Different Conditions But Similar Diet Plan
The National Institute of Health created the DASH eating plan to help lower blood pressure. Studies have shown it does lower blood pressure, LDL cholesterol and uric acid levels.
Does it help with gout? Yes. The DASH diet incorporates more fruits, vegetables, seeds, whole grains, low-fat/nonfat dairy and lean meats. The diet limits eating foods high in saturated fat, such as fatty meats, high-fat dairy products, and certain oils. Also, other recommendations include consuming less salt, sweets, sugar-sweetened beverages, and alcohol.
Theres nothing new to the DASH diet. It been around since 1992. However, it is a prudent starting point to improve your current crappy diet. Since the DASH diet recommends eating less gout-causing foods like meats, alcohol and high-fructose drinks, it is highly recommended to all gout sufferers.
When it comes to gout, the main issue is overeating those savory purine-rich foods like red meats and shellfish. For any diet, the biggest challenge is starting healthier habits like choosing more nutritional snacks and meals than unhealthy ones.
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Lifestyle Tips For Gout
How to Live With Gout
Although you cant predict when a gout attack will occur, there are several things you can do to try to prevent an attack. Developing a healthy lifestyle is one of these things.
The lifestyle tips below play a major role in preventing a gout attack. As an added bonus, they may also help prevent some complications of gout such as kidney disease and heart disease.
Also, as part of any healthy diet, you should drink plenty of water. This is particularly important if you have gout since staying hydrated can help flush out uric acid and prevent uric acid crystals from forming.
What stress management techniques work for gout? Try relaxation techniques, such as meditation and deep breathing. A little bit of stress relief can go a long way.
Medications That Can Trigger Gout
Some medications can trigger gout symptoms. This includes common pain medications. Even small amounts of these drugs can impact gout. Your doctor may recommend changing these medications if you notice more gout symptoms.
Aspirin or acetylsalicylic acid raises uric acid in your blood. Even low doses of aspirin can trigger gout. Research shows that this effect of aspirin is more common in women than in men.
Diuretics or water pills help to treat conditions such as high blood pressure and edema or swelling in the legs. These medications work by getting rid of excess water and salt from the body. However, they can also cause a side effect of too much uric acid in the body, triggering gout. Diuretic drugs include:
- chlorothiazide
may have high levels of the hormone insulin. This can cause too much uric acid in the body, triggering gout symptoms in your joints.
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Enjoy Sugary Beverages And Snacks In Moderation
Sweets abound during the holidays. Cookies, fruit punch, and other common party staples often contain high amounts of sugar, which can increase blood sugar levels. High blood sugar is linked to high uric acid, particularly in adults who are overweight or obese.
Avoiding soda, fruit juices, and other beverages and foods with high sugar content may help prevent gout flare-ups as you navigate the holidays this year.
The Role Of Medication In Prevention Of Gout
Table 3: Medications to pevent attacks of gout
Standard medications in preventing gout attacks
i. Colchicine : using the matches analogy discussed above1, using colchicine can be seen as dampening the uric acid matches. Colchicine does not lower the bodys store of uric acid, but it decreases the intensity of the bodys inflammatory reaction to these crystals. Recent studies have shown that at least one mechanism of colchicines action is by acting to prevent a cascade of reactions that lead to the production of interleukin 1-beta, which is an inflammatory protein , which is important in gouty inflammation.8
ii. Allopurinol: This agent is presently the most commonly used drug for the prevention of gout. Allopurinol blocks the enzyme xanthine oxidase, which blocks the breakdown of purines, thus decreasing the bodys total amount of uric acid. Allopurinol is effective in preventing gout no matter what the mechanism of the elevated uric acid was. Whether a person is making too much uric acid, or has difficulty excreting it via the kidney, allopurinols decrease in uric acid production leads to the same goal: a decreased total body uric acid.
Table 4: Reasons to use medication to lower uric acid
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Cheaper Shoes For Gout Patients Might Help
Further research needs to be done that will allow doctors and patients to better recognize the best shoes available for comfort that also are economically priced, the researchers write. Gout patients need shoes that are wide enough, have ample cushioning, and allow motion control.
More than half of those in the study mentioned cost as a factor in shoe selection, suggesting that cost may influence gout patients to purchase improper footwear.
Obesity may also be a factor in pain related to the footwear of gout patients, the researchers write.
Rome and his colleagues suggest that proper footwear selection be discussed with gout patients to reduce foot pain and impairment.
Previous research has shown that gout is on the increase around the world and is the most common form of inflammatory arthritis affecting men.
The study is published in Arthritis Care & Research, a journal of the American College of Rheumatology.
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Most Common Kidney Problems
Acute gout attacks can be extremely painful, but the symptoms are often brought under control with medication, and theres a chance you wont experience another painful episode. However, when uric acid is allowed to build up in the blood over a long period of time, gout can lead to widespread problems in multiple systems. In some cases, the damage can be permanent.
Your kidneys are responsible for removing excess uric acid from the bloodstream, so when theres too much of it to dispose of, the kidneys can be overworked. In turn, you could develop:
Kidney Stones
When uric acid crystals lodge in the joints, you get a gout attack when they settle in the kidneys or urinary tract, you get kidney stones. These small stones are hard and insoluble, and the larger they are, the more pain they will cause.
The sharp edges of kidney stones can physically scar your kidneys, or obstruct pathways and interfere with waste removal. If they go untreated for long enough, infections can develop.
Kidney Disease
Damaged kidneys are at a much higher risk for kidney disease, which is diagnosed when kidney function is severely reduced for three months or more. In many cases, symptoms of kidney disease are vague or mild, especially in the early stages.
Instead of relying on physical symptoms, your doctor can conduct an estimated glomerular filtration rate test or a urine albumin test to get a better idea of your kidney function.
Kidney Failure
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How Does Diet Impact Gout
Though diet isnt the only factor that leads to gout, it can play a role. To know why, its important to understand what causes gout in the body .
Gout occurs when an excess of uric acid in the body crystallizes in the joints, most commonly in the big toes, fingers, wrists and knees. These sharp crystals cause sudden swelling and are the source of the pain associated with a gout attack.
Uric acid is produced naturally when the body breaks down purines. Most purine is produced inside the body, though purines are also contained in some foods. Normally, uric acid doesnt cause problems because the body is able to secrete it easily through urine. However, some people produce too much uric acid or are unable to secrete enough of it. In these cases, the result is gout.
Though the body produces uric acid naturally, making gout largely unavoidable, consumption of foods rich in purines can exacerbate the problem. In fact, one study found that high purine intake was associated with five times greater risk of recurrent gout attacks .
In addition to foods rich in purine, those with gout should also avoid foods with lots of added sugars and refined carbs. Though more research needs to be done, reducing glycemic index seems to correlate with lower uric acid levels .
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Stage : Intercritical Gout
After a first gout flare, 75 percent of people will have a second within a year but some people can go years before another attack, says Dr. Fields. The in-between stage is where a person has already had a gout flare but is presently not having any joint pain or swelling, he says. Almost all gout patients will go through this phase, since it is the nature of gout to have flares and then quiet down for a period of time before the next flare.
Even though it may seem like nothing is happening, this is the point in which patients should begin long-term treatment. Lowering uric acid levels with medication can prevent future gout flares and long-term complications that go with them.
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Hypertension Causes Major Complications
Regularly monitoring your blood pressure is quite important and yet overlooked. Hypertension does not usually show obvious or early symptoms. That is why it known as the silent killer. Your blood pressure can quickly rise and remain high without you knowing it until a major health issue happens.
Over time, unmanaged high blood pressure can cause serious complications: heart attack/failure, stroke, aneurysm, chronic kidney disease, eye damage, and clogged arteries.
Hypertension sets up disorders of lesser degree such as fatigue, dizziness, blurred vision, irregular heartbeat, difficulty breathing and gout symptoms.
The link between gout and hyperuricemia are often overlooked even when 74% of chronic gout sufferers have high blood pressure. If you have hypertension, make sure to ask your doctor to test for your uric acid levels as well.
Here is a fantastic video illustrating high blood pressure, atherosclerosis and plaque.
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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How Gout Affects Your Kidney Disease Risk
Your risk for kidney disease jumps quite high when you suffer from gout: about 40 percent of gout patients also have chronic kidney disease. Moreover, the more advanced the kidney disease, the likelier you are to suffer from gout symptoms.
A Dangerous Cycle
Experts suspect that the relationship between kidney disease and gout is so pronounced because each condition feeds the other.
On the one hand, the kidneys excrete uric acid, and that uric acid can accumulate and crystallize, causing gout. However, hyperuricemia can also speed up the progression of kidney disease by overwhelming the waste-removing organs.
The result? A vicious cycle that puts your kidneys at great risk of damage, and eventually, failure.
The Source of the Trouble
As is the case with many chronic diseases, ongoing low-grade inflammation is likely the culprit behind the elevated risk of kidney, hyperuricemia and gout. In these diseases, inflammation is systemic that is, not necessarily limited to a specific area which creates a widespread problem that is difficult to control.
Limit Alcohol And Stress To Prevent Gout Episode
Gout is a type of arthritis that can involve pain and inflammation of one or more joints. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, there are 6 million adults over the age 20 who have reported gout.
The disease occurs when your body makes too much uric acid or has trouble getting rid of it. Uric acid is the result of the body breaking down purines, which are found in certain foods and drinks. It is usually eliminated from the body after it dissolves in the blood stream and passes through the kidneys. If this does not happen, uric acid builds up in the blood, and uric acid crystals can be deposited in joints or soft tissue, leading to inflammatory arthritis. Gout is more common in adult men. Drinking in excess, a rich diet and high blood pressure all increase your chances of getting the disease. Certain medicines, like diuretics, aspirin and cyclosporine may also trigger an attack. It is possible to have high levels of uric acid in your blood but not develop gout.
SymptomsFound most often in the large joint of your big toe, gout can also affect other joints, including those at the knees, ankles or wrists. Intense joint pain can occur suddenly along with swelling, which makes the area red, purple or tender. Gout is typically episodic but can become chronic. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, chronic gout usually develops over years and can mean permanent joint damage.
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Might Have Trouble With Diagnosis
Youve probably already noticed that the symptoms of gout are very similar to those affecting arthritis patients. Because of this, gout can be very hard to diagnose. Health.com notes that in order to get a definitive diagnosis, doctors must use a needle to draw out joint fluid from the affected area, then they look for uric acid crystals under the microscope.
To make matters even more complicated, the source notes that some gout sufferers have a normal or even lower amount of uric acid during one of their attacks, so the needle method isnt always accurate. If this is the case, doctors can also use CT scans. If its a very severe case of gout, they could also look for joint damage in an X-ray, says Health.com.
Can Gout Be Cured
Gout cannot be cured. However, most patients can manage their symptoms and largely avoid gout flare-ups. Your doctor will discuss diet and lifestyle changes that may help. If symptoms are intense, persistent, or highly resistant to these changes, prescription medication can reduce the level of uric acid in the body. Anti-inflammatory medication is used during attacks.
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Kidney Problems Can Complicate Treatment
There are many medications on the market to treat gout, but co-existing diseases make some options too dangerous. Non-steroidal anti-inflammatory drugs are often a first line of attack for acute gout attacks, but not a good choice for those with chronic kidney disease.
Likewise, colchicine is often used for gout pain, but brings side effects that can be too much to bear when another chronic disease is involved.
Drugs that block uric acid production, like allopurinol and febuxostat, can be a better solution, but any medication must be carefully limited and closely monitored to make sure no further damage is done to the kidneys. There is no universal course of action for treating gout and kidney problems simultaneously your doctor will have to choose and adjust mediation based on the severity of your gout pain, the severity of your kidney problems, and your overall health.
How Does A Doctor Diagnose Gout
If you have sudden or severe pain in a joint, you should talk to your primary care provider . Your PCP may send you to a rheumatologist, a doctor who specializes in gout and other kinds of arthritis.
Healthcare providers consider several things when confirming gout:
- Symptoms: The provider will ask you to describe your symptoms, how often they happen and how long they last.
- Physical examination: Your provider will examine the affected joint to look for swelling, redness and warmth.
- Blood work: A test can measure the amount of uric acid in your blood.
- Imaging tests: You may have pictures taken of the affected joint with X-rays, an ultrasound or MRI.
- Aspiration: The provider may use a needle to pull fluid from the joint. Using a microscope, a team member can look for uric acid crystals or a different problem .
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How To Prevent Gout Attacks
Theres nothing you can do about your genetics, but you can make healthy lifestyle changes that may help reduce the likelihood of developing gout. They include:
