The best way to treat a gout attack

Jul 10, 2020
Gout attacks can come on suddenly and be extremely painful. Source: Getty.

The stereotypic image of a person with gout is the overweight middle-aged male who indulges in rich food and consumes too much alcohol. Although this may certainly be an example of someone with gout, this common and complex form of arthritis can affect anyone.

Gout is, in fact, an inherited metabolic disease related to insulin resistance. Gout typically manifests as acute, very painful arthritis of the big toe but in reality, can affect any of the major joints in the body. Although the last thing you want to experience is painful arthritis, gout has other associations and as with all other medical conditions, the best treatment of gout is prevention.

The basic metabolic abnormality is an elevated uric acid — a waste product created during the normal breakdown of purines (a type of chemical found in foods and drinks). The crystals of uric acid precipitate in the joint leading to the painful arthritis. But these crystals of uric acid can also affect the kidney leading to varying degrees of kidney impairment and hypertension (high blood pressure).

There are very effective treatments to settle down an acute episode, but there is also a drug that has been available for many years, which in most cases is very safe: allopurinol (sold under the brand names Allohexal, Allosig, Progout and Zyloprim). Taking allopurinol once the episode has settled in increasing doses to a maintenance of 300mg daily should prevent gout with minimal, if any, side effects. This will not only prevent further episodes of gout but will also protect the kidney from damage and help reduce blood pressure.

Interestingly, a recent large study published in the Journal of Hypertension of just under 24,000 people with hypertension showed the commonly prescribed blood pressure pill amlodipine when compared with diuretic or another commonly prescribed group of blood pressure drugs, ACE inhibitors, lowers the risk for gout by around 35 per cent.

So if you have unfortunately experienced gout in your life and also have hypertension, it’s worth discussing with your doctor the preventative management for gout, but also taking the appropriate therapy for your blood pressure.

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