Vernilyn Juan, M.D.
Gout is a joint disease that causes extreme pain and swelling. It used to be associated with kings who overindulged in rich food and wine. However, anyone can get gout. It is often linked with obesity, high blood pressure, high levels of lipids in the blood (hyperlipidemia) and diabetes. But avoiding gout can be as easy as changing your diet.
What causes gout?
Gout is caused by monosodium urate crystal deposits in the joints. This is due to an excess of uric acid in the body. Excess uric acid can be caused by multiple things such as the body making too much uric acid or eating food high in purines. Purine is a specific chemical compound found in food that breaks down into uric acid.
Foods high in purines:
- High fructose drinks
- Red and processed meats, such as game meats, kidney, brains and liver
- Dried beans and dried peas
- Seafood, such as anchovies, herring, scallops, sardines and mackerel
Gout attacks can also be triggered by:
- Emotional stress
- Minor surgery
How can you reduce your risk of gout?
- Drink plenty of water
- Consume high amounts of fruits, vegetables, legumes, nuts, low-dairy products and whole grains, such as cherries. Cherries are proven to lower uric acid for people with gout.
- Eat food low in salt and fat
- Lose excess weight
- Exercise regularly
- Make sure any health conditions, diabetes, high cholesterol or high blood pressure, are under control.
- Take all medications recommended by your physician
- Discuss with your physician the risks of taking aspirin, which may interfere with your medications.
How do you manage a gout attack?
There are a few things you can do to ease the pain of the attack:
- Take any anti-inflammatory medicine on hand, such as ibuprofen
- Apply an ice pack to your painful joint up to 30 minutes several times of day
- Drink plenty of fluids to flush out the uric acid
- Elevate your foot to reduce the swelling
- Try de-stressing; stress can worsen a gout attack
- Walk with a cane to keep pressure of your joints
Most importantly, call your doctor immediately if you experience a gout attack.
Medication can be used to treat an acute attack and prevent future attacks:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce gout inflammation.
- Colchicine is a type of pain reliever.
- Corticosteroids can also reduce gout inflammation.
- Xanthine Oxidase Inhibitors blocks uric acid production
- Probenecid can improve your kidneys ability to remove uric acid
Making lifestyle changes can also treat your gout attack:
- Exercise regularly.
- Drink plenty of fluids and limit alcohol consumption
- Limit intake of food high in purines
- Eat less protein-rich food and more fiber
You can also receive surgery to remove extremely large tophi. Talk with your healthcare provider about the risks, benefits and possible side effects of any of these medications and lifestyle changes.
Vernilyn Juan, M.D. is a Family Medicine physician with Crescent City Physicians, Inc., a subsidiary of Touro. Dr. Juan is certified by the American Board of Family Medicine.