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Patient Guide to GOUT

Gout, a painful form of arthritis, has long been associated with diet, particularly overindulgence in meat, seafood and alcohol. As a result, gout treatment used to include severe dietary restrictions, which made the gout diet hard to stick to. Fortunately, newer medications to treat gout have reduced the need for a strict gout diet.

In many ways, the gout diet resembles the healthy eating plan recommended for most people. Besides helping you maintain a healthy weight and avoid several chronic diseases, this diet may contribute to better overall management of  your gout.

Gout occurs when high levels of uric acid in your blood cause crystals to form and accumulate around a joint. Your body produces uric acid when it breaks down purines. Purines occur naturally in your body, but you also get them from eating certain foods, such as organ meats, anchovies, herring, asparagus and mushrooms.

Purpose

A gout diet helps to control the production and elimination of uric acid, which may help prevent gout attacks or reduce their severity. The diet isn’t a treatment for gout, but may help you control your attacks. Obesity also is a risk factor for gout, so losing weight can help you lower your risk of attacks.

Diet details

A gout diet reduces your intake of foods that are high in purines, which helps control your body’s production of uric acid. If you’re overweight or obese, lose weight. However, avoid fasting and rapid weight loss because these can promote a gout attack. Drink plenty of fluids to help flush uric acid from your body. Also avoid high-protein diets, which can cause you to produce too much uric acid (hyperuricemia).

To follow the diet:

  • Limit meat, poultry and fish. Animal proteins are high in purine. Avoid or severely limit high-purine foods, such as organ meats, herring, anchovies and mackerel. Red meat (beef, pork and lamb), fatty fish and seafood (tuna, shrimp, lobster and scallops) are associated with increased risk of gout. Because all meat, poultry and fish contain purines, limit your intake to 4 to 6 ounces (113 to 170 grams) daily.
  • Eat more plant-based proteins. You can increase your protein by including more plant-based sources, such as beans and legumes. This switch will also help you cut down on saturated fats, which may indirectly contribute to obesity and gout.
  • Limit or avoid alcohol. Alcohol interferes with the elimination of uric acid from your body. Drinking beer, in particular, has been linked to gout attacks. If you’re having an attack, avoid alcohol. However, when you’re not having an attack, drinking one or two 5-ounce (148 milliliter) servings a day of wine is not likely to increase your risk.
  • Drink plenty of fluids, particularly water. Fluids can help remove uric acid from your body. Aim for eight to 16 8-ounce (237 milliliter) glasses a day.
  • Choose low-fat or fat-free dairy products. Some studies have shown that drinking skim or low-fat milk and eating foods made with them, such as yogurt, help reduce the risk of gout. Aim for adequate dairy intake of 16 to 24 fluid ounces (473 to 710 milliliters) daily.
  • Choose complex carbohydrates. Eat more whole grains and fruits and vegetables and fewer refined carbohydrates, such as white bread, cakes and candy.
  • Limit or avoid sugar. Too many sweets can leave you with no room for plant-based proteins and low-fat or fat-free dairy products — the foods you need to avoid gout. Sugary foods also tend to be high in calories, so they make it easier to eat more than you’re likely to burn off. Although there’s debate about whether sugar has a direct effect on uric acid levels, sweets are definitely linked to overweight and obesity.

There’s also some evidence that drinking four to six cups of coffee a day lowers gout risk in men.

Results

Following a gout diet can help you limit your body’s uric acid production and increase its elimination. It’s not likely to lower the uric acid concentration in your blood enough to treat your gout without medication, but it may help decrease the number of attacks and limit their severity. Following the gout diet and limiting your calories particularly if you also add in moderate daily exercise, such as brisk walking also can improve your overall health by helping you achieve and maintain a healthy weight.

Cure your GOUT pain today! Call us at +65 6471 2744 (24 Hours) / Email: info@boneclinic.com.sg

Patient Education for Gout

Gout is an arthritic condition that occurs primarily on the feet, although it certainly can manifest itself in other parts of the body. It affects about 3% of the population and is predominantly a male disorder with only 5% of the cases affecting females, generally post menopause.

This condition is associated with hyperuricemia which is an increased amount of uric acid crystals circulating through the blood, however, not all people with hyperuricemia experience gout attacks.

Unlike osteoarthritis or the “wear and tear” arthritis we all suffer, the symptoms of gouty arthritis are different in that it is manifested by an acute onset of severe pain, redness and swelling, many times for no apparent reason. Many patients will complain of a sudden onset of pain occurring early in the morning while asleep. The theory behind this is that when sleeping, the feet are elevated and there is a slight diminishment of blood to the feet which in turn decreases the temperature of the feet just enough for the uric acid to crystallize in the joint of the foot and create pain.

Other factors that may precipitate this attack include local trauma, including foot surgery, with an acute medical illness, or following a high purine (protein) diet or alcohol binge.

These attacks most commonly occur in the foot, primarily in the big toe joint. The next most common locations are the middle of the foot followed by the ankle joint. They can also occur at the attachment of tendons such as the Achilles tendon into the heel. It is possible to have these attacks in more than one area at the same time.

Diagnosis is generally on clinical appearance and the presenting history because it is not uncommon for a patient’s uric acid level to be normal during an attack. Colchicine is the drug of choice in acute attacks and is almost diagnostic for gout if the pain is alleviated by the drug. There are other drugs available, primarily the anti-inflammatory class of drugs, but it is important to note that they all do not work in gout. In fact, low doses of aspirin will actually worsen an attack. Consultation with your foot specialist is essential.

The pain generally lasts a few days, and then begins to diminish. The problem is when a person experiences multiple gout attacks over short periods of time. Aside from the pain of the attack, each attack does damage to the affected joint and a person can reach the point where there is so much damage from the repeated attacks, which the joint now becomes constantly painful and surgical intervention is usually necessary.

In those individuals experiencing repeated attacks of gout it is necessary to find out why. Generally speaking, it is usually from either the body overproducing too much uric acid or the kidneys excreting too little uric acid. In either event there is too much uric acid circulating throughout the body. Consultation with specialist is necessary to determine the cause. There is medication available to treat both causes.

Patients who are prone to gout attacks should modify their diets in regards to a low purine diet and should abstain from organ meats such as sweetbread, liver, kidney; anchovies, sardines; rich gravies and alcohol.

A simple gout treatment that has been mentioned in various sources is that of eating cherries or drinking cherry juice on a regular basis. This may diminish gout attacks. It is postulated that the anthrocyanins in cherries reduces the amount of uric acid circulating in the blood.

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