levels.
On the one hand, alcohol inhibits the excretion of uric acid via the kidneys, and on the other hand excessive consumption leads to hyperacidity of the blood, which further reduces the solubility limit of uric acid (uric acid precipitates more quickly). The very high purine content of beer must also be taken into account. It is also important to note that chamfering cures or zero diets can possibly trigger an attack of gout. During the fasting the body forms increased ketone bodies, which inhibit the excretion of uric acid over the kidney. Altogether a weight reduction e.g. by sport, particularly perseverance sport affects however positively the illness.
