Many patients are concerned about how can my gout be cured? The first question is how to be pain-free, that is, to control the immediate gout attack; the second question is how to be pain-free in the future, that is, to prevent the next gout attack. Let’s solve the problems one by one. How to control the gout that is attacking? Rheumatologists have three axes, which are easy to learn. The first axe: pain relief. The main symptom of gout patients is pain. So our first priority is to get the pain under control. Not all painkillers are suitable for treating gout. There are many kinds of painkillers, from those for pain caused by inflammation, to those for nerve pain, to those for wound pain. Gout is actually an inflammatory disease, so the most effective painkillers are “non-steroidal anti-inflammatory drugs”, also known as “antipyretic and analgesic drugs”, we commonly use Fotarine, Fenbid, Meloxicam, Indomethacin and so on. This type of medicine has a mild anti-inflammatory effect along with pain relief. Some of the less severe gout can sometimes be controlled with just this one drug. But remember, this kind of medicine, do not take two together, and the dosage should not exceed the maximum dosage of the instructions, otherwise it will have a great adverse effect on the liver, kidneys and gastrointestinal tract. For example, it is not right to take Fentanyl when you think it is not effective, or to take one tablet of Fentanyl when you think it is not effective and increase it to 3 tablets or more. So, if you take painkillers do not work well how to do? This is when you need to get on the second axe: anti-inflammatory. This is the most central part of the treatment of gout. This is because gout is fundamentally an inflammatory condition! This is where some people ask: when I had gout, taking cephalosporins and antibiotics didn’t work! You should know that the inflammation of gout is not what we usually call bronchitis ah, pneumonia ah kind of inflammation. Those are external sources of infection resulting in inflammation, while gout is an autoimmune inflammation, also known as “sterile inflammation”. So you can’t use antibiotics to reduce inflammation, but need to use drugs to fight “sterile inflammation”. The two most common types are colchicine and hormones. Colchicine is very effective in controlling the acute phase of gout attacks, and the earlier you start taking it, the better the results. Most patients have an effect within 24-48 hours. It can at least take the patient from being unable to sleep through the pain to being able to move around slightly. Some people may read the drug’s instructions and think that colchicine has a lot of side effects and affects both the liver and kidneys. In fact, the side effects of colchicine are not as great as they are said to be. Moreover, the treatment of gout is short-term, usually controlled in 1-2 weeks. The side effects are minimal when colchicine is taken orally in such a short period of time. Another person said, “I took one tablet in 2 hours according to the instructions, but I didn’t take it several times before I got diarrhea, how can I break it? The dosage of colchicine in the instruction manual is actually on the high side. The international dosage of colchicine in gout is now much smaller than this. It is enough to take one tablet three times a day. It is effective in most patients and avoids the side effects of diarrhea. However, there are times when colchicine and painkillers do not completely control the inflammation and pain, or when someone has diarrhea even after taking 1 tablet of colchicine, or when some patients with renal insufficiency cannot take colchicine and painkillers. There is no need to worry, we still have hormones. Hormones are very effective in controlling this “sterile inflammation”, but they may have side effects such as raising blood pressure and blood sugar. However, for gout patients, they are only used for a short period of time and often do not have that many side effects. Hormones work more quickly than colchicine, and symptom relief can often be felt within a few hours. However, the dosage of hormones varies from person to person, and we recommend that you go to the hospital and use the medication under the guidance of your doctor. The above two measures are basically enough to relieve inflammation and the pain it causes. But the next third axe is also very important: alkalinization. Alkalizing the urine so that uric acid is excreted as quickly as possible is important to lower uric acid and prevent the formation of urinary stones. You can choose to drink soda or take oral sodium bicarbonate, 2 tablets, 3 times a day. Economically speaking, the latter is more cost-effective. Many people have a misconception about the treatment of gout. That is, as soon as gout strikes, rush to take uric acid-lowering drugs, allopurinol, or benzbromarone. These drugs are used to lower uric acid in the non-acute attack period, not only can they not control the acute attack of gout, but also aggravate it. So don’t take these drugs in the acute phase anymore. Generally speaking, the earlier you treat a gout attack, the better the results. If the treatment is timely, the symptoms can be completely relieved in as little as three or four days or a week or two. But if you keep putting off the treatment, or use the wrong medication, it’s hard to say, it lasts for one or two months, and three or five months. The longest I’ve seen is half a year, and a young man in his 30s couldn’t get downstairs for half a year because his gout wasn’t treated promptly and effectively, which is also drunk. Many people are happy that their gout symptoms are relieved in the acute stage, and they can walk as fast as they can, trek through the mountains again, and eat meat in big bowls. The pain is forgotten after the wound is healed, and the result is that the pain returns in a few days. In fact, controlling the inflammation and pain in the acute phase of gout is only a small goal that we have accomplished, but it is more important to keep gout free for a long time.