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Gout

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Gout

I recently was diagnosed with gout. Can you tell me more about it?
Gout often is identified by a sudden onset of an arthritis-type pain that usually starts in the big toe and goes up the leg. It is caused by a build-up of a normal substance in the body called uric acid.

When you have gout, too much uric acid ends up in the blood. This can result from the body producing too much uric acid or by the kidney’s inability to excrete uric acid. Gout develops when uric acid deposits in the joints, causing the pain that is so common when gout is diagnosed. Many people have high uric-acid levels without getting gout. 
                     
What causes gout?
The exact cause is unknown. Men get gout more often than women, and those with a family member with gout are at an increased risk. Heavy alcohol use (especially beer), diabetes, high blood pressure, obesity, sickle-cell anemia, and kidney disease increase your risk for gout. It also may develop in people who take medications that interfere with uric acid excretion, including some diuretics, low-dose aspirin, and niacin.

What is a gout attack?
Usually the onset of pain from gout is sudden and may include fever, chills, and malaise. This type of gout attack can last up to several days and possibly is triggered by stress, alcohol, drugs, crash diets, or another illness. Another attack may not occur for several months and often seemingly occurs at random.

Did my diet cause my gout?
Maybe. Evidence shows that certain lifestyle factors are associated with gout. A diet high in meat and saturated fats, alcohol intake, obesity, and medications such as thiazide and loop diuretics all are associated with gout. While it is unlikely that any one food in particular causes gout, the combination of eating and drinking too much and gaining weight seems to make a person more apt to get gout.  

How is gout treated?
No cure for gout exists, but treatment is possible. Pain management during attacks is recommended, as is treatment of existing medical conditions, such as diabetes or renal disease. Medications can help reduce the uric acid levels in the blood. Eating a healthy diet may help prevent attacks.

What should I eat to help manage my gout?
It is important to drink plenty of fluids during or between attacks. Experts recommend drinking 8–16 cups of fluid each day, at least half as water. You also should limit your alcohol intake. It may help to limit foods high in purines.

High-purine foods include:

  • Organ meats (brain, kidney, and heart)
  • Anchovies
  • Sardines
  • Shellfish, such as scallops and mussels
  • Mackerel
  • Herring
  • Goose
  • Consommé
  • Bouillon
  • Broth
  • Fish eggs

The following foods are moderately high in purine:

  • Meats, poultry, and fish
  • Certain vegetables, such as:
    • Asparagus
    • Dried beans 
    • Lentils  
    • Mushrooms 
    • Dried peas 
    • Spinach

Some experts suggest that you try not to eat foods high in purine more frequently than every other day in an attempt to help reduce uric-acid buildup.

To help prevent gout and during a gout attack, limit meat, fish, and poultry to 4–6 ounces/day. This recommendation is consistent with the Dietary Guidelines for Americans, not just for individuals with gout.

Food sensitivity in patients with gout varies for each individual. It is best to pay attention to what you eat before, during, and after a gout attack, and try to identify foods that cause attacks or make them worse. Keeping a food diary during gout attacks can help determine foods that are triggers for you. Because of the risk for nutrient deficiencies, it is important not to completely eliminate foods unless you suspect the food will trigger a gout attack.

 

References
Academy of Nutrition and Dietetics. Nutrition Care Manual®. Available to subscribers at: www.nutritioncaremanual.org. Accessed April 11, 2012.

Mahan LK, Escott-Stump S, Raymond JL. Krause’s Food and Nutrition Care Process. 13th ed. St Louis, MO: Elsevier Saunders; 2012.

MedlinePlus. Gout. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000422.htm. Accessed April 11, 2012.

 

Review Date 4/12
G-0590

G_0590_Gout.doc

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