Gout: Flare Management and Diet Guide

Gout is caused by uric acid crystals in a joint, most often the big toe, triggering sudden severe pain that peaks within 12 to 24 hours. Most flares resolve in 5 to 10 days with treatment. Long-term, the goal is to prevent flares with diet, lifestyle, and (usually) medication.

1 During an active flare

Take prescribed flare medication immediately (NSAIDs, colchicine, or steroids)
Rest the joint; avoid pressure or weight-bearing
Apply ice 15 to 20 minutes, several times daily
Drink water — at least 8 glasses daily
Avoid starting allopurinol during a flare (can prolong it)
Avoid even light pressure (no socks, sheets, or shoes touching the toe)

2 Foods that trigger flares

Limit: red meat, organ meats (liver, kidney), shellfish (shrimp, crab, lobster, mussels)
Avoid: beer, hard liquor, sugary drinks (especially high-fructose corn syrup)
Eat more: low-fat dairy, cherries, vegetables, whole grains
Drink: plenty of water; coffee in moderation may help
Maintain healthy weight (gradual loss; crash diets trigger flares)

Call your doctor today if:

Fever along with the flare (could be infection, not gout)
Joint warmth, redness, or swelling spreading rapidly
This is your first suspected flare (need diagnosis confirmation)
Multiple joints affected at once
No improvement after 48 hours of flare medication
Joint is red, hot, swollen, AND you feel ill (must rule out septic joint, an emergency)

Preventing future flares

Most patients eventually need uric-acid-lowering medication (allopurinol, febuxostat) — taken for life
Goal serum uric acid: under 6.0 mg/dL
Diet alone usually drops uric acid by only 1 to 2 mg/dL
Recheck uric acid every 3 to 6 months; annual kidney function check