Gout in Bangkok — looking for "quick fix" (does not have to be easy!)

[Richard Cook]

Hi folks, I’m new to all this gout stuff and am having a rather unpleasant time trying to quickly eliminate my first gout attack while here on vacation in Bangkok.

I’ve been given some colchicine 0.6 mg tablets to be taken twice per day. Also arcoxia 120 mg for inflammation. Still the pain persists. I don’t think my attack is the worst ever by any means, but it’s definitely hampering my ability to explore Bangkok. A cane is helping but still I’m sore when I go to sleep and when I wake up, with a period of relative comfort during the daylight hours.

What’s the most aggressive approach I can take to get quick relief ASAP? I can muster the discipline to do anything I need.

I’ve stopped drinking, is that necessary?

How do I get enough protein in my diet if I’m supposed to avoid chicken, meat and fish?

Thanks for any help!

[Keith Taylor]

Hi Richard,

It’s easy:
1. One colchicine at bedtime.
2. If any gout symptoms next morning: second colchicine (max 2 per day) plus 120mg Arcoxia (Etoricoxib).
3. If pain persists: Max strength Tylenol (acetaminophen / paracetamol) every 4 hours.

That should keep you mobile, so gentle exercise will resolve pain even quicker.

When you say “stopped drinking,” I assume that means alcohol. When I suffered gout pain, I always found it easier to tolerate and quicker to resolve with a few pints. Everyone is different, so be guided by your own experience. Don’t be led by a single day. You have to repeat drinking days and none drinking days. You have to record your symptoms in a diary. Whichever you choose, always ensure adequate hydration. That means sufficient fluid to ensure urine is pale straw color.

It’s a bit late for avoiding flesh purines now. Gout attacks come from uric acid crystals that started forming many months ago. As soon as your vacation is over, get uric acid control (best to ask in my new gout forum). Free Fatty Acids (FFAs) are thought to trigger attacks, but the science is too new to make specific diet recommendations. Make sure 80% of your food is fruit and veg. Low fat dairy helps, but as I say, probably too late for current attack.

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