Gout & Crystal Arthritis
Acute attack management, urate-lowering therapy, and long-term prevention strategies.
Book a consultation →Gout is the most common form of inflammatory arthritis, caused by the deposition of monosodium urate crystals in joints and surrounding tissues as a result of high uric acid levels in the blood (hyperuricaemia). Acute gout attacks are characterised by sudden, intense pain, typically in the big toe joint, but can affect other joints as well.
- Sudden, intense pain, usually at night
- Swelling, warmth and redness of the affected joint
- Big toe joint — the classic location
- Fever during acute attacks
- Tophi (crystal deposits) after years of disease
- Kidney stones (uric acid nephrolithiasis)
Gout treatment has two phases: management of the acute attack for immediate pain relief, and long-term treatment to lower uric acid levels and prevent future attacks.
- ✓Colchicine, NSAIDs or corticosteroids for acute attacks
- ✓Allopurinol or Febuxostat for long-term urate lowering
- ✓Pegloticase for refractory gout
- ✓Target uric acid level: < 6 mg/dL (< 5 mg/dL for tophi)
- ✓Dietary modification: reduction of purines, alcohol, fructose
- ✓Adequate hydration and treatment of risk factors (hypertension, diabetes)
Do I need to stop alcohol completely if I have gout?
Beer and spirits are the main triggers and should be significantly reduced or stopped. Red wine in moderate quantities carries lower risk, but complete avoidance is ideal during attacks.
Which foods should be avoided?
Organ meats (liver, kidney), red meats, shellfish and oily fish (sardines, herring) are high in purines. Added fructose (sweet drinks) also raises uric acid.
When should urate-lowering medication be started?
Usually after the second attack or when there are tophi, renal disease or very high uric acid levels. Starting during an acute attack is not recommended as it can prolong it.
Is gout curable?
Gout can be managed very effectively and attacks can be completely eliminated with proper treatment. By reaching the target uric acid level, crystals gradually dissolve.
Can I have gout even without eating a lot of meat?
Yes. Only about 30% of uric acid comes from diet — 70% is produced by the body. Genetics, kidney function and certain medications (diuretics, low-dose aspirin) have significant influence.
Ready to take the first step?
Book your consultation
I'm here to help you with the right diagnosis and treatment.