NICE Gout Guidelines – Quick Guide

If you’ve been told you have gout or you suspect it, the NICE (National Institute for Health and Care Excellence) guidelines are the go‑to resource in the UK. They spell out which medicines work best, when to start treatment, and how lifestyle changes can keep flare‑ups down. This page breaks the advice into bite‑size pieces so you can understand it without digging through long PDFs.

How NICE Defines Gout and Who Gets It

NICE says gout is a form of arthritis caused by high levels of uric acid that form crystals in joints. It usually shows up as sudden, painful swelling in the big toe, but it can hit the ankle, knee or wrist too. The guidelines point out that men over 40 and post‑menopausal women are most at risk, especially if they drink a lot of alcohol, eat too much red meat, or have conditions like high blood pressure or kidney disease. Knowing your risk factors helps your doctor decide when to test your blood uric‑acid level.

Key Treatment Steps Recommended by NICE

The first step is to start a low‑dose colchicine or NSAID (like ibuprofen) as soon as a flare begins. This helps control pain and swelling fast. If you have frequent attacks, NICE recommends moving to a uric‑acid‑lowering drug such as allopurinol or febuxostat. The guidelines stress that you should keep the dose low at first, then increase slowly while checking your uric‑acid levels every few months. The goal is to keep the level below 300 µmol/L (or 6 mg/dL) to prevent new crystals from forming.

Beyond medicines, NICE highlights lifestyle tweaks. Cutting down on sugary drinks, beer, and foods high in purines (like organ meat and some seafood) can make a big difference. Staying hydrated – aim for at least 2 litres of water a day – helps flush uric acid out. Regular exercise is encouraged, but avoid intense activity during a flare because it can worsen pain.

Another practical tip from NICE is to keep a gout diary. Write down what you ate, drinks you had, and any pain you felt. Over time you’ll see patterns and can share them with your GP to fine‑tune treatment. The guidelines also say you should get a full check‑up for related health issues – blood pressure, cholesterol, and kidney function – since they often go hand‑in‑hand with gout.

Finally, the guidelines remind you that treatment isn’t a one‑off thing. You’ll need regular follow‑ups to adjust medication doses and monitor side effects. If you ever feel side effects like rash, nausea, or severe stomach pain, call your doctor straight away. Staying on top of your plan, sticking to the diet changes, and keeping open communication with your health team are the fastest routes to fewer flare‑ups and better joint health.