Gout Treatment in Australia: Attacks & Prevention

What Is Gout?

Gout is a common form of inflammatory arthritis. It happens when uric acid (urate) builds up in the blood and forms tiny, needle-sharp crystals inside a joint. Those crystals trigger sudden, intense inflammation — the joint becomes hot, red, swollen and extremely painful, often within a few hours. Roughly half of all first attacks strike the joint at the base of the big toe, a pattern doctors call podagra, though gout can also affect the ankle, knee, midfoot, wrist or fingers.

Uric acid is a waste product made when your body breaks down substances called purines, which come both from your own cells and from certain foods and drinks. Most people clear urate through their kidneys without any trouble. Gout develops when the body either makes too much urate or cannot clear enough of it, so levels rise. According to the Australian Institute of Health and Welfare, gout affects a substantial number of Australians and is more common in men and in older age groups.

How to Relieve an Acute Gout Attack

The golden rule is to start treatment as early as possible — ideally within the first 24 hours of a flare beginning. The sooner you settle the inflammation, the shorter and milder the attack tends to be. Alongside medicine, simple self-care makes a real difference: rest the joint, apply an ice pack wrapped in a cloth for 15 to 20 minutes at a time, and keep the limb elevated. Drink plenty of water and avoid alcohol while the joint is inflamed.

Anti-inflammatories (NSAIDs)

Non-steroidal anti-inflammatory drugs (NSAIDs) are a first-line treatment for an acute attack. They work by reducing the inflammation that urate crystals set off. Ibuprofen (for example Nurofen) is available over the counter in Australian pharmacies and supermarkets and can help a milder flare. Stronger NSAIDs used for gout, such as naproxen and indomethacin, are typically prescribed by a GP at anti-inflammatory doses. NSAIDs are not suitable for everyone — they can be a problem if you have kidney disease, stomach ulcers, heart failure or are on blood thinners — so check with your pharmacist before starting one.

Colchicine and steroids (GP-directed)

If NSAIDs are unsuitable or not tolerated, your GP may prescribe colchicine or a short course of corticosteroids. Colchicine is a prescription-only anti-inflammatory used specifically for gout; Australian guidance recommends a low-dose regimen (for example 1 mg straight away, then 500 micrograms an hour later, up to a maximum of 1.5 mg per course), as higher doses cause more side effects such as diarrhoea and nausea. Corticosteroids — oral prednisolone tablets or a steroid injection into the joint — are another option, particularly for people who cannot take NSAIDs or colchicine. Both are GP decisions, not over-the-counter choices.

Preventing Future Attacks: Urate-Lowering Therapy

If you have recurrent attacks (generally two or more a year), visible urate lumps under the skin (tophi), kidney stones or kidney disease, your GP will usually recommend long-term urate-lowering therapy. The goal is to bring your serum urate down below a target level — commonly under 0.36 mmol/L — so existing crystals dissolve and no new ones form. This is a genuine long-term strategy that can control gout when taken consistently, not a quick fix.

Allopurinol is the most widely used urate-lowering medicine in Australia. It reduces how much urate your body makes and is started at a low dose (typically 50 to 100 mg daily), then increased gradually every few weeks until you reach your target level. Febuxostat is an alternative when allopurinol is not tolerated or suitable. Two points trip people up: urate-lowering medicines can briefly trigger a flare when you first start them (so your GP may add short-term cover), and you should not stop them during an attack. All of these medicines are prescription-only and require a diagnosis and blood tests first.

Diet and Lifestyle Triggers

Diet alone rarely controls gout once it is established, but the right changes can reduce how often attacks happen and support your medicines. The biggest levers are alcohol, sugary drinks and body weight. Beer is a particular problem because it is both high in purines and interferes with urate clearance. Sugary drinks and foods high in fructose raise urate too. Dehydration can tip a susceptible joint into a flare, so staying well hydrated genuinely helps.

A few extras are worth knowing. Low-fat dairy is linked with lower urate and may be mildly protective. Vitamin C and coffee have some association with lower urate levels, though neither is a treatment on its own. Cherries and cherry juice are a popular home remedy with limited but promising evidence for reducing flares — reasonable to try, but not a substitute for prescribed urate-lowering therapy. Ignore any product promising a rapid gout cure; there is no verified overnight fix, and lasting control comes from consistent treatment and sensible habits.

When to See a GP

Gout is very treatable, but it needs a proper diagnosis. See your GP in the following situations rather than trying to manage everything yourself.

• radio_button_uncheckedYour first suspected attack — a diagnosis (often confirmed with a blood test or joint fluid sample) rules out other causes and sets up the right treatment.
• radio_button_uncheckedRecurrent attacks — two or more flares a year is the usual trigger to discuss long-term urate-lowering therapy.
• radio_button_uncheckedAttacks that are not settling with over-the-counter measures within a day or two, or that keep coming back.
• radio_button_uncheckedYou want to start or adjust preventive medicine such as allopurinol — this is always a GP decision with monitoring.
• radio_button_uncheckedYou have kidney disease, stomach ulcers, heart problems or take other medicines — these affect which gout treatments are safe for you.
• radio_button_uncheckedAny hot, painful joint with fever or feeling very unwell — seek urgent care to rule out a joint infection.

FAQ

What are the 5 worst foods to eat if you have gout?

The foods most likely to trigger gout are high in purines or fructose. The usual offenders are: organ meats such as liver and kidney; game and red meats in large portions; shellfish and oily fish like sardines, anchovies and mussels; sugary soft drinks and juices high in fructose; and beer, which is both purine-rich and reduces urate clearance. You do not have to eliminate every one, but cutting back on these — especially alcohol and sugary drinks — can help reduce how often you flare.

What is the quickest way to get rid of gout?

The fastest way to settle an acute attack is to start an anti-inflammatory as soon as the flare begins, then rest, ice and elevate the joint and keep up your fluids. An over-the-counter NSAID such as ibuprofen can help a mild attack, while a GP can prescribe a stronger NSAID, colchicine or a short steroid course for more severe flares. There is no verified overnight cure — most attacks ease over several days to a couple of weeks — and preventing the next one requires longer-term treatment.

What can I drink to flush out gout?

Water is the simplest and most useful drink during a flare: staying well hydrated supports your kidneys in clearing urate and helps you avoid the dehydration that can trigger attacks. Low-fat milk and, for some people, coffee are associated with lower urate levels over time. What to avoid is just as important — beer, spirits and sugary soft drinks all raise urate or worsen flares. No drink literally flushes crystals out on demand, so treat hydration as support, not a cure.

Can you get anything from a chemist for gout?

Yes — for a mild attack, an over-the-counter anti-inflammatory such as ibuprofen (for example Nurofen) is available from Australian pharmacies and supermarkets and can help relieve pain and swelling. Ask the pharmacist first, as NSAIDs are not safe for everyone. However, the medicines that control gout properly — stronger prescription NSAIDs, colchicine, corticosteroids and urate-lowering therapy like allopurinol — are prescription-only and need a GP. A pharmacist can advise on short-term relief and point you to a GP for a proper plan.

What flares up gout the most?

Common triggers include drinking alcohol (especially beer), sugary drinks and binge eating of purine-rich foods, along with dehydration, crash dieting, injury to a joint and certain medicines such as some diuretics. Starting or changing a urate-lowering medicine can also set off a flare in the early weeks, which is why doctors introduce it slowly and sometimes add short-term cover. Identifying and reducing your personal triggers, alongside any prescribed treatment, is a key part of managing gout.

Does allopurinol help during a gout attack?

Allopurinol is a preventive medicine, not a pain reliever, so it will not settle an attack that is already happening. Importantly, if you are already taking allopurinol you should not stop it during a flare — stopping and starting can actually make gout worse. Manage the attack itself with an anti-inflammatory and self-care, and keep taking your allopurinol as prescribed. If you are not yet on urate-lowering therapy, your GP will usually wait until the acute attack has settled before starting it.