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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Gout In Ankles. Family History Of Gout. Prescribed Allopurinol. Want Help

I ve just survived my first battle with Gout , starting in my right ankle, and then moving to my left ankle...God forbid I m unfortunate enough to get it again. There is a family history of it, my late father and one brother. My doctor has just given me a req for blood work to determine if my Uric acid level is now low enough to start me on Allopurinol .......This whole painful episode lasted approximately 2+ months, with numerous trips to the doctors........Does it get better from here. I have said to my husband several times that the pain was so intense that I wished I was dead.....I am a 58 year old female with a fairly high threshold for pain, but not with the gout....the threshold went right out the window!!!!! Would appreciate your comments/advice/help....Patricia Ward
Mon, 11 Feb 2013
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Nephrologist 's  Response
Thank you for using heathcare magic.

One detail which was not mentioned in your question was whether or not during an episode if a physician removed fluid from the joint and had the fluid examined to determine if your symptoms were gout vs some other form of inflammatory arthritis.

Assuming then that this is gout, long term management would be medications and lifestyle modification. For long term management you would benefit from being on a medicatioon such as allopurinol however this should be initiated once the acute attack has resolved. Other medications such as probenecid and colchicine can also be used as a preventative however allopurinol or the newer medication Uloric would be first line agents. The goal of preventative treatment would be to acheive a uric acid level

Take Care and Be well

Lifestyle modification will include reduction in purine intake such as reduction in red meat, cheese, wine etc. I would suggest that you search online for "diet in persons with gout" and you should find adequate information regarding dietary restrictions that would help prevent recurrence.

I would also suggest that you speak with your primary care doctor regarding a prescription for medication to have on hand in the event of a recurrent attack. Early initiation of treatment may reduce the severity of the attack. Medications such as NSAIDS (indomethacin), colchicine and steroids are used in acute attacks. The appropriate agent for you will be determined by your doctor based on your other medical history.

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Have Gout In Ankles. Family History Of Gout. Prescribed Allopurinol. Want Help

Thank you for using heathcare magic. One detail which was not mentioned in your question was whether or not during an episode if a physician removed fluid from the joint and had the fluid examined to determine if your symptoms were gout vs some other form of inflammatory arthritis. Assuming then that this is gout, long term management would be medications and lifestyle modification. For long term management you would benefit from being on a medicatioon such as allopurinol however this should be initiated once the acute attack has resolved. Other medications such as probenecid and colchicine can also be used as a preventative however allopurinol or the newer medication Uloric would be first line agents. The goal of preventative treatment would be to acheive a uric acid level Take Care and Be well Lifestyle modification will include reduction in purine intake such as reduction in red meat, cheese, wine etc. I would suggest that you search online for diet in persons with gout and you should find adequate information regarding dietary restrictions that would help prevent recurrence. I would also suggest that you speak with your primary care doctor regarding a prescription for medication to have on hand in the event of a recurrent attack. Early initiation of treatment may reduce the severity of the attack. Medications such as NSAIDS (indomethacin), colchicine and steroids are used in acute attacks. The appropriate agent for you will be determined by your doctor based on your other medical history.