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My husband had a gout attack that just ended last week. Last night he woke up and the gout was back his doctor just started him on Allopurinol 100mg on Monday. Would this medication bring the gout back? He is also taking Colcrys when he has a gout attack and anti-inflammatory medication. He can’t have this gout attack last as long or longer than it did last time which was around 12-14 days. He is drinking cherry juice as well. What else can he do to reduce the gout attack this time around?
Gout never really goes away. The uric acid crystals that cause gout attacks build up slowly over many months and years.
These cause gout attacks at random intervals, often triggered by saturated fats. Attacks get worse as uric acid crystals spread into more joints. This must be stopped because uric acid crystals will destroy joints and spread into soft tissues if uric acid is not made safe. When allopurinol, or other treatment lowers uric acid in the blood, old crystals start to dissolve, and this can lead to a gout attack.
Treatment is in two halves – allopurinol for lowering uric acid and pain control to beat the inflammation.
Allopurinol is only any good if it lowers uric acid to 5mg/dL or below. Your husband should have a blood test booked for around Monday 13th October for first follow-up blood test. Increase allopurinol if safe target not reached. Repeat the test and dose adjustment every 2 weeks until uric acid is stable below 5. If your husband has had gout for several years, I highly recommend aiming as low as possible for one year to get rid of old crystals as fast as possible. Once most of the old crystals have dissolved, gout will not return.
Whilst crystals exist, there is a risk of a gout attack. There are lots of things you can do to avoid this.
Pain relief
Colcrys (colchicine) is only worth taking before an attack, or at the very first sign. It does nothing for pain, but it does slow the spread of inflammation. When starting allopurinol, or changing dose, my doctor advised daily colchicine as a preventative for two weeks.Where Colcrys is too late, or insufficient, anti-inflammatory meds are required. This must be prescribed at gout strength for severe attacks. OTC dose is only good for mild/medium gout attacks.
In the worst cases, seek medical advice on alternating anti-inflammatory with a compatible pain blocker. Your doctor or pharmacist can say what will work with your chosen anti-inflammatory.
Other actions:
Keep hydrated – fluid intake should be sufficient to maintain pale straw colored urine. Skim milk may help reduce exposure to attacks.
Concentrated cherry juice helps some people. Others swear by black bean broth http://www.goutpal.com/1700/natural-remedy-for-gout/
Avoid cold – keep affected joints warm.
Avoid saturated fats
@melanie-nitto I really hope this helps. If you or your husband need clarification, please reply. Future replies should get posted immediately, now that your first post is approved. And sorry for my garbled Facebook message. My keyboard kept going haywire – very frustrating.@melanie-nitto I wonder how your husband’s gout is progressing.
Can you persuade him to join here? He will get great advice on managing his gout in the best way that suits him. It seems a shame to wait for it to get worse before dealing with it. I did that to myself, and I regret the permanent joint damage that I could have avoided if I’d got gout under control sooner.
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