Gout

There is currently no cure for gout but the symptoms and its progression can be controlled by a combination of medication and special diet.

NSAIDs (non-steroidal anti-inflammatory drugs or COX-2 inhibitors (eg. Celebrex and Arcoxia) are often prescribed to reduce the pain, swelling, and stiffness that result from the gout attack. Colchicine is also very effective in relieving the acute pain and can be taken two or three times a day. Colchicine can also be used to prevent acute attacks. A short course of steroids like prednisolone is also very effective in relieving an acute attack.

Often, a combination of drugs is used to treat the symptoms. To control gout in the long-term, other medication may be prescribed. Allopurinol, which reduces the production of uric acid, is often used. Such drugs need to be taken for the long term in order to control the uric acid level and prevent further acute attacks. Your doctor can advise you on the medication you need.

To further reduce the level of uric acid in the blood, a special low-purine diet is recommended. Foods that are high in purine, such as alcohol, liver, kidneys, salmon, sardine, dry beans, bean curd and soya bean drink should be

avoided, and daily intake of protein-rich food like red meat should be limited. It is essential to seek advice from a dietician for complete details. Overweight and obese patients need to go on a supervised weight loss programme. However, fasting and crash diets are not recommended as they aggravate the condition.

Surgery is rarely used to treat gout. It is sometimes required when there is a need to remove infected tophi or tophi that interferes with joint movement. Tophi tend to recur unless hyperuricaemia (high uric acid in the blood) is corrected. In patients with extremely painful joints like the big toe or knee, an injection of steroid directly into the joints may be helpful.