Gout is a painful inflammatory form of arthritis, that affects more than 9 million Americans. Gout usually impacts one joint in the lower leg -often the big toe or the ankles, but it can also strike at the knee, elbow, hands and wrist. Gout is caused by excess uric acid (hyperuricemia) that forms painful crystals in your joints and causes pain and swelling. The flare may last a week or two before is clears up. Regular flares can progressively worsen and lead to long term gouty arthritis. Gout flare ups can be mostly controlled through diet and lifestyle management.
Gout is caused by a build-up of uric acid. While the body naturally makes uric acid, for some individuals, the uric acid is not cleared properly or too much is produced. The kidneys generally process uric acid and urination clears it from the body. When too much uric acid remains in the body, it forms crystals that settle in joints causing extreme pain.
Not everyone with high uric acid levels get gout. Men are most at risk for gout, but women past menopause are also at risk. Those with the following health conditions are more at risk for gout:
- Obese and overweight
- Diabetes
- Congestive heart failure
- Hypertension
- Kidney disease
- Blood cancer
Symptoms of gout can come on very quickly.
Common gout symptoms include:
- Intense pain at the joint (50% of cases occur at the big toe) with very light touch
- Swelling
- Discoloration of the skin
- Intense sensation of heat at the joint
Other factors that increase your risk of gout include:
- A family history of gout
- A heavy intake of animal proteins
- Alcohol consumption
- Sugary beverage consumption
- Intake of diuretics
- Use of immunosuppressants
Gout is diagnosed while the joint is inflamed with the uric acid crystals through x-rays, MRI, CT scans and blood tests. A Rheumatologist will care for cases of gout along with other forms of arthritis. While gout is treatable there is no cure. Untreated gout may lead to more flares so prompt attention to the condition is imperative.
Treatment for gout includes:
- Use of anti-inflammatory drugs like NSDAIDS
- Corticosteroids taken orally or by injection
- Diet changes including limiting animal proteins
- Restricting alcohol intake
- Losing weight
- Regular exercise
- Taking drugs to lower the uric acid levels in the body
Lifestyle Rx:
Avoid foods high in purine, which causes more uric acid in the blood and may lead to a gout flare.
Foods to avoid:
- Organ meats like liver and kidneys
- Seafood like shellfish, anchovies, tuna and shrimp
- Red meat like beef, lamb, pork and bacon
- Game meat like goose, veal and venison
- Turkey, especially deli turkey
- Yeast
- Sugary drinks like soda and fruit juice
- High fructose corn syrup found in many processed foods
- Alcohol
Add more of these foods:
Eating a healthy diet, rich in fruits (cherries) and vegetables, varied protein sources, whole grains (not oats), drinking plenty of water, including some dairy, supplementing with Vitamin C, and even including coffee can help reduce your risk of gout. Getting to, and staying at, a healthy weight with a healthy diet and exercise, will greatly reduce your risks.
Sleep and Stress:
Sleep and stress management are also key for the prevention of a gout flare. Lack of sleep and stress, both cause inflammation in the body, increase the risk for gout. Eight hours of quality sleep is ideal. Exercise, meditation, journaling, and yoga can all help with stress management.
Gout can make it painful or impossible to complete activities of daily living like walking, climbing stairs, and cooking. For drivers, it can make it difficult to drive, and it needs to be managed with your medical provider. It is key to seek treatment immediately to reduce the severity of the flare and prevent future flares. For more information check out The Alliance for Gout Awareness.
By: Christy Coughlin, Wellness Coach