Question 1

What is gout and what causes gout attacks?

Accepted Answer

Gout is a form of inflammatory arthritis caused by the deposition of monosodium urate crystals in joints and surrounding tissues, resulting from chronically elevated blood uric acid levels (hyperuricemia). Acute gout attacks cause sudden, severe joint pain, swelling, redness, and warmth — most classically in the big toe — and can be triggered by alcohol (especially beer and spirits), high-purine foods (organ meats, shellfish, red meat), dehydration, certain medications (diuretics, low-dose aspirin, cyclosporine), and sudden medical illness.

Question 2

What medications treat an acute gout attack?

Accepted Answer

The American College of Rheumatology (ACR) recommends NSAIDs (e.g., indomethacin, naproxen), colchicine, or corticosteroids (oral or injected) as equally effective first-line options for acute gout flares, with the choice guided by comorbidities, tolerability, and kidney function. Colchicine is most effective when started within 24–36 hours of flare onset; do not start urate-lowering therapy during an acute attack, as it can prolong the flare — consult your healthcare provider for the most appropriate acute treatment.

Question 3

What medications lower uric acid to prevent future gout attacks?

Accepted Answer

Urate-lowering therapy (ULT) is recommended for patients with two or more flares per year, tophi (urate crystal deposits), or gout-related joint damage, with a serum urate target of less than 6 mg/dL (below 5 mg/dL for tophaceous gout) per ACR guidelines. Allopurinol is the preferred first-line ULT for most patients; febuxostat is an alternative for those who cannot tolerate allopurinol; probenecid (a uricosuric) is an option for under-excretors with normal kidney function — consult your healthcare provider to determine whether you need long-term ULT.

Question 4

What dietary changes help prevent gout attacks?

Accepted Answer

Dietary strategies that reduce uric acid levels include limiting alcohol (especially beer and spirits), reducing intake of high-purine foods (organ meats, shellfish, red meat), avoiding high-fructose corn syrup beverages, staying well-hydrated, and maintaining a healthy weight. Low-fat dairy products and coffee consumption are associated with lower uric acid levels in observational studies; while diet alone rarely normalizes uric acid sufficiently to prevent all flares, it complements medication and can reduce attack frequency — consult your healthcare provider about whether dietary changes are sufficient or ULT is also needed.

Gout

Overview

Drug classes used to treat gout

Medications for gout

Drug comparisons for gout

Frequently asked questions