Ask the Doctor: The facts about gout
Over the past month, I have had a number of requests to discuss the topic of “gout.” It seems as though there are quite a number of you experiencing the excruciating, throbbing or crushing pain brought on by this severe and painful form of arthritis.
Gout occurs when uric acid levels in the blood are too high and the uric acid crystals build up in the joints. It usually affects one joint but repeated episodes may involve more than one joint especially the big toe, knee or ankle joints.
Repeated gouty attacks may cause deformities and loss of motion in the joint. Some gouty sufferers may develop nodules or lumps called “tophi” that appear below the skin around the joints, on the hands, elbows or ears and may drain a chalky material. Many people affected with gout will complain of pain especially at night, being unable to tolerate even the light pressure of a sheet from simply touching their big toe or affected joint.
Gout is more common in men over age 30 than in women. It tends to run in families and children are rarely affected. Flare-ups of gout may be brought on by a number of factors that increase your risk including:
• Being male
• Obesity
• Family history of gout
• A diet rich in meat and seafood
• Consumption of alcohol, especially beer
• Use of more than 1 or 2 aspirin a day
• Use of diuretics (medicines that remove salt and water from the body)
• Very low calorie diets
• Major illness, infection or joint injury
If you experience the pain of gout, you should elevate and rest the painful joints until the attack eases and for 24 hours after the attack.
Non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen and naproxen may help in relieving the inflammation. Aspirin can make symptoms worse and should not be taken. Your doctor may choose to inject the inflamed joint with corticosteroids to relieve the pain.
Medicines like colchicines may be prescribed to help reduce pain, swelling and inflammation. In cases of severe pain, strong painkillers may be needed. If you have had several gouty attacks during the same year or signs of gouty arthritis, your doctor may prescribe daily allopurinol or probenecid to decrease the uric acid levels in your blood.
What can you do to make a difference in improving your chances of avoiding a gouty attack?
To decrease recurrences you should make every attempt to:
• Control your weight. If you are overweight, avoid fasting or going on fad diets where you eat very few calories. Such diets will bring on a gout attack by increasing the amount of uric acid the body produces. Eat enough carbohydrates and lose weight slowly. Keep your weight within the normal range for your height. A low fat diet is recommended.
• Avoid or limit alcohol, especially beer.
• Limit the amount of meat or seafood you eat.
• Avoid anchovies, sardines, herring, organ meat (liver, kidney and sweetbreads), oils, gravies, legumes (dried beans and peas), spinach, asparagus, mushrooms, cauliflower, consommé and baking or brewer’s yeast.
• Avoid fatty foods such as ice cream, fried foods and salad dressings.
• Limit your intake of aspirin. Although the use of low dose aspirin has been shown to raise uric acid levels, your doctor my want you to continue taking it since low-dose aspirin is important for the prevention of stroke and heart attacks.
• Get regular exercise.
• Drink plenty of water and other fluids.
Although gout itself may not be preventable, proper treatment of acute attacks will allow people to live a normal life. If you suffer with gout, please make the dietary and lifestyle changes that may help you manage your symptoms.
This is Dr. Beryl Bachus-Keith reminding you that prevention is the key to good health and wellness, so make a vow and commit to good health.
“An ounce of prevention is worth a pound of cure”.
