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What is the treatment for gouty arthritis?

Q: I am a 40 years old man was diagnosed with gouty arthritis 2 years back. That time I was already taking the treatment for sub acute thyroiditis. At that time, my uric acid level was 8.3 mg/dl. I took Declofenac, Colchicine for 2 months; and, Alluporinol 100 mg for 2 weeks, 200 mg for another 2 weeks and now I am taking 300 mg of Alluporinol. My present uric acid level is 7.0 mg/dl. Is there any treatment for my problem?

A:Before I can advise you on the treatment, it would be very necessary to be sure that your disease is gouty arthritis. As you have not described your symptoms I am not sure about your diagnosis. High uric acid is NOT synonymous with gout; high uric acid is quite common in otherwise normal persons. There is no definite consensus if asymptomatic hyperurcaemia requires any treatment except careful assessment of cardiac status, metabolic syndrome and renal functions and hypertension. For these you will have to be under care of your physician. If your diagnosis has been confirmed by the demonstration of monosodium urate crystals in your joint fluid during acute attacks, then the treatment being given to you appears to be OK but probably the dose of allopurinol is not adequate. To prevent acute attacks of gout, the uric acid level must be brought down to 6 mg/dl by adequate (increased) dose of Allopurinol.

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