No cure for drop does not exist for the moment. The therapeutic approach acts on 2 levels. She aims :

• à relieve symptoms (pain and inflammation) from an acute attack and interrupt the crisis thanks to anti-inflammatory agents;
• à prevent recurrence and complications, in the long term, using medicines that lower the level of uric acid in the blood.

Medicines to relieve pain and fight inflammation

In the event of a crisis, nonsteroidal anti-inflammatory drugs Oral (NSAIDs) are prescribed, such as ibuprofen (Advil®, Motrin®) or naproxen (Naprosyn®, Aleve®, Anaprox®). They act quickly.

If nonsteroidal anti-inflammatory drugs are ineffective, oral therapy with Colchicine (Colchimax®), may help. This drug has an anti-inflammatory and pain-relieving effect. It was the first to be used to relieve gout. Taken for a long time, it also reduces the frequency of seizures. On the other hand, it does not prevent the formation of uric acid crystals in the joints. The majority of users experience nausea, vomiting, diarrhea, and abdominal cramps. These important side effects explain why colchicine is no longer the first drug offered to relieve pain.

If the patient is not relieved by previous treatments, steroidal anti-inflammatory drugs, or corticosteroids, may be prescribed (for example, prednisone). They are taken either orally, in tablets, or by injection into the diseased joint.

Drugs to prevent recurrence and complications

The medication aims to lower uricemia to prevent seizures and reduce the risk of kidney problems and permanent joint damage. It works in 2 ways and gives interesting results.

Increase the excretion of uric acid. Some medicines work on the kidneys to make the body eliminate more uric acid. In addition to lowering the level of uric acid in the blood, they prevent the deposition of crystals in the joints. The most effective drug is probenecid (Bénemide in France, Benuryl in Canada). He is contraindicated in the case of people with kidney failure or kidney stones.

Decrease the production of uric acid. Allopurinol (Zyloric® in France, Zyloprim® in Canada) effectively limits joint damage that can occur in the long term. A significant drop in uric acid level is observed 24 hours after the start of treatment. It continues and results in a satisfactory rate after 2 weeks of treatment. Allopurinol works by inhibiting an enzyme that participates in the synthesis of uric acid.

Caution. Do not start treatment with allopurinol until an acute attack of gout has completely ended. Otherwise, the crisis is likely to resurface.

Food during a crisis

Here are a few tips :

• Avoid alcohol or limit yourself to 1 drink in a day, and do not exceed 3 drinks per week⁶.
• It is good to restrict the consumption of game, seafood and fish, which are foods rich in purines, especially if one or the other of these foods has been noticed to trigger the seizure.
• Refrain from consuming foods that are very high in fat⁶.
• Drink 2-3 liters of fluid per day, at least half of which should be water⁶.

Other changes in diet, which vary from person to person depending on health status, may be beneficial. It is better to consult a nutritionist for personalized advice.