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Gout, swelling and pain on toe, had voltaren, colchicine, want to take zyloric. Done blood test for uric acid level and ultrasound

Hello Doctor I am new to gout , the swelling and pain started 2 weeks ago on my right toe . I went to the first doctor who checked ultrasound and found the fluid builtup on my joints and he gave me an injection of steroid right into the joint. Ouch but it helped subside the pain and swelling right the next day. Then I was put on some painkillers and anti inflammatory like voltaren 5o mg by an orthopedist since the pain and swelling started coming back. It did not work. Meanwhile I have done my blood tests. Blood Uric acid level is 7.7 I went to a rheumatologist and he gave me colchicine 1 mg twice a day for 2 days and then once a day for 2 days and then once in 2 days ….i have taken four tablets of colchicine so far (total of 4 mg) but it does not seem to work…swelling persists…am I expecting relief too soon? I also read higher doses of colchicine that other gout sufferers take….is my dose right? I have missed a few days of work already since I can t wear a shoe and it hurts after walking for a while. Is complete rest the only option? How do other people with gout manage going to work? I am told I should take zyloric only after 1 month. Does it usually take such a long time for relief from gout attack before taking zyloric to control Uric acid level? Thanks a lot.
Asked On : Thu, 24 May 2012
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Orthopaedic Surgeon, Hand Surgery 's  Response
welcome to hcm forum
people with gout either produce more uric acid or they have a problem in removing it.The first attacks usually lasts for1 --3 weeks. While the pain and swelling completely go away, gouty arthritis commonly returns in the same joint or in another joint. With time, attacks of gouty arthritis can occur more frequently and may last longer.your dose is can go back to your job .. with gout you dont have to be complete bed rest . what you have to do is take atleast 2 liters of water, and avoid food which increases the uric acid level in the blood like redmeat, cauliflower,potato,few of the dals etc, no nothiong like that, intial when the pain is more we dont give the zyloric because it may increase the pain or anothe r attack of gout can occur. once the pain is control with analgesics and antiinflammatory drug we can start the zyloric drug. IF still the pain is not coming down then steroid and febuxsatat can be started.

it is advised that you meet the orthopaedcian who will treat appropriately

wish you early recovery
Answered: Thu, 24 May 2012
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