Suffered gout attacks for the past 4 years and the last bad attack was the big toe again on the right foot so trip to the doctor about five weeks ago and since then I have been taking alluprinol 100mg, however this trigger a second attack in the left foot and the right ankle.
The left foot has cleared but I still have pain in the right ankle that just refuses to go away, can an attack in the ankle remain for so long? Do I stop the alluprinol and see it if clears before restarting it.

Geoff
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First Helper Geoffm1066
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replied July 31st, 2013
Geoff,
The problem with stopping allopurinol is that the act of stopping it can trigger another gout attack. My physician (and I) decided that colchicine was a far better approach. You can take the colchicine at the first sign of an attack (and you get to know the warning twinges well if you pay attention). I have finally settled on two 6mg doses of colchicine, 800 to 1000mg of ibuprofen, and a quarter teaspoon of baking soda at the first sign of a gout attack anywhere, followed by another round in four to six hours, but in follow-on doses, use one 6mg colchicine pill. After as few as one and as many as three of those doses, the gout is gone. Unfortunately, the result of taking colchicine is normally an emptying of one’s lower gastrointestinal system in a less than pleasant manner. From my perspective, that is a low price to put a stop to the intense pain of a gout attack.

Yes, by the way, gout can move into one’s ankle and camp out there. It can occur in any joint, and occasionally in any joint or pretty much anywhere it wants. The initial attacks are almost always in the lower extremities, but particularly in obese persons they can then manifest pretty much anywhere. Weight loss, a fair bit of exercise, ample water consumption, and a reduction in carbohydrates often reduces the incidence and severity of the attacks.

As far as I know there are no clinical studies to back this up, but I read about the preventative measure of a quarter teaspoon of baking soda per day and more often during an attack, and it seems to have further reduced the severity and frequency of my attacks.

Fair warning here: Colchicine is a poison. It is used in chemotherapy, and is effective in blocking a portion of protein metabolism, which is why it works so well against gout. To the best of my knowledge there is no antidote for a severe colchicine overdose. In fact, it was a fairly popular way to get rid of one’s enemies during the Roman empire. Use with care and keep out of the reach of children.
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Users who thank Loden for this post: Geoffm1066 

replied August 12th, 2013
Loden
Hi, I'm grateful for the reply since I first posted the ankle has cleared of gout for the first time in four months I can walk pain free so I'm going to continue with the Allopurinol and see what the future brings. I've cut out the beer and a lot of food stuffs high in purines so onwards & upwards.

Geoff
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