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Gouty Arthritis: Treatment, Procedure, Cost and Side Effects

What is the treatment? How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent? What are the alternatives to the treatment?

What is the treatment?

Gout is a kind of arthritis that develops when uric acid crystals build-up in the joints. When the uric acid gets crystallized in the joint, painful arthritic attacks and kidney stones can occur. The uric acid crystals can block the kidney filtering tubules and this can ultimately lead to kidney failure. Medications alone can treat mild cases of gout. However, recurring attacks of gout require long-term treatment or otherwise there can be damage to bone and cartilage and the kidneys can also get affected.

An excess of uric acid in the blood causes gout. Extra uric acid is usually filtered through the kidneys and is excreted. Uric acid crystals form in the joints if the body produces too much uric acid or fails to excrete it. The crystals cause intense inflammation in the joints and this result in pain and swelling. People who drink too much are the most vulnerable. However, a person can be affected by gouty arthritis due to a number of reasons like injury, surgical procedures, hospitalizations, stress, diet rich in meat. Tumors, cancers and psoriasis can also be accompanied by gout. People who themselves or their family members have suffered from obesity, diabetes or high blood pressure are at risk of gouty arthritis.

Gout, in its mild form, and when it is not frequent and complicated, can be treated with a proper diet and making some changes in lifestyle. However, there are 3 types of medications that are used to treat gout. They are medications for lowering uric acid, prophylactic medications which are used together with the uric-acid lowering medications and rescue medications to deal with gout pain.

How is the treatment done?

The primary treatment of gout are the uric-acid lowering medications. They help to decrease the total amount of uric acid in the body and also lowers the serum uric-acid levels. The goal of lowering the overall uric acid content is to achieve a serum uric acid level of less than 6mg/dl. Some of the medications used to decrease the level of uric acid are allopurinol, febuxostat, probenecid and pegloticase.

Prophylactic medications are used together with uric-acid lowering medications for about the first 6 months of therapy. This is to prevent the gout flares or to reduce the severity of such flares. Any medication that works to reduce the level of uric acid in the body can also trigger a gout attack and so prophylactic medications are used. Some of the medicines used for this purpose are: aolcrys and any of the non-steroidal anti-inflammatory drugs like indomethacin, diclofenac, ibuprofen and others.

Corticosteroids like prednisone, prednisolone and methylprednisolone are used during acute gout attacks so as to lower the pain and inflammation. These medications can also be injected in an inflamed joint to get relief from the pain and inflammation if the medicines are not working. These medications, however, start working within 24 hours of their consumption.

In some cases surgery may be required to treat the gout if the joint has been significantly harmed due to insufficient treatment in the initial stage.

Who is eligible for the treatment? (When is the treatment done?)

A person suffering from gout will experience symptoms like sudden onset of joint pain, swelling of the joint, heat in the area that is affected and redness of the joint. More severe the inflammation, more severe is the pain that afflicts a patient. A person will be eligible for treatment if he/she is experiencing some or all of these symptoms and if a doctor has diagnosed him/her to be suffering from such. Doctors diagnose gout by finding out whether the fluid from the inflamed joint has uric-acid crystals or not.

Who is not eligible for the treatment?

A person, not experiencing the symptoms associated with gout and who has not been diagnosed by doctors to be suffering from this condition, is not eligible for the treatment. A person suffering from pseudo-gout, which has symptoms similar to that of gout, is not suitable for undergoing treatment using these medications.

Are there any side effects?

The medicines that a person needs to consume to treat gout has a number of side-effects. Allopurinol, the medication used to lower uric acid levels can cause very severe allergic rashes. Intake of colcrys can have a number of side-effects like nausea and diarrhea and they also rarely cause muscle weakness and abnormal blood counts. NSAIDs can cause ulcers and irritation of the stomach while febuxostat can also cause abnormalities of the liver, rashes and nausea.

What are the post-treatment guidelines?

There are certain post-treatment guidelines that a person needs to follow to prevent another gout attack even after he/she has been treated for this condition. A person should exercise and also eat a balanced diet so as to keep the weight in check. Another important guideline is to keep drinking a lot of water so that the body remains hydrated. A person should avoid sugary drinks and alcohol in excess quantities. It would be beneficial for a person to skip meat and seafood and rather meet the protein requirements with the help of low-fat dairy like yoghurt, cheese and milk.

How long does it take to recover?

It takes 12 to 24 hours for an acute gout attack to reach its peak. This condition normally subsides even without treatment. However, a person will require 7-14 days to recover fully from an acute gout attack. A gout attack lasts for 3-10 days with or without medication. So the recovery time will depend on how long the attack actually lasts.

What is the price of the treatment in India?

10 ml of ibuprofen may cost anything in between Rs 10 and Rs 112.50 in India. The cost of medicines to reduce uric acid in the body varies between Rs 900 and Rs 4000. Colcryx, which is a prophylactic medicine, will cost around Rs 14,000 in our country. The cost common version of prednisone, which is used to reduce pain and inflammation, can cost something around Rs 300.

Are the results of the treatment permanent?

Gouty arthritis occurs due to the accumulation of uric acid in the bloodstream. This condition can occur after a surgery, trauma or dehydration. If some people are on diuretics, their risks of developing gout are substantial. Certain other medications can also cause uric acid to get concentrated in the blood. Cancer treatment also causes uric acid to get deposited in excess. In addition to these, genetics and obesity can also play a crucial factor in increasing uric acid count. Therefore, it is to be understood that there is no permanent cure for gouty arthritis as the condition may again flare up when the uric acid level increases in our blood.

What are the alternatives to the treatment?

Due to their anti-oxidant properties, cherries and ginger roots can fight inflammation and bring relief from gout pain. Drinking lots of water helps to flush out a lot of uric acid from the body. The acidity of the apple cedar vinegar is a simple home remedy that helps to treat pain and swelling. Babana is another important home remedy for gout as it is high in potassium which converts the uric acid crystals in the body to liquid. The Vitamin c in banana also helps to reduce pain and inflammation.

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Popular Questions & Answers

I am diabetic and hypertensive for last 20 years. Also has high triglycerides. All are in moderate control and in medication regularly. My challenge is gout as my uric acid levels are always between 6 and 10 and keep getting gouty attack once a month on toe, ankle or knee. I will become completely immobile for 3 to 5 days. My medication: vobit m 0.2 mg - 1-0-0 onglyza 5 mg - 1-0-0 ace revelol 25/2.5 - 0-0-1 zyloric 100 mg - 1-0-1 rozucor asp 10 mg - 0-0-1 I have hb1ac at around 7.5 bp is normal after regular medication lipid profile is also normal. Whenever I consume even 2 legs of whisky (even once a month also) I get gout. My protein diet is limited. But we eat lot of udid dal breakfast like idli and dosa. My kidney and liver function is normal. I do master health checkup including TMT every year. Moderate physical activities. Vegetarian diet. Let go fish-eating also. Please suggest what else I can do to control my gout.

MBBS, Diploma in Family Medicine, Fellow of Medical Specialities, Diploma in Geriatric Medicine, Certificate Course in Management of Hypertension, Certificate course in Gestational Diabetes Mellitus- Cycle IV, Certificate course in Evidence Based Management of Diabetic Retinopathy, Cycle I
Diabetologist, Bhubaneswar
Thank you for your query. It seems from your query that you have increased uric acid levels for which you need to modify or add another tablet like febuxostat. For complete advice and prescription you can book an consultation with me on Lybrate. T...

I am a patient of gout. First attack was in Jul 18 second in Dec 18. Then medication started. Colchicine bd and allopurinol 300 od now reduced to 200 and colchicine has been stopped. Right now very very mild attack observed. No non veg no alcohol. Uric acid 4.3. Why mild attack. Uric acid is within limits .medication on. No bad habits exercise daily?

MBBS Bachelor of Medicine and Bachelor of Surgery, MD - Internal Medicine, Fellowship in Rhuematology, DNB (Internal Medicine)
Rheumatologist, Chennai
hi gout is a metabolic disease it has various ramifications pl consult me through lybrate for resolution.. u may have an attack even at normal serum uric acid levels

I am 34 years old male I have suffering from gout issue (pain on foot and ankle, hand) and my uric acid level is 7.5, orthopaedic surgeon suggested that there is no need of medicine for this just asked me to drink enough water and have half an hour walk daily, is it correct or I need to take any medicine to lower my uric acid level.

MPT - Orthopedic Physiotherapy, Fellowship In Orthopaedic Rehabilitation (FOR) Advanced Diploma in Nutrition & Diet
Physiotherapist, Kolkata
Uric acid at this level can be well managed by a healthy diet , avoiding purine rich foods and taking daily coconut water along with Healthy wild caught fish for omega 3 fatty acids or Chia seeds/ pumpkin seeds as veg. source. Many other Lifestyle...
1 person found this helpful

Took Febuget 40 for three months for my creatine levels it is 1.17 at present should I continue this med for longer time to keep my creatine level in normal range.

MBBS, MD - Internal Medicine, MRCEM(UK), MEM, Diploma in Rheumatology, PGCC - Rheumatology, MACEP, FCCS
Rheumatologist, Kolkata
Hello. Febuget 40 is a drug to lower your uric acid. It has no relation with your creatinine level. Check your present uric acid level. If it is within normal range, then consult your doctor if the tablet can be withdrawn or need to be continued. ...

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PDCC - Pain Management,MD - Anaesthesiology,DNB Anaesthesiology,MBBS
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