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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Recurrent Gout Attacks Be Treated?

Hello I am 86. I have ad two bouts of gout, this month with gout. Have not had in ages. I am careful of diet I believe.because cannot take acidic food. Tomatoes, oranges etc. I do eat lots potatoes? Cannot figure out why getting gout First in big toe and this week in finger joints. I am on lactose and gluten free dies for several. years. Only diet change recently is pork roast this week. How to relieve the pain also?
Mon, 27 Mar 2017
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Diabetologist 's  Response
Hello,

Welcome to Healthcare Magic.

I have read your question fully and understand your concerns.

Gout occurs due to increased levels of uric acid in the blood, these accumulate as crystals in the joints leading to pain and swelling of the joints.

Gout occurs due to many reasons. If a person is obese or if he drinks excess alcohol including beer there is an increased chance of getting gout. Some conditions like diabetes, high blood pressure, kidney problems, and heart problems can also cause gout. I do not think potatoes cause gout. And just eating pork roast once should not cause gout either.

As you had 2 recent episodes of gout, I would advise you to see your doctor. He would do a complete evaluation of you and would also check your serum uric acid levels.

Regarding treatment, you could take pain killers like Ibuprofen 200 mg-400 mg 2-3 times/day, or naproxen 250-500 mg two times a day (provided you are not allergic to them, take them with food, as if they are taken on empty stomach they can cause gastritis. You could also take Ranitidine 150 mg twice a day to prevent gastritis).

But my advice would be to see your doctor first even before starting ibuprofen. Ibuprofen or naproxen though mild-moderate pain killers can still cause kidney problems. As a person ages, his kidneys can slowly deteriorate, this may be alright for him and he is functioning normally, but sometimes even a few doses of ibuprofen can cause worsening effects on the already compromised kidney. Further, as person ages he is more susceptible to other side effects like gastritis etc.

There is another medicine called Colchicine which can be prescribed by your doctor. It can be given if a person has contraindication to Ibuprofen group of medicines.
Corticosteroids can be given to the patient if he cannot take either ibuprofen or colchicine. This is also a prescription only medicine.

For recurrent gout: there is a medicine called allopurinol. Your doctor will put you on a small dose first and measure your uric acid levels, if the levels are still high, he would keep increasing the dose until the uric acid levels are in normal range. You need to take this medicine everyday to prevent gout from recurring.

I do not know what the status of your kidneys is. I do not know what other medications you are on. Before you take any new medicines, the doctor needs to be sure that the new medicines do not interact with the already existing medicines that you taking. The doctor also needs to be sure that the new medicines that he prescribes are not contraindicated for you and that it would not harm you.

So, my sincere advice is for you to see your doctor first before you self-medicate.

I wish you a speedy recovery.

I hope this answer has helped you.

Thank you
Regards
Dr Sunita Sayammagaru
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How Can Recurrent Gout Attacks Be Treated?

Hello, Welcome to Healthcare Magic. I have read your question fully and understand your concerns. Gout occurs due to increased levels of uric acid in the blood, these accumulate as crystals in the joints leading to pain and swelling of the joints. Gout occurs due to many reasons. If a person is obese or if he drinks excess alcohol including beer there is an increased chance of getting gout. Some conditions like diabetes, high blood pressure, kidney problems, and heart problems can also cause gout. I do not think potatoes cause gout. And just eating pork roast once should not cause gout either. As you had 2 recent episodes of gout, I would advise you to see your doctor. He would do a complete evaluation of you and would also check your serum uric acid levels. Regarding treatment, you could take pain killers like Ibuprofen 200 mg-400 mg 2-3 times/day, or naproxen 250-500 mg two times a day (provided you are not allergic to them, take them with food, as if they are taken on empty stomach they can cause gastritis. You could also take Ranitidine 150 mg twice a day to prevent gastritis). But my advice would be to see your doctor first even before starting ibuprofen. Ibuprofen or naproxen though mild-moderate pain killers can still cause kidney problems. As a person ages, his kidneys can slowly deteriorate, this may be alright for him and he is functioning normally, but sometimes even a few doses of ibuprofen can cause worsening effects on the already compromised kidney. Further, as person ages he is more susceptible to other side effects like gastritis etc. There is another medicine called Colchicine which can be prescribed by your doctor. It can be given if a person has contraindication to Ibuprofen group of medicines. Corticosteroids can be given to the patient if he cannot take either ibuprofen or colchicine. This is also a prescription only medicine. For recurrent gout: there is a medicine called allopurinol. Your doctor will put you on a small dose first and measure your uric acid levels, if the levels are still high, he would keep increasing the dose until the uric acid levels are in normal range. You need to take this medicine everyday to prevent gout from recurring. I do not know what the status of your kidneys is. I do not know what other medications you are on. Before you take any new medicines, the doctor needs to be sure that the new medicines do not interact with the already existing medicines that you taking. The doctor also needs to be sure that the new medicines that he prescribes are not contraindicated for you and that it would not harm you. So, my sincere advice is for you to see your doctor first before you self-medicate. I wish you a speedy recovery. I hope this answer has helped you. Thank you Regards Dr Sunita Sayammagaru