What is GOUT?
Gout is a type of arthritis that results from the buildup of uric acid crystals in the joints, causing pain, inflammation, and discomfort.
WHAT CAUSES GOUT?
Diet
A diet rich in purines can increase the risk of gout. Purines are substances found in certain foods and drinks, such as red meat, organ meats (liver, kidney), seafood (especially shellfish), and sugary beverages, which can lead to higher uric acid levels.
Alcohol
Excessive alcohol consumption, particularly beer and spirits, has been linked to gout. Alcohol can both increase the production of uric acid and reduce its excretion by the kidneys.
Obesity
Excess body fat can lead to higher levels of uric acid and reduce the kidneys’ ability to eliminate it effectively.
Genetics
Some people have a genetic predisposition to gout. A family history of gout can increase the likelihood of developing the condition.
Medical Conditions
Certain medical conditions can contribute to gout. These include high blood pressure (hypertension), kidney disease, metabolic syndrome, and diabetes.
Medications
Examples include diuretics (water pills), aspirin, and certain immunosuppressant drugs.
Dehydration
Insufficient fluid intake or chronic dehydration can reduce the kidneys’ ability to excrete uric acid, leading to higher levels in the bloodstream.
Stress or Trauma
Physical or emotional stress and joint injuries can sometimes trigger gout attacks in individuals predisposed to the condition.
If you suspect you have gout or have experienced gout attacks, it’s essential to consult a healthcare professional for a proper diagnosis and management plan. Treatment for gout typically involves medications to manage pain and inflammation, as well as lifestyle modifications to reduce uric acid levels and prevent future attacks.
TREATMENT
DIET
Top of Form
Dietary changes can play a significant role in managing gout and reducing the frequency and severity of gout attacks.
Low-Purine Foods
Uric acid is formed when the body breaks down purines found in certain foods. To reduce uric acid levels, focus on consuming foods that are low in purines. These include:
- Fruits, particularly cherries, strawberries, and blueberries.
- Leafy green vegetables, broccoli and bell peppers.
- Entire grains, similar to brown rice, entire wheat bread, and oats
- Low-fat dairy products.
Moderate Protein Intake
Protein is vital for the body, but it’s important to choose lean sources to help manage gout. Red meat, particularly organ meats like liver, is high in purines and should be limited to reduce the risk of gout attacks. Use proteins like poultry and fish.
Hydration
Drinking plenty of water is crucial for gout. Adequate hydration helps dilute uric acid in the body and promotes its elimination through urine. Plan to drink a lot of water over the course of the day to remain very much hydrated.
Cherries
Cherries, whether eaten fresh, in the form of cherry juice, or as a cherry extract supplement, have been linked to reduced gout attacks. They contain compounds that may help lower uric acid levels and reduce inflammation.
Vitamin C
Foods rich in vitamin C can potentially assist in lowering uric acid levels. Citrus fruits like oranges and grapefruits, as well as strawberries and kiwi, are excellent choices to include in your diet.
Coffee
Some studies suggest that moderate coffee consumption may be associated with a reduced risk of gout attacks. However, it’s important not to overindulge
Low-Fat Dairy
Low-fat dairy products like milk, yogurt, and cheese are not only a good source of protein but may also have a protective effect against gout. They contain certain compounds that can help lower uric acid levels.
Whole Grains
Whole grains like whole wheat bread, brown rice, and oats are rich in complex carbohydrates. These grains can help with weight management, which is important for gout management, as excess body weight can exacerbate gout symptoms.
Limit Alcohol
Alcohol, especially beer and spirits, can lead to an increase in uric acid levels and trigger gout attacks. If you choose to consume alcohol, do so in moderation and consider avoiding high-purine alcoholic beverages.
Avoid High-Purine Foods
High-purine foods, such as red meat, organ meats, seafood like anchovies and sardines, and certain gravies or broths, should be consumed sparingly or avoided entirely. These foods are known to contribute to elevated uric acid levels and can increase the risk of gout attacks.
EXERCISE
Exercise can be beneficial for individuals with gout as it can help improve joint function, maintain a healthy weight, and promote overall well-being. However, it’s essential to choose exercises that are gentle on the joints and reduce the risk of triggering gout attacks. Here are some suitable exercises for individuals with gout:
Low-Impact Cardiovascular Exercises:
- Walking: Walking is a low-impact exercise that can improve cardiovascular fitness without putting excessive stress on the joints.
- Swimming or Water Aerobics: Water provides buoyancy and support, making aquatic exercises ideal for those with gout.
- Cycling: Riding a stationary or regular bicycle can be a good option, especially on flat terrain or using a stationary bike.
Range-of-Motion Exercises:
- Gentle stretching exercises can help maintain joint flexibility. Perform these stretches regularly to keep the affected joints mobile.
- Yoga and tai chi are low-impact activities that can improve flexibility, balance, and joint mobility.
Strength Training:
- Strength training with light weights or resistance bands can help maintain muscle mass and support joint stability. Focus on strengthening the muscles around the affected joint to reduce stress on the joint itself.
- Perform strength training exercises with proper form to avoid straining the joints.
Breathing and Relaxation Exercises:
- Deep breathing exercises and relaxation techniques can help manage stress, which is a potential trigger for gout attacks.
Foot Care:
- For gout affecting the feet, exercises that involve gentle foot stretches and toe movements can help maintain foot flexibility and reduce the risk of stiffness.
While practice is helpful, avoiding potential risk is essential:
- Stay well-hydrated to help prevent dehydration, which can trigger gout attacks.
- Wear appropriate footwear with good arch support and cushioning, especially if gout affects your feet.
- Listen to your body. If you experience pain or discomfort during exercise, stop and rest.
- Consult your healthcare provider before starting a new exercise program, especially if you have severe gout or other underlying medical conditions.
Remember that the choice of exercises should be tailored to your individual health status and gout severity. It’s advisable to work with a healthcare professional or physical therapist to develop a personalized exercise plan that meets your needs and minimizes the risk of gout flares.
MEDICATION
Here are common medications used in the management of gout:
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):
- NSAIDs such as ibuprofen (Advil, Motrin), naproxen (Aleve), and indomethacin (Indocin) are often prescribed to reduce pain and inflammation during gout attacks.
- They can provide quick relief but should be used with caution, especially in individuals with a history of gastrointestinal issues or cardiovascular problems.
Colchicine:
- Colchicine is an anti-inflammatory medication specifically used to treat and prevent gout flares. It can be effective when taken at the first sign of an attack.
- It may cause gastrointestinal side effects and should be used with care.
Corticosteroids:
- Oral or injected corticosteroids like prednisone can help reduce inflammation and pain during severe gout attacks.
- They are often prescribed when NSAIDs or colchicine are not suitable or effective.
Xanthine Oxidase Inhibitors:
- Medications like allopurinol (Zyloprim) and febuxostat (Uloric) are used to lower uric acid levels over time.
- These drugs work by inhibiting the production of uric acid in the body and are typically taken daily as a preventive measure.
- Allopurinol can sometimes cause skin rashes or other side effects and may require dose adjustments.
Uricosuric Agents:
- Probenecid is an example of a uricosuric medication that helps the kidneys excrete more uric acid, thereby reducing its concentration in the blood.
- Uricosuric agents are considered in cases where xanthine oxidase inhibitors are not effective or tolerated.
Pegloticase (Krystexxa):
- Pegloticase is a medication for individuals with severe, refractory gout. It is administered intravenously and works by breaking down uric acid into a more soluble form that can be eliminated by the body. This medication is typically reserved for cases where other treatments have not been successful.
It’s important to note that the choice of medication and treatment plan should be tailored to the individual’s specific condition, medical history, and the severity of gout. Additionally, lifestyle modifications, such as dietary changes to reduce purine intake and maintaining a healthy weight, are often recommended in conjunction with medication to manage gout effectively.
Consult with a healthcare provider, preferably a rheumatologist or an experienced primary care physician, to determine the most appropriate medication and treatment plan for your particular situation. Long-term management and monitoring of uric acid levels are essential to prevent future gout attacks and complications.