Getting rid of gout requires two things: stopping the painful flare you’re dealing with right now, and lowering your uric acid levels over time so flares stop coming back. Gout happens when uric acid builds up in your blood, forms sharp crystals in a joint, and triggers intense inflammation. The good news is that gout is one of the most treatable forms of arthritis, with clear targets and proven strategies for both immediate relief and long-term control.
How to Treat an Active Flare
The single most important factor in treating a gout attack is speed. Starting treatment within 24 hours of the first twinge gives you the best chance of a rapid, complete resolution. Waiting longer than 72 to 96 hours makes some medications significantly less effective.
Three types of medication are commonly used for acute flares. NSAIDs (like ibuprofen or naproxen) reduce inflammation and pain quickly. Colchicine, a drug specific to gout, works best when taken at the very first sign of an attack and should be stopped once pain improves or if you develop nausea or diarrhea. Corticosteroids are an option when NSAIDs or colchicine aren’t suitable, particularly for people with kidney problems. Your doctor will help you choose based on your health history, but the principle is the same for all three: act fast.
While you wait for medication to kick in, icing the joint for 20 minutes at a time and elevating it can take the edge off. Rest the affected joint as much as possible. Most treated flares resolve within a few days to a week, though some linger longer.
Foods and Drinks That Trigger Gout
Your body produces uric acid when it breaks down compounds called purines, which are found in certain foods. Cutting back on high-purine foods won’t cure gout on its own, but it removes fuel from the fire. The Cleveland Clinic identifies these as the top dietary triggers:
- Organ meats: liver, kidneys, sweetbreads, and tripe
- Certain seafood: herring, scallops, mussels, codfish, tuna, trout, and haddock
- Red and game meats: beef, lamb, pork, bacon, venison, veal, and goose
- Turkey: especially processed deli turkey
- Sugary drinks and sweets: table sugar is half fructose, which breaks down directly into uric acid
- High-fructose corn syrup: a concentrated source of fructose found in sodas and many packaged foods
- Gravy and meat sauces
- Yeast and yeast extract
- Alcohol: even low-purine drinks are a problem because alcohol prevents your kidneys from clearing uric acid, pulling it back into your body where it accumulates
Beer is a double hit because it’s both alcoholic and high in purines. Wine appears to be somewhat less risky, but no alcohol is truly safe during active gout. Among non-alcoholic drinks, sodas sweetened with high-fructose corn syrup are consistently linked to higher uric acid levels.
Why Hydration Matters
Water helps your kidneys flush excess uric acid out through urine. Research presented at the American College of Rheumatology supports the physiology that increased water intake improves uric acid excretion, though the exact amount needed hasn’t been pinned down in a clinical trial. A reasonable goal is eight or more glasses per day, with extra during flares or hot weather. Dehydration concentrates uric acid in your blood and can directly trigger an attack, which is one reason gout flares often strike overnight or after heavy drinking.
Cherries and Other Home Remedies
Tart cherries have the strongest evidence of any home remedy for gout. A study of 633 gout sufferers found that cherry consumption was associated with a 35% lower risk of flares. Smaller studies have shown that cherries and cherry products lower uric acid levels after consumption, and a placebo-controlled trial found that daily cherry juice concentrate reduced uric acid in adults who were overweight. The active compounds are likely anthocyanins and other plant chemicals that both lower uric acid and reduce inflammation.
You can get cherries in several forms: fresh tart cherries, tart cherry juice concentrate, or cherry extract supplements. There’s no established “dose,” but most studies used the equivalent of about 10 to 12 cherries or one to two tablespoons of concentrate daily.
Vitamin C supplements have shown modest uric acid-lowering effects in some research, though the reduction is usually small compared to medication. Coffee (both regular and decaf) is associated with lower uric acid levels in population studies. Low-fat dairy also appears protective. None of these replace medical treatment for frequent flares, but they can complement it.
Long-Term Uric Acid Control
Diet and lifestyle changes alone are often not enough to keep uric acid below the threshold where crystals form. For people with recurring gout, the real game-changer is urate-lowering therapy: daily medication that reduces how much uric acid your body produces. The American College of Rheumatology strongly recommends this approach for anyone who experiences two or more flares per year, has visible uric acid deposits (called tophi) under the skin, or shows joint damage on imaging.
Even if you’ve had only one flare, urate-lowering therapy may be recommended if you also have moderate-to-severe kidney disease, very high uric acid levels (above 9 mg/dL), or kidney stones.
The two most common medications work by blocking the enzyme that converts purines into uric acid. With prolonged use, they don’t just prevent new crystals from forming. They actually dissolve existing crystal deposits, including tophi, reversing damage that has already occurred. The goal is to get your blood uric acid level below 6 mg/dL and keep it there. This is the concentration below which crystals can’t form and existing ones gradually dissolve.
What to Expect When Starting Treatment
One frustrating reality: when you first start urate-lowering medication, you may temporarily get more flares, not fewer. As uric acid levels drop, existing crystal deposits shift and break apart, which can trigger inflammation. This is not a sign that the medication isn’t working. It’s actually a sign that it is.
To prevent these early flares, the ACR recommends continuing an anti-inflammatory medication (typically a low-dose NSAID or colchicine) for three to six months after starting urate-lowering therapy. Your dose will be gradually increased over weeks to months, guided by blood tests, until your uric acid hits the target of below 6 mg/dL. This “treat-to-target” approach, similar to how blood pressure or cholesterol is managed, produces far better outcomes than simply taking a fixed dose and hoping for the best.
One important note: you can start urate-lowering therapy even during an active flare. Older advice suggested waiting until the flare resolved, but current guidelines say starting during a flare doesn’t worsen or prolong symptoms, as long as anti-inflammatory treatment is also provided.
Putting It All Together
Getting rid of gout is a layered process. For immediate relief, early treatment of flares with anti-inflammatory medication is essential. For prevention, the combination of dietary changes, staying well hydrated, and, for most people with recurring attacks, daily urate-lowering medication is what actually makes gout go away long-term. The target is clear: uric acid below 6 mg/dL. Once you reach and maintain that number, flares become rare, tophi shrink, and for many people, gout effectively becomes a thing of the past.