Most patients improve quickly with a taper-down dosing of Indocin, but the reason for the attack, a high blood-uric-acid level, must be dealt with to prevent recurrence of symptoms and eventual joint destruction. This intervention usually takes the form of medication to improve the kidneys’ capacity to excrete uric acid more efficiently. Reducing the patient’s intake of foods that break down into purines (the precursor of uric acid) is also helpful. Avoiding shellfish, which we find to be most frequently the culprit, is recommended.