I have had it for about 8 years and attacks used to come in groups, sometimes 1 or 2 per week. poor circulation I believe has something to do with some of the build ups, I take Flubuprofen when an attak occurs and it it works well. My doctor mentioned that there are other medications that were mentioned in other posts , but with some medications you have to take it everyday to keep the gout away. If you only suffer occasioanally. I think diet can make it either better or worse as well. One other note, is that since I was put on metformin for diabetes my gout attacks are almost non existent.