There is not cure for gout and coping with the condition can be challenging: Flare-ups can occur with no warning and last days or weeks, significantly affecting quality of life. However, gout can be effectively managed with a combination of lifestyle measures and medication.
Lifestyle
In the same way lifestyle factors can increase the risk of gout, a modification of unhealthy behaviors can greatly reduce the risk. The key modifiable risk factors are diet, body weight, and alcohol consumption.
Diet
Gout symptom often are triggered by eating foods rich in purine, an organic substance that becomes uric acid when broken down by the body.
To reduce your risk:
Become familiar with the high-purine foods you need to avoid or limit, such as beer and shellfish. Increase intake of gout-healthy foods, such as fresh fruit, fresh vegetables, whole grains, nuts, and low-fat and non-fat dairy products like yogurt and skim milk. Drink coffee in moderation. For a sweet treat, eat fresh cherries, which also have a uric acid-reducing effect. Avoid beverages sweetened with fructose, including sodas and fruit drinks, as this can slow the excretion of uric acid by the kidneys.
Weight Loss
Being overweight or obese increases your risk of a gout attack, probably by increasing your uric acid levels. The risk is further increased if you have excessive visceral (abdominal) fat associated with metabolic syndrome.
To decrease your risk, focus on not only weight loss but an exercise plan designed to gradually burn fat. This requires a slow-but-steady approach, ideally with a nutritionist experienced in gout and a physical trainer experienced in metabolic syndrome.
Embarking on an overly aggressive workout plan can sometimes trigger a gout attack, especially if you place undue stress on the affected joint or get dehydrated. Similarly, launching yourself into a crash diet can trigger symptoms.
Alcohol
Alcohol is problematic as even modest amounts can cause uric acid to soar. By far, the worse of the lot is beer, which is made with brewer’s yeast, one of the highest sources of purine. Studies remain largely split on whether wine is linked to gout attacks, and some have even shown that women may be less likely to suffer than men.
You do not have to eliminate alcohol entirely, but limiting your intake is recommended. Since not everyone suffers gout in the same way, you need to take a sensible approach to drinking. Among some of the strategies to consider:
If you’re out with friends for cocktails, most bars and lounges today offer non-alcoholic options. But, again, watch the ingredients and avoid fruity drinks which are often made with fructose-sweetened juice. If you do opt to have a drink, limit yourself to one and water it down so that you consume less alcohol over the course of an evening. You should also snack or have a meal to soak up some of the excess alcohol. Also, have a glass or two of water after a drink. Not only will this dilute the alcohol in your system, it can make you feel fuller and less likely to order another drink. It will also promote urination and keep your kidneys working.
On the other hand, if you suffer severe or recurrent attacks and find it difficult not to drink, speak with your healthcare provider and ask about treatment options.
Practical
If ever you experience an acute gout attack, there are immediate steps you can take to treat your condition. As symptoms tend to increase in the early part of an attack, quick action can save you a whole lot of pain and suffering.
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Start by taking a nonsteroidal anti-inflammatory drug (NSAID) like Aleve (naproxen) or Advil (ibuprofen). If your foot is involved, elevating the foot above your hip can alleviate some of the throbbing pain and discomfort. Use an ice pack on the affected joint, covering it with a thin towel and keeping it on the skin for no longer than 15 to 20 minutes at a time to prevent frostbite. Try to relax. Turn to an activity you find calming, such as watching a movie, talking with a friend, reading a book, or listening to music. If your big toe is affected, cut a hole large enough for it to stick out of in an old sock. This little fix can keep your foot warm while keeping pressure off the toe. Make your bed so that your foot can stick out at the bottom of the bed sheets. During an acute attack, even the weight of a sheet can cause extreme agony. If you need to walk, use a cane or get a pair of crutches from your healthcare provider or a home healthcare supply store. Don’t drive, as this may hurt your foot or even cause an accident. Instead, take a cab or ask a friend to drive you. If you are on uric acid-reducing medications like Zyloprim (allopurinol) or Uloric (febuxostat), do not stop. Some of these drugs can trigger attacks in the early stages of treatment. Even if they do, you need to push through. Stay positive. If anything, remind yourself that an attack is not forever, and there are steps you can take to avoid future ones. Given the importance of early treatment initiation in order to reduce the attack severity, ask your healthcare provider for a gout attack plan. For example, have colchicine or prednisone tablets available to use in the event of an acute attack.
If your symptoms don’t improve after 48 hours or last for more than a week, call your healthcare provider and schedule an appointment.
If you are on treatment, you may need to make changes to your therapy or explore other lifestyle interventions. If you are not, it may be time to explore treatment options.
