Hi there! Thank you for your question. Allow to explain about the management of gout briefly. There are 2 medical approaches for gout. One is for acute flares and the other one is for long-term control of the diseases itself.

There are 3 medication groups for acute flares. First line is NSAIDs (e.g. diclofenac). May need concomitant gastro-protection (drugs to protect the stomach lining). SEs: GI upset, GI bleed/perforation/ulcer, nephrotoxicity. Second line is colchicine. Use when NSAIDs are contraindicated, e.g. active gastritis, renal disease. SEs: GI upset especially diarrhea, nephrotoxicity, myelosuppression.

Third line is glucocorticoids; e.g., prednisolone. Can be oral, or by injection into joint or soft tissues. SEs: dose and duration dependent, worsening of diabetic control most immediate issue often

Long-term Urate Lowering Therapy (ULT) is the collective term for the long term management. ULT when there is recurrent acute attacks or disabling attacks occur. There are 4 examples of Long-term Urate Lowering Therapy (ULT)
• Allopurinol (Xanthine oxidase inhibitor). It blocks urate production. SEs: rarely severe allergies Stevens-Johnson syndrome, rash, fever, leukopenia. The stomach bloating that you experience is probably due to water retention which is a rare side effect (SE).
• Febuxostat (A non-purine selective inhibitor of xanthine oxidase). Use if intolerant to allopurinol. SEs: joint pain/swelling/stiffness, GI upset, rash.
• Uricosuric drugs e.g. probenecid are less commonly used. It is not used in patients who are overproducers of uric acid, have a history of urinary tract stones and kidney failure. SEs: GI upset, polyuria, headache.
• Raspuricase. It is arely used. It is given by IV; rash and allergy relatively common.
Since you are intolerant to Allopurinol, I suggest you explain this side effect that you are experiencing to your doctor. Get a change of medication for better control of your gout.

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