Gout: UK Online Doctor Treatment & Long-Term Management
Educational information — not medical advice.
This article was prepared by the OnlineDoctor24 editorial team and reviewed for factual accuracy against UK clinical guidance (NHS and NICE). It is not written by a doctor and does not replace personal medical advice. For symptoms specific to you, book an online doctor consultation.
Key points
- Gout is caused by uric acid crystals in joints.
- Acute attacks: NSAIDs, colchicine or steroids.
- Recurrent attacks need long-term urate-lowering therapy (allopurinol).
- Diet and alcohol matter, but medication is usually needed.
Symptoms
Sudden severe pain, redness and swelling, usually in one joint — most often the big toe (podagra). Attacks last 5–10 days. May be triggered by alcohol, rich food, dehydration or trauma.
Acute treatment
- NSAID (naproxen 500mg twice daily) — usually first-line if no contraindication.
- Colchicine 500mcg 2–4 times daily.
- Oral steroid (prednisolone) if NSAIDs/colchicine not suitable.
- Ice packs help.
Preventing future attacks
- Allopurinol — start low (100mg), titrate to target urate <360 µmol/L.
- Always cover initial allopurinol with NSAID/colchicine for 3–6 months — starting allopurinol can trigger attacks.
- Continue lifelong if recurrent gout, tophi, or kidney stones.
Lifestyle
- Reduce beer and spirits.
- Limit red meat, offal, shellfish.
- Stay hydrated.
- Lose weight gradually (rapid loss can trigger attacks).
- Cherries and low-fat dairy may be protective.
Frequently asked questions
Common questions UK patients ask about gout.
How an online doctor can help
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This article is for general information only and does not replace personal medical advice from a qualified doctor. Content is reviewed against UK NHS and NICE guidance by the OnlineDoctor24 editorial team and is not authored by a medical doctor. If your symptoms worsen or you are unsure, please book a consultation with a GMC-registered GP.
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