What Can I Do To Prevent Gout

Does Avoiding Alcohol Help

There are only a few studies looking into the influence of alcohol on gout. They suggest that people with gout are more likely to have an attack if they have had more than one or two alcoholic drinks in the last 24 hours. One alcoholic drink is equivalent to a small bottle of beer , a small glass of wine or a double schnapps .

There are various reasons why alcohol can trigger gout attacks. On the one hand, it increases uric acid production and reduces the amount of uric acid expelled by the kidneys. On the other, the diuretic effect of alcohol can increase the risk of gout. Uric acid crystals form more readily in joints if the surrounding tissue doesnt contain enough fluid. Beer in particular contains a relatively high amount of purines too, which could also be a factor.

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An estimated 70% of uric acid in the blood is made inside the body. This means that even by following a strict low-purine diet, it will only be possible to lower uric acid levels by 30% at the most. But not all foods are the same: Our bodies absorb purines differently from different foods, so it might not make sense to avoid all foods that contain purines especially if you already eat a balanced diet. There are no high-quality studies on the effectiveness of strict low-purine diets. Besides, they can be quite difficult to stick to.

What Are The Signs And Symptoms Of Gout

Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remissionweeks, months, or yearswithout symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.

Symptoms in the affected joint may include:

• Pain, usually intense

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What Is The Recommended Diet For Gout Sufferers

There are no foods that can completely prevent the symptoms of gout, but a diet low in purines may help to reduce the frequency of attacks. Following a nutritionally balanced, healthy diet that is low in saturated and trans fats and rich in unprocessed foods can help to reduce the risk of gout attacks. Care needs to be taken with certain vegetables such as asparagus, beans, cauliflower, lentils, mushrooms and spinach as these contain medium levels of purines.

While these dont need to be avoided completely, portion size is important a moderate intake should not increase the risks of gout. All other vegetables should be eaten freely. There is also evidence to suggest that a high consumption of low-fat dairy products , limiting sugary drinks and having a daily vitamin C supplement of 500mg may reduce the risk of gout. Speak to your GP before starting new supplements or altering your diet to manage gout.

It is important to note that it is the quantity of purine-rich food consumed that is more important than the purine content in each food. However, if a patient is keen to measure quantities of food, a maximum total daily purine intake of around 200mg is recommended.

What Are The Symptoms Of Gout

Gout flare-ups are extremely unpleasant. The main symptoms are intense and even excruciating joint pain that eventually subsides to discomfort, inflammation and redness. Here are some common symptoms of gout to look out for.

1. Pain in Your Big ToePain in the big toe is the most common symptom of gout. Excess uric acid accumulates in the joint of the big toe, resulting in a very sore toe and the inability to walk. The pain can be so bad that it causes you to limp until it fades after a few hours or days.

2. Tenderness, Swelling and RednessThese three things are all signs and symptoms of gout. After the initial pain of a gout attack has subsided, you will likely experience all these things at one point or another. You may notice them directly on the joint, or in the surrounding areas and even across the body. If you have gout in your big toe, you may notice your entire foot and leg affected by these symptoms.

3. Pain Attacks People with gout experience sudden pain attacks, most often in the toes, feet, legs and lower extremities. These attacks can reverberate throughout your body and make it hard for you to walk or stand. These pain attacks often happen in the middle of the night, making it difficult for you to get back to sleep.

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Who Can Develop Gout

If you eat a lot of foods that are rich in purines, you may be at an increased risk for gout. Some of these foods are salmon, sardines, organ meats, asparagus, mushrooms and herring.

You are more likely to develop gout if youre overweight, drink excessive amounts of alcohol or have high cholesterol, diabetes or high blood pressure. Men develop gout more often than women. Women are more likely to develop gout after menopause. Gout is also hereditary .

Medicines that may cause gout include the following:

• Certain diuretics used to treat high blood pressure
• Niacin
• Aspirin
• Cyclosporine, which is used to prevent the body from rejecting a new organ after transplant surgery
• Some drugs used to treat cancer
• Certain medications used to treat tuberculosis

Home Remedies For Gout

Because of the rise in health care costs and the popular inclination to try natural home remedies to prevent the need for prescription drugs and surgeries, many people are turning toward alternative remedies to treat gout. A number of these home remedies have been acknowledged for treating gout. But, are they effective or not? We will present a number of them below and discuss their likelihood of success.

1. Apple Cider Vinegar

Apple cider vinegar is used to treat gout because its acidity relieves the acute pain associated with gout and other types of arthritis. The vinegar increases the bodys alkalinity and has anti-inflammatory properties. Some individuals also add honey to the apple cider vinegar because of honeys anti-inflammatory properties.

The bad news is that you take the concoction by the spoonful, and apple cider vinegar isnt exactly known for its amazing taste. To be most effective, you need to take up to two tablespoons of apple cider vinegar three times a day. Scientific results are lacking in evidence that apple cider vinegar really works. There was a study in Japan in 2010 which looked at different diets to improve alkalization of urine to increase the removal of uric acid from the body. Apple cider vinegar was in one of the diets, but was not tested alone.

Success stories are hit or miss with apple cider vinegar and the treatment of gout. We give it two stars.

2. Ginger Root

3. Baking Soda

4. Lemon Juice

5. Epsom Salt

6. Cherries

7. Bananas

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What Foods Are High In Purines And Why Should I Avoid Them

In your body, uric acid is made from the breakdown of chemicals called purines, which come from the foods we eat. Some foods have more purines than others. It’s important to eat a balanced diet and include a variety of healthy foods in your diet, but to avoid eating too many foods that are high in purines. Eating these foods can trigger an attack of gout.

Examples of foods that have high purine content are:

• seafood, such as mussels and other shellfish, crab, fish roe, whitebait and trout
• game such as venison and rabbit
• offal such as liver, kidneys, heart and sweetbreads
• meat and yeast extracts such as Marmite, Bovril and commercial gravy.

A number of vegetables such as such as asparagus, mushrooms, cauliflower and spinach are also rich in purines, but these appear less likely to trigger gout than shellfish and game meats.Most people taking medicines to reduce uric acid levels find they can still eat purine-rich foods without attacks of gout by being careful with how much they eat.

What Else Should I Ask My Healthcare Provider About Gout

Consider asking your healthcare provider:

• What is causing the gout?
• Do I have any joint damage?
• What can I do to prevent future attacks?
• Can any gout medications help me?
• How long will I need to take gout medications?

A note from Cleveland Clinic

Gout is a painful form of arthritis. Extra uric acid in your body creates sharp crystals in the joints, leading to swelling and extreme tenderness. Gout usually starts in the big toe but can affect other joints. Gout is a treatable condition, and the uric acid level can be decreased by medication and lifestyle changes. Talk to your healthcare provider about medications that can reduce uric acid levels. They can also discuss changes you can make to your diet and lifestyle to prevent and reduce gout attacks.

Last reviewed by a Cleveland Clinic medical professional on 11/15/2020.

References

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Hot And Cold Compresses

Switching between a hot compress for three minutes and a cold compress for 30 seconds on the affected area can help reduce pain and swelling that occurs during a gout attack.

In most people, a first acute gout attack comes without warning, and there arent any other symptoms of high uric acid. Prevention efforts for gout are focused on preventing future attacks or lessening their severity.

What If I Dont Get Treatment

If you dont get treatment, a gout attack can last for days or even weeks. If you keep having more attacks, more joints may become affected and the attacks will last longer.

If you have gout attacks for many years, you may develop tophi . These are uric acid crystals that form lumps under the skin. Tophi usually form on the toes, fingers, hands and elbows. You may also develop kidney disease or kidney stones from uric acid crystals that collect in the urinary tract. Over time, even the bone around a joint may be destroyed by gout.

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What You Need To Avoid Consuming To Help Tame Gout

7) Alcohol and Gout Do Not Go Together

Okay, this can really suck, but unfortunately, alcohol can worsen the symptoms of gout by increasing the level of uric acid in your body. Beer, in particular, is high in purines, which the body breaks down into uric acid. If you suffer from gout, it is essential that you avoid beer, and other alcoholic beverages, which we know is especially hard during the holidays.

8) Seafood and Meat Are Healthy for Some, but Not if You Have Gout.

Consumption of seafood and meat puts you at greater risk of developing gout or contributes to its severity. Red meat reduces the excretion of uric acid by the kidneys, thus increasing its level in the body.

While seafood is rich in omega-3 fatty acid, which is essential for a healthy heart, it also is high in purines. Individuals suffering from gout must avoid seafood. It can be replaced with soy and walnuts, which are also good sources of omega-3 fatty acids. Not all seafood is necessarily a problem if eaten in moderation, though certain seafood should be avoided whenever possible.

Youll want to pass on meats such as liver, kidney, and sweetbreads, which are high in purines and contribute to increased blood levels of uric acid. Stay away from seafood that is high in purines such as anchovies, herring, sardines, mussels, scallops, trout, haddock, mackerel, and tuna .

9) Alcohol and Seafood or Meat Together, a Double Whammy

How Gout Treatment Prevents Disease Progression

Fortunately, in part because of its long history, gout is one of the most well-understood and most medically treatable forms of arthritis. The progression of gout is preventable by starting appropriate treatment as soon as possible, Dr. Meysami says. Uric acid-lowering agents, such as allopurinol , can decrease uric acid levels and prevent gout attacks.

During flares, gout patients can take NSAIDs or corticosteroids to calm the attack. Local steroid injections may also be given. A medication called colchicine is also often used to stop acute attacks, but its given now at a much lower dose in order to avoid side effects, including stomach upset.

After a flare ends, long-term treatment can begin. Almost all people with gout will need medication to control their urate, Dr. Fields says. To get a good outcome, people with gout need to get their blood urate level below 6.0 mg/dl and keep it there. By doing that, the body will gradually pull the urate crystals out of their joints, and the flares can stop. Tophi will also gradually disappear.

Medications called xanthine oxidase inhibitors limit the amount of uric acid your body produces. These include allopurinol and febuxostat . Colchicine, which decreases the inflammatory response to gout, may also be given along with allopurinol at the start of long-term treatment after a flare subsides.

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What If Changing Your Diet Isnt Enough

Some people manage to get their uric acid levels under control by changing their diet. But many people will need to take medication. Most of the uric acid in your body is made inside your body, so changing your diet only has a limited effect. Treatment with medication is considered if the gout attacks are frequent or if you have complications like kidney stones or tophi.

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If You Are Having Repeated Attacks See Your Doctor

Some patients can go a long time between attacks. In fact, for 62 percent of patients the next attack will be more than a year away, and some won’t have another attack in the next 10 years. However, if you begin to have more frequent attacks, talk to your doctor about escalating treatment. People think its normal to have flares every now and then, but its not. The gout can be doing damage to your joints. It means you still have too much uric acid, says Shakouri. In particular, ask about allpurinol. It wont help with an acute attack but will help prevent future attacks by reducing uric acid production.

Drink Fluids But Avoid Alcohol

One way to prevent a new gout attack is to consume 16 cups of fluids per a single day. I actually use this method for some time and the results are impressive. The gout attacks are rarer than ever and they are less painful than ever before. The main reason why this method is so effective is the fact it reduces the levels of uric acids. It also keeps you safe from kidney stones, which is an issue commonly related to the high levels of uric acid.

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When I said fluids, I meant water or natural juices. Alcohol must be avoided at all cost. It is rich in purines which will increase the levels of uric acid, so they will also be responsible for new gout attacks. Keep in mind that this refers to all types of alcohol.

Besides alcohol, avoid shellfish, processed food, and red meat. They are also rich in purines, the ingredient you must avoid at all cost.

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What Role Do Purines Play

An estimated 70% of uric acid in the blood is made inside the body. This means that even by following a strict low-purine diet, it will only be possible to lower uric acid levels by 30% at the most. But not all foods are the same: Our bodies absorb purines differently from different foods, so it might not make sense to avoid all foods that contain purines especially if you already eat a balanced diet. There are no high-quality studies on the effectiveness of strict low-purine diets. Besides, they can be quite difficult to stick to.

What Should I Do If I Have A Gout Attack

The sooner you get treatment, the sooner the pain will go away. Your doctor can prescribe medicine to stop the joint swelling and pain.

You should rest in bed. Putting a hot pad or an ice pack on the joint may ease the pain. Keeping the weight of clothes or bed covers off the joint can also help.

With treatment, your gout attack should go away in a few days. You may never have another attack.

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