Foods, Drugs, Health Conditions, and More

Written by WebMD Editorial Contributors

Medically Reviewed by Jennifer Robinson, MD on January 26, 2022

• Foods
• Health Conditions and Treatments
• Keep Track of Your Triggers

Once you’ve had one gout flare, you really don’t want another. To avoid them, it’s important to figure out the things that set off your symptoms. Here’s a rundown of the usual suspects and what you need to do.

Some can raise the level of uric acid in your body, and that’s what causes gout. If you can limit them, you could head off another flare.

Red meat and seafood. Meat (especially organ meats like liver and sweetbreads) and seafood (like fish and shellfish) can be high in chemicals called purines. When your body breaks them down, your level of uric acid goes up.

Instead, go forprotein from low-fat dairy products, like skim milk, cheese, and yogurt. You can also eat more beans, soy, and other plant-based forms of protein.

Sweetened drinks. Sodas and juices flavored with fruit sugars, like high-fructose corn syrup, can trigger gout flares.

For a sweet substitute, switch to flavored water or diet soda, which won’t raise your odds of an attack. In general, make sure to drink a lot of fluids. Aim for at least eight glasses a day, with at least half being water.

Alcohol. Liquor and especially beer can make you more likely to have gout. You don’t have to give up on cocktail hour forever, but your best bet is to limit how much you drink. Your doctor can help you figure out how much is OK.

Certain drugs, health problems, and lifestyle choices can trigger gout, too.

Medications. Aspirin, certain diuretics for high blood pressure (and other conditions), and drugs for people who had organ transplants can trigger gout. After a flare, go over all the medicines you take with your doctor. If needed, they should be able to find another option.

Being overweight. When you slim down, you can protect yourself from another flare. 

Fasting or crash diets. If you lose weight too quickly or fast, you could raise your chances of an attack. 

High blood pressure, kidney disease, diabetes, and heart disease. These health conditions make you more likely to have gout, especially if you don’t get treatment. Work with your doctor to keep them under control.

Injuries or surgery. When your body is stressed or sick, you’re more likely to have a flare. Of course, you can’t always avoid this trigger. But if you need to have an operation, make sure your doctor knows you’ve had gout in the past.

Gout triggers differ from person to person. Some people can eat a steak or drink an occasional beer with no problems. Others can’t tolerate a bite or a sip without a flare. So you need to learn what yourtriggers are.

Keep a diary of what you eat for a while. That way, you can go back and see whether you can link flares with specific foods. Then you’ll know what you really need to avoid.

Along with avoiding triggers, here are other things you can do to stay healthy and prevent flares:

• See your doctor regularly. You may need to adjust your dose of gout medication over time.
• Always have medicine on hand for flares. The faster you take it, the sooner you can control the symptoms.
• Eat a heart-healthy diet full of vegetables, fruits, whole grains, low-fat dairy, and plant proteins (like beans and nuts). Cut down on processed foods (like white bread, cakes, and candy).
• Get regular exercise.

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Best (and Worst) Foods for Gout

Medically Reviewed by Brunilda Nazario, MD on September 30, 2021

Top a nice plain low-fat yogurt with some berries for a gout-friendly breakfast or snack. Certain proteins in milk help tell your body to get rid of uric acid, the culprit behind your condition.

Not all coastal fare is bad for gout, but it’s best to only dabble in dishes of mussels, scallops, squid, shrimp, oysters, crab, and lobsters. Overindulging could raise uric acid levels and make gout symptoms worse.

Grapefruit, oranges, pineapples, and strawberries are all great sources of vitamin C, which lowers your uric acid levels and helps prevent gout attacks. But if you take colchicine for your gout, skip the grapefruit. It can interact with your meds.

Meats like liver and tongue are chock-full of purines, compounds that your body tends to turn into uric acid. Leave these out of your diet.

Shore up those healthy fats while getting your antioxidants, too. Avocados are high in vitamin E, an anti-inflammatory that can help curb gout flares.

Red meat isn’t as high in purines as organ meats are, but they have enough that it’s wise to eat beef, venison, and bison only on occasion to keep your uric acid levels lower. Your safest picks are white meats like pork and chicken.

The pigments that give cherries their deep purple-red color are called anthocyanins. They give you an antioxidant boost and help reduce inflammation in the body.

The quicker a food raises your blood sugar, the worse it is for uric acid levels. Refined carbs like white bread, cookies, and cake can send your blood sugar soaring and aren’t great for gout.

Since many meats are (mostly) off the menu, you can get your protein from plants such as peas, beans, and lentils. They’re uric acid-neutral and may even help ward off gout attacks.

Honey is high in fructose, a natural sweetener that releases purines when it breaks down in your body. A spot here and there is OK, but keep your fructose-filled eats to a minimum.

Chug your water to help flush uric acid out of your system. Down eight glasses a day, or 16 if you’re having a gout flare. And coffee can help, too. Regular, caffeinated coffee can help lower gout risk.

A glass of wine every once in a while is fine, but beer isn’t great for gout. It raises uric acid by 6.5%. Even nonalcoholic beer bumps it up by 4.4%.

IMAGES PROVIDED BY:

1) HUIZENG HU / Getty Images

2) LauriPatterson / Getty Images

3) Grace Cary / Getty Images

4) Ann_Zhuravleva / Getty Images

5) Jose Marquina / EyeEm / Getty Images

6) karandaev / Getty Images

7) Vedrana Sucic / EyeEm / Getty Images

8) DaveBolton / Getty Images

9) ALLEKO / Getty Images

10) Westend61 / Getty Images

11) Cavan Images / Getty Images

12) AZemdega / Getty Images

SOURCES:

American Journal of Clinical Nutrition: “Milk- and soy-protein ingestion: acute effect on serum uric acid concentration.”

Arthritis Foundation: “Gout Diet: Dos and Don’ts,” “Fructose and Gout: What’s the Link?”

Mayo Clinic: “Colchicine (Oral Route),” “Gout diet: What’s allowed, what’s not.”

Arthritis & Rheumatology: “Effects of Lowering Glycemic Index of Dietary Carbohydrate on Plasma Uric Acid Levels: The OmniCarb Randomized Clinical Trial. ”

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symptoms, causes, diagnosis and treatment

Contents

• 1 Gouty arthritis: symptoms, diagnosis and treatment
  • 1.1 Acute gouty arthritis:
    • 1.1.1 Manifestations of the disease
    • 1. 1.2 Causes of disease
    • 1.1.3 Diagnosis of the disease
    • 1.1.4 Treatment of the disease
  • 1.2 Symptoms of acute gouty arthritis
  • 1.3 Causes of acute gouty arthritis
  • 1.4 Diagnosis of acute gouty arthritis
    • 1.4.1 Anamnesis and examination
    • 1.4.2 Laboratory and instrumental methods of research
  • 1.5 Treatment of acute gouty arthritis
    • 1.5.1 Principles of treatment
    • 1. 5.2 Prevention of relapse
    • 1.5.3 Elimination of the causes of the disease
  • 1.6 Prevention of acute gouty arthritis
  • 1.7 Complications of acute gouty arthritis
    • 1. 7.1 Osteoarthritis
    • 1.7.2 Complications of the kidneys
    • 1.7.3 Depression
  • 1.8 Diet for gout
  • 1.9 Physiotherapy for gout
  • 1.10 General recommendations for gout
    • 1.10.1 Observe Eat a diet
    • 1.10.2 Drink enough fluids
    • 1.10.3 Exercise regularly exercise
    • 1.10.4 Quit nicotine and alcohol
    • 1.10.5 Regularly monitor blood uric acid levels
  • 1.11 Forecast
  • 1.12 Related videos:
  • 1.13 Q&A:
    • • 1.13.0.1 What are the symptoms of acute gouty arthritis?
      • 1.13.0.2 What causes acute gouty arthritis?
      • 1.13.0.3 How is acute gouty arthritis diagnosed?
      • 1.13.0.4 What are the treatments for acute gouty arthritis?
      • 1.13.0.5 What are the consequences if acute gouty arthritis is not treated?
      • 1.13.0.6 What are the preventive measures for acute gouty arthritis?

Acute gouty arthritis is a disease that causes severe pain and limited movement in the joints. Learn how to recognize and treat gout to avoid complications and keep your joints healthy.

Acute gouty arthritis is an acute form of crystalline arthropathy caused by an increase in the level of uric acid in the blood. This leads to the formation of uric acid crystals in the joints, which in turn leads to inflammation and pain. Gouty arthritis usually affects the big toe, but it can also occur in other joints of the body.

Symptoms of gouty arthritis include sharp pain, swelling, redness and burning sensation in the joint. There may also be an increased body temperature and a feeling of general weakness. Pain symptoms can occur suddenly and so severe that the patient cannot stand on his leg or even touch the sore spot.

Diagnosis of gouty arthritis includes a physical examination, blood tests to measure the level of uric acid in the blood, and analysis of synovial fluid from the diseased joint to look for uric acid crystals. It is important to start the treatment process as early as possible to prevent recurrences and reduce the risk of complications.

Treatment for gouty arthritis includes reducing blood uric acid levels with diet and medications, and medications to reduce inflammation and pain. In cases where gouty arthritis affects multiple joints or is complicated by other conditions, more serious treatment may be needed, such as injections of glucocorticosteroids or drugs to chemically remove uric acid crystals.

Acute gouty arthritis:

Disease manifestations

Acute gouty arthritis is an extremely painful inflammation of the joints, which manifests itself as a sharp onset of tenderness and swelling of the joints. Most often, an acute attack of gouty arthritis develops at night and is accompanied by sharp pains in the big toe, which leads to the inability to touch small movements, as well as various damage to the skin and nails.

Causes

Gouty arthritis is caused by high levels of uric acid in the blood, which leads to the formation of uric acid crystals in large joints, especially the thumbs. Under the influence of certain factors, such as too much meat or spicy garlic, the level of uric acid in the blood can increase, which contributes to the development of gouty arthritis.

Diagnosis of the disease

To diagnose acute gouty arthritis, it is necessary to perform a number of studies – a clinical blood test, urinalysis, X-ray and ultrasound examination to determine the presence of uric acid crystals in the joint fluid. When properly diagnosed, an attack of gouty arthritis can be treated with treatment.

Treatment of the disease

Treatment of acute gouty arthritis may include taking anti-inflammatory drugs, vitamin complexes, and regulating the patient’s diet. Drug treatment can eliminate the symptoms of the disease, but for a complete cure it is necessary to avoid certain foods and control the level of uric acid in the blood. In case of complications associated with gouty arthritis, additional medical procedures are prescribed.

Symptoms of acute gouty arthritis

Acute gouty arthritis is characterized by severe pain, swelling and redness of the joints. The joints of the legs are usually affected, especially the big toe. The pain begins suddenly, usually at night, and gradually worsens to the point where even light contact causes acute pain.

Gout often causes fever and may also enlarge the lymph nodes in the affected joints. The pain attack may last for several days, after which the symptoms subside and the affected joint can resume its function. However, with repeated attacks of gout, gradual destruction of the joints can occur.

• Severe swelling of the joints – the affected joints increase significantly in size due to the accumulation of uric acid and the inflammatory response of the body.
• Skin redness – There is a red, infected area of ​​skin around the affected joints due to inflammation.
• Severe pain – Pain in acute gouty arthritis is so severe that the patient is unable to move the affected joint or join daily activities.

In this regard, timely diagnosis and treatment of acute gouty arthritis is necessary in order to avoid possible consequences.

Causes of acute gouty arthritis

Gouty arthritis is one of the manifestations of gout, the most common type of arthritis in the world, which is associated with impaired metabolism of purine compounds in the body. At the same time, uric acid crystals, which are formed in the blood and deposited in the tissues, cause an inflammatory reaction and pose a danger to the health and life of the patient.

Other causes of acute gouty arthritis may include excessive consumption of alcohol and certain foods (eg, meats and hot spices), obesity, diabetes, hypertension, kidney failure, and certain medications (eg, diuretics or aspirin).

1. Heredity
2. Disorder of purine metabolism
3. Alcohol and certain food abuse
4. Obesity
5. Diabetes
6. Hypertension
7. Kidney failure
8. Certain medications

Diagnosis of acute gouty arthritis

History and examination

For the diagnosis of acute gouty arthritis, a thorough examination and history taking of the patient is necessary. The doctor needs to find out information about when the first symptoms began and how they manifest themselves. It is important to clarify the presence of such cases in the family and the presence of other diseases in the patient.

On examination pay attention to the swelling and redness of the joints, pain when touched. The presence of bumps (nodules) on the joints and skin is also checked.

Laboratory and instrumental tests

The diagnosis of acute gouty arthritis may require the use of laboratory and instrumental tests. The patient’s blood is examined for elevated levels of uric acid. An X-ray of the joints or an ultrasound may also be prescribed.

To confirm the diagnosis of acute gouty arthritis, a synovial biopsy may be required – taking a sample of tissue from a joint for detailed examination in a laboratory.

Treatment of acute gouty arthritis

Principles of treatment

Treatment of acute gouty arthritis is aimed at eliminating pain symptoms, preventing a recurrence and eliminating the causes of the disease.

The main principle of treatment is the use of non-hormonal anti-inflammatory drugs such as diclofenac, indomethacin or colchicine.

For excessive pain symptoms, local injection of glucocorticosteroids into the affected joint may be prescribed.

Prevention of recurrence

To prevent recurrence of acute gouty arthritis, a diet that restricts alcohol, meat, fish, and foods high in purines should be followed.

Medications that lower blood uric acid levels, such as allopurinol or febuxostat, are also recommended.

Treatment of the causes of the disease

If there are diseases associated with acute gouty arthritis, such as diabetes or obesity, attention should be paid to the treatment of these diseases.

Determining the cause of elevated blood uric acid levels in a particular patient helps to more targeted and effective treatment of acute gouty arthritis.

Prevention of acute gouty arthritis

Acute gouty arthritis is a chronic disease that develops due to a long-term disturbance in the metabolism of uric acid in the body. However, there are several effective ways to prevent the development of this disease or reduce the risk of its occurrence.

• Dieting. Gout is often caused by eating foods that are rich in purines. It is necessary to give up spicy, fatty foods, meat, seafood, beans and other products containing purine.
• Refusal of bad habits. Smoking and alcohol consumption increase the risk of developing gout. Therefore, for prevention, it is advisable to abandon these habits or reduce their consumption level.
• Weight control. Excess weight is an additional load on the joints, which can lead to the development of gout. Watch your weight and try to avoid extra pounds.
• Learn to control your uric acid levels. Take medicines that help lower your uric acid levels. Also monitor the level of uric acid in the blood and timely do the necessary cleansing procedures for the kidneys and liver.

Taking simple preventive measures can help reduce your chances of developing acute gouty arthritis and keep you in good health for years to come.

Complications of acute gouty arthritis

Osteoarthritis

Prolonged and incorrect treatment of acute gouty arthritis may lead to the development of osteoarthritis, a joint disease that leads to disruption of their functioning and loss of mobility. It occurs due to tissue damage, as well as due to the sequestration of uric acid crystals in the joint.

Kidney complications

In acute gouty arthritis, an increase in the level of uric acid in the blood is possible, which in turn can lead to the formation of kidney stones, as well as the development of chronic kidney failure.

Depression

Acute gouty arthritis can significantly impair the patient’s quality of life and cause depression. Therefore, it is important to seek help from specialists in a timely manner and carry out the correct and comprehensive treatment.

Gout diet

Gout diet plays an important role in the treatment of this disease. It aims to reduce the level of uric acid in the blood, which is the main cause of gout. At the same time, it is necessary to monitor not only the quantity of products used, but also their quality.

Basic principles of the gout diet:

• Restriction of protein intake (meat, fish, dairy products). This is due to the fact that proteins are a source of purines, which, when broken down, form uric acid.
• Increased intake of plant foods (vegetables, fruits, herbs). These foods are lower in purines and are rich in vitamins and antioxidants.
• Alcohol restriction , especially beer, as it contains a lot of purines and contributes to the retention of uric acid in the body.
• Increase fluid intake , especially water, to remove uric acid from the body by the kidneys.

In addition, fast food, foods high in sugar and fat, highly salty and spicy foods should be avoided. It is recommended to use additional vitamin C and a complex of vitamins of group B. The diet should be balanced and compiled individually under the supervision of a physician.

Indicative list of foods Recommended Restricted Excluded

9 0277 Meat (especially liver and kidneys), spinach, peas, cauliflower, sardines, sprats, lard, canapes, bacon, smoked meats, canned food, fast food

Physiotherapy for gout

Physiotherapy is one of the main directions in the complex treatment of gout. It is an effective method to reduce pain, inflammation and protect against recurrence. Physiotherapeutic methods can be applied both in the acute period and in the intercritical period.

In addition, the use of laser therapy significantly accelerates wound healing, reduces swelling and inflammation, and improves the resumption of blood circulation. Electrophoresis with painkillers and anti-inflammatory drugs is also effective: it provides a quick saturation of the body with useful elements.

• Ultrasound therapy
• Magnetotherapy
• Laser therapy
• Electrophoresis

It is important to note that physiotherapy can affect the cause of the disease only in combination with other treatment methods, such as dietetics, taking medications and physical exercises. Specific methods of physiotherapy are prescribed depending on the stage of the disease, concomitant diseases, age and other factors.

General recommendations for gout

Eat a diet

Eat a diet low in purines, as they are the main source of uric acid in the body. Avoid fish, meat, seafood, beer, and other alcoholic beverages. Limit your gluten intake.

Drink plenty of fluids

Protect your kidneys and drink at least 2-3 liters of fluid per day. This allows you to remove uric acid from the body and protects against the formation of kidney stones.

Exercise regularly

It is not necessary to exercise, but regular exercise will help strengthen muscles and joints, improve blood circulation and reduce weight. Light endurance exercises such as walking, swimming, yoga are suitable.

Give up nicotine and alcohol

Nicotine and alcohol reduce the effectiveness of treatment and contribute to the aging of gout. Avoid salty and fatty foods, smoking and drinking alcohol, as they contribute to exacerbations.

Monitor your blood uric acid levels regularly

Monitor your blood uric acid levels at regular intervals to reduce the risk of gouty arthritis and other complications associated with high levels of uric acid in the body.

Prognosis

The prognosis of acute gouty arthritis depends on a number of factors, such as the age of the patient, the presence of concomitant diseases, the stage of the disease, and the effectiveness of the treatment.

An important factor for prognosis is timely diagnosis and initiation of treatment. With the right approach to the treatment of acute gouty arthritis, patients can experience a complete recovery, prevention of recurrences and relief of symptoms of the disease.

However, without comprehensive and targeted treatment, acute gouty arthritis can take a long time and with complications, which can negatively affect the patient’s quality of life.

At the first signs of acute gouty arthritis, you should consult a doctor who will conduct the necessary diagnosis and select the most effective treatment.

Related videos:

Q&A:

What are the symptoms of acute gouty arthritis?

Acute gouty arthritis is characterized by sudden pain and swelling in one or more joints, most commonly the big toe. Redness and increased sensitivity of the skin in the area of ​​the affected joint may also occur.

What causes acute gouty arthritis?

Acute gouty arthritis is caused by an excess of uric acid in the blood, which may be due to malnutrition, heredity, or kidney problems. There are also possible causes behind the increase in uric acid, such as alcohol.

How is acute gouty arthritis diagnosed?

Diagnosis of acute gouty arthritis is based on a description of symptoms and additional tests, such as blood tests for uric acid, gouty nodules, or x-rays of affected joints.

What are the treatments for acute gouty arthritis?

Treatment of acute gouty arthritis begins with the use of non-steroidal anti-inflammatory drugs to reduce pain and swelling. Medications that lower uric acid levels, as well as corticosteroids, are often prescribed to prevent further attacks. For the treatment of severe cases, drugs that modify the course of the disease can be used.

What are the consequences if acute gouty arthritis is not treated?

If left untreated, acute gouty arthritis can become chronic, often resulting in joint destruction and deformity. In addition, an acute attack can make movement very difficult and increase the risk of developing other comorbidities.

What are the preventive measures for acute gouty arthritis?

Preventive measures include a healthy lifestyle, proper nutrition, and limiting alcohol and purine-rich foods, which can increase blood uric acid levels. It is also important to avoid unnecessary physical exertion and monitor weight.

Gout

Gout, or as it is often called “the disease of kings”, is a metabolic disease accompanied by the accumulation of uric acid in the body and the deposition of its salts (urates) in various tissues and is manifested in acute attacks of gouty arthritis and the formation of specific nodules (tophi ). The essence of the disease is hyperuricemia (accumulation of uric acid in the body) and impaired purine metabolism. This is not a disease of one joint of the foot, as many are accustomed to thinking, but of metabolism as a whole.

Description of the disease “Gout”

Symptoms of the disease “Gout”

The symptoms of gout can vary depending on the nature of the disease.
There are the following main types of gout:

– Sharp. An acute attack, accompanied by a characteristic painful swelling of the affected joint.

– Subacute. Accompanied by moderate pain in the affected joint.

– Asymptomatic. It is expressed in slight redness and slight pain in the joint.

– Chronic. It is accompanied by severe limitation of mobility and deformation of the affected joint, as well as subluxation of the toes.

– Rheumatoid. The symptoms are most similar to rheumatoid arthritis.

In most cases, gout begins with an acute attack. Most often this happens at night (less often – early in the morning), due to eating meat, fatty, spicy or salty foods the night before, drinking alcohol, and also hypothermia.

Such an attack is accompanied by the rapid formation of edema around the affected joint, local fever and redness. These symptoms go away on their own after a while. The first attack is followed by a period of remission. During this period, gout symptoms are absent. However, if after the first attack you do not become alert and do not seek appropriate help, the attacks will reappear. The intervals between subsequent attacks will be shorter, and their course will be more intense.

In the later stages of the course of gout, gouty nodes (tophi) are formed.

The causes of gout are a decrease in the ability of the kidneys to filter and excrete harmful substances, genetic predisposition, and malnutrition.

Often, before the formation of tophi, a person is diagnosed with urolithiasis. If at this stage the excretion ability of the kidneys is improved and the body is completely cleansed, the risk of gout is greatly reduced.

It should be noted that men suffer from gout more often than women. Because female sex hormones contribute to a better exchange of uric acid in the body.

In ancient times, gout was called the “disease of kings.” Due to the fact that only those who had the opportunity to eat well and satisfyingly suffered from it. These days, gout is called the “meat-eater’s disease” because meat and offal are foods high in purines.

Depending on the causes of occurrence, two types of gout are distinguished: primary and secondary.

Primary gout is the most common form of this disease. It is determined by the nature of nutrition, i.e. the use of foods with a high content of purines (meat and offal, legumes, some types of fish), spicy and salty foods, as well as alcohol (especially wines and beer).

Secondary gout develops as a result of another disease. It can be various diseases of the kidneys or blood.

Diagnostic methods

Diagnosis of gout is carried out using some methods of laboratory and instrumental studies, namely:

1. Serum uric acid. An elevated level of uric acid is an argument in favor of the diagnosis of gout. However, not all people with elevated uric acid levels develop gout. At the same time, in a small number of patients with severe manifestations of this disease, the level of uric acid in the blood may be within the normal range.
2. In the acute period of the disease, the level of uric acid in the serum is not so important, since uric acid is released into the tissues and its concentration in the blood may decrease.
3. Complete blood count (without leukocyte formula and ESR) (OAC). During an acute attack of gout, white blood cell levels may rise moderately and the erythrocyte sedimentation rate (ESR) may increase markedly.
4. Examination of synovial (articular) fluid. Detection of uric acid crystals in it is specific for gout.
5. X-ray of joints and bones in gout is of auxiliary importance. In the later stages of the disease, large tubercles can be seen on bone radiographs – signs of deposition of uric acid salts in them.

Methods of treatment

Gout can be treated in two ways:

– Interruption of a painful attack;

– Improved metabolism (metabolism), i.e. cleansing the body of excess urates and preventing their appearance outside of attacks.

First of all, a gout patient is prescribed a strict diet. Meat and fish dishes, offal, legumes are excluded from the diet. It is recommended to reduce the consumption of foods containing methylpurines (tea, coffee, cocoa and chocolate), as well as foods containing oxalates (sorrel, rhubarb, spinach, peppers and radishes). Fasting is strongly discouraged.

With gouty arthritis, it is allowed to eat meat or fish stewed or baked, but in no case fried. And no more than once a week.

In acute attacks, non-steroidal anti-inflammatory drugs (NSAIDs) are used: ibuprofen, naproxen. These drugs are prescribed for topical treatment, pain relief and reduction of inflammation. NSAIDs are an important component of the complex treatment of gout. However, do not try to treat gout with only them, because the problem of the disease is much deeper and these drugs reduce symptoms, and do not cure the disease.

Drugs used in the treatment of gout:

– Allopurinol.