In the case of gout, it is important that therapy begins as early as possible. This can often prevent complications such as damage to joints and internal organs, as well as a chronic course. Generally, treatment is distinguished between acute and long-term therapy.
Acute and long-term therapy
The initial therapy serves to stop the gout attack and relieve the pain. Here, the use of medications plays an important role. The medications cause the acute symptoms to subside, but they do not lower the uric acid level. The aim of long-term therapy is to reduce the uric acid level in the blood to such an extent that no further attacks of gout occur. This is intended to prevent a chronic course. Long-term treatment of gout involves the use of drugs that help to stabilize the uric acid level. In addition, however, an adapted, healthy diet is particularly important.
Medications for acute gout attacks
An acute gout attack can usually be treated well by taking medication. Cortisol-free (nonsteroidal) anti-inflammatory drugs (NSAIDs), cortisone preparations, and the herbal poison colchicine are all considered. NSAIDs such as diclofenac or indometacin ensure that the inflammation subsides more quickly and the pain is relieved. Cortisone preparations – mostly prednisolone is used for gout – can be taken in the form of tablets or injected directly into the affected joint. They are preferable to treatment with NSAIDs, especially in cases of impaired kidney function. Colchicine can effectively relieve joint pain in an acute attack of gout. However, because of its side effects, the herbal poison is nowadays rarely used immediately at the start of gout therapy. As a rule, it is now only used as a reserve remedy
Caution with certain medications
If you suffer from gout, you should definitely also talk to your doctor about what other medications you are taking. This is because some agents can cause uric acid levels in the blood to increase, which can make your symptoms worse. These medications include laxatives, diuretics, and cancer drugs. Likewise, it is better to avoid acetylsalicylic acid for pain relief.
Take it easy on the affected joint
In addition to taking medication, there are a number of things you can do during an attack of gout to help the symptoms subside quickly. It is important that the affected joint is elevated and spared. If necessary, you should stay in bed for this reason. However, make sure that the joint does not become too warm. Ideally, cool it with cold compresses. During a gout flare-up, eat foods that are as low in purine as possible. It is therefore essential to avoid sausage and meat. Dairy products and most fruits and vegetables, on the other hand, are well suited. Even after the gout attack has ended, you should make sure to eat a low-purine diet. In addition to diet, it is also important that you drink enough fluids. This is the only way to flush the excess uric acid out of the body. Mineral water and herbal teas are particularly suitable. On the other hand, you should avoid alcohol in any case, because alcohol blocks the excretion of uric acid.
Low-purine diet
Once the acute gout attack has subsided, the goal must be to keep the uric acid level in the blood at a normal level and thus prevent the occurrence of another gout attack. A balanced diet plays a particularly important role here. Gout patients should generally not consume more than 500 milligrams of uric acid per day and 3000 milligrams per week. In the long term, your uric acid level should ideally settle at around six milligrams per deciliter. It is best to get a nutrient chart that shows the purine content of various foods. You can also find more information on the right diet for gout here.
More diet tips for gout
In addition to foods rich in purine, you should also avoid alcohol as much as possible. Beer in particular is harmful, as it not only inhibits the excretion of uric acid, but also contains a lot of purines itself. Also important are the following factors:
- Drink at least two liters of fluid every day, provided there are no medical objections to this.This will ensure that the kidneys are flushed sufficiently.
- Avoid periods of thirst and fasting. You should also better avoid very lavish meals.
- Reduce your excess weight. However, proceed slowly and do not do a zero diet.
- Move yourself! Physical training has a positive effect on the uric acid level namely.
Drug therapy
In addition to a healthy diet, certain medications can also help keep uric acid levels constant. The following agents, among others, are suitable for this purpose:
- Uricostatic drugs such as allopurinol inhibit the formation of uric acid.
- Uricosuric drugs such as benzbromarone promote the excretion of uric acid
At the beginning of long-term therapy, uricostats and uricosurics are often used together. After a few months, it is then often sufficient to continue treatment with uricostats.
