Treatment & Prognosis
In many cases gout is self-limiting, as a balanced, healthy lifestyle will typically contribute to resumption of normal uric acid levels, including production and excretion.
However, care must be taken to ensure that, after the rapid treatment of painful flare-ups and restoration of joint function, patients are aware of the potential need for ongoing treatment to prevent recurring, future attacks, and to prevent the possibility of more serious “gouty” expressions, such as destructive joint inflammation, growth of crystalline structures on the bone, and kidney stones.
Effective treatment for acute cases of gout flare-ups include the use of:
NSAIDs (non-steroidal anti-inflammatory drugs), such as indomethacin, and others which can be tapered back and discontinued over time, due to the common risk of gastrointestinal complications
Colchicine, a natural product extract taken orally. Elderly patients and those with kidney or liver ailments should only used this under medical supervision. Highly effective within the first 24 hours of a gout flare-up, though patients should be aware of side effects that include gastro-intestinal toxicity.
Injectable steroids and corticosteroids (such as prednisone) are also helpful in treating inflammation in specific joints.
In most cases, the goal of drug therapy is to ease inflammation and pain in areas where gouty arthritis has occurred, while the cause(s) of uric acid over-production or under-excretion are addressed.
In cases where over-production must be addressed by drugs specifically, your doctor may prescribe one of two xanthine oxidase inhibitors, powerful drugs that not only reduce uric acid production, but also directly combat the growth of crystalline uric acid deposits:
If gout cannot be contained early on and it becomes chronic (as with multiple attacks within one or two years, and other manifestations of continuous hyperuricemia), your doctor may prescribe you lifelong drug therapy.
The prognosis for those suffering from gout is good; gout is often treated successfully, without serious complications.
Management of the disease in early stages can be challenging, because of a number of factors related to the individuality of the disease’s manifestation from patient to patient:
- Gout is often accompanied by or associated with other disorders
- Symptoms from a gout flare-up can be prolonged or exacerbated by experimentation with drugs and dosages
- Gout can require changes to lifestyle, particularly diet