Prevention of gout

Identifying things that cause you to have gout symptoms can help you to eliminate these triggers and reduce your chances of having it again. Gout can be prevented from reoccurring so often and so severely by making changes to your diet and taking medicines if needed.

Diet

What you choose to eat and drink can have an impact on gout. There are some foods that are very high in purines, which can increase the amount of uric acid in your blood. It’s best not to eat much of these foods very often. These include:

• liver and kidneys
• oily fish, such as mackerel, sardines and anchovies
• shellfish, including mussels, crab and shrimp
• certain vegetables, such as asparagus, cauliflower, lentils, mushrooms and spinach
• oats and oatmeal

If you’re planning to make changes to your diet, ask your doctor or a dietitian for advice to ensure you still get all the nutrients you need. Eating a well-balanced diet will help you to manage your symptoms. See our frequently asked questions for more information.

Aim to drink less alcohol – especially cutting out beer, stout, port and fortified wines because these can have the greatest effect on causing gout symptoms. Drinking enough water every day will help to dilute your blood and urine, lowering the uric acid levels in your body.

If you need to lose excess weight, doing regular exercise will help you towards your goal. The recommended healthy level of physical activity is 150 minutes (two and a half hours) of moderate exercise over a week in bouts of 10 minutes or more. You can do this by carrying out 30 minutes on at least five days each week.

Medicines

In addition to changing your diet, you may need medicines to prevent gout. These help control the levels of uric acid in your blood. The aim is to prevent you getting gout again and if you do, make it last for a shorter time and be less severe. These medicines aren't used to treat symptoms of gout and are usually prescribed several weeks after your last gout symptoms have gone.

Your doctor may prescribe you a medicine called allopurinol to take daily. An alternative is febuxostat if there is a reason why you can’t take allopurinol. Both of these medicines prevent gout by stopping the formation of uric acid. Both allopurinol and febuxostat may actually cause more symptoms of gout when you first start taking them. To help prevent this happening, your doctor may prescribe NSAIDs, colchicine or steroid tablets for you to take alongside allopurinol or febuxostat for up to three months. Make sure you drink enough fluids when taking these medicines.

Your doctor may prescribe you other medicines, such as probenecid, to increase the amount of uric acid that is removed from your body in your urine.

Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

Treatment of gout

You will usually have symptoms of gout for up to two weeks and then they will go away, even without treatment. You may only have one episode of gout in your lifetime, but it might return. If you have no treatment to prevent gout, there is an eight in 10 chance of it returning within three years. Your symptoms of gout may also be more frequent and last for longer.

Self-help

There are a number of steps you can take to reduce the pain and swelling from having gout.

• Raise and rest your joint. Don’t do any vigorous physical activity. Rarely, your doctor may give you a splint to wear to stop you moving your joint.
• Keep your joint cool and don't cover it. Ice the affected joint using an ice pack or ice wrapped in a towel for about 20 minutes at a time to reduce swelling and bruising. Don’t apply ice directly to your skin as it can damage it. If you need to repeat this, let your joint return to its normal temperature first.
• Drink enough water.

Medicines

There are medicines your doctor can prescribe to help to ease your pain and swelling from gout.

Your doctor may prescribe non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, which may relieve pain and inflammation. If you have a heart condition, high blood pressure, kidney or lung disease, or if you're over 65, these medicines may be harmful, so you need to talk to your doctor before taking them. Don’t take aspirin because this medicine can affect your uric acid levels and make your gout last longer.

If NSAIDs aren't suitable for you, your doctor may prescribe a medicine called colchicine instead. Colchicine also reduces inflammation, but in a different way to NSAIDs. You may have side-effects from this medicine including diarrhoea, but this can be reduced by taking lower doses.

Occasionally, your doctor may prescribe steroid tablets if you can't take NSAIDs or colchicine. Alternatively, he or she may recommend a steroid joint injection if you have gout in a large joint (such as your knee).