What is Gout and How is it Triggered?

Gout is the most common form of inflammatory arthritis. A gout attack is characterized by sudden and severe episodes of pain, warmth, and swelling in a joint. Its underlying cause is a build-up of uric acid in the body over time. Uric acid is the resultant substance of purines processed in the body, in which purines are a type of protein found in human cells and in many foods.

Uric acid is transported by the blood to the kidneys and eliminated in the urine. Normally, the kidneys’ filtering mechanisms facilitate the ridding of this waste substance efficiently. However, if your cells overproduce uric acid or they produce a normal amount but your body cannot efficiently eliminate it, you have a rare genetic abnormality, or your diet and lifestyle elevate the amount of uric acid leading to a buildup, needle-like crystals can start to form in your tissues, resulting in swollen, painful joints.

Gout Triggers

Although triggers differ from one individual to the next, once you identify your specific triggers, gout can become easier to manage. Common triggers include:

• Alcohol – This includes excessive intake of alcohol, especially beer, or binge drinking
• Purine-Rich Foods – Eating large amounts of foods high in purines
• Uric-Acid Lowering Medicines – Although they are perhaps the best long-term solution for controlling gout, beginning a new course of treatment using uric-lowering medications can actually trigger attacks. Contact the medical profession who prescribed the treatment if gout symptoms develop
• Surgery or Sudden Illness – Those who are in bed or stationary for a long period of time are at higher risk of developing gout
• Crash Diets
• Radiation Therapy

Dietary Triggers

A study in the New England Journal of Medicine confirms what physicians have been advising their patients with gout for years: avoid frequent consumption of purine-rich foods such as meat, seafood, animal protein, and purine-rich vegetables; increase consumption of dairy products, as their proteins help lower uric acid levels in the blood.

Developing a lifelong eating strategy that focuses on following a healthy diet should be the goal for people with gout to reduce the likelihood of its recurrence. In general, it is advisable to reduce the amounts of food that you eat that are high in purines. If you already suffer from gout, eating a diet that is rich in purines can result in a five-fold increase in recurrent gout attacks.

Avoid the following high purines foods:

• Red meat (beef, lamb, pork)
• Offal (liver, kidneys, heart)
• Seafood (especially shellfish such as shrimp and lobster, and oily fish)
• Beverages and snacks that are high in sugar
• Excessive alcohol — Drinking alcohol can increase your risk of developing gout and can bring on a sudden attack if you are already suffering from gout. Many beers contain large quantities of purines from the fermenting process; moreover, alcohol stimulates the production of uric acid by the liver. More importantly, alcohol is converted in the body to lactic acid which interferes with the removal of uric acid from the body by the kidneys. Reduction in alcohol consumption is particularly important for people with gout, especially if you are drinking more than the recommended healthy limit of 21 units per week for men, or 14 units per week for women.

On the other hand, the following foods may lower the level of uric acid in the body:

• Skim milk and other low fat dairy products
• Whole grain foods
• Plant oils (olive, canola, sunflower)
• Fruits with low levels of fructose
• Vitamin C supplements
• Fluids other than alcohol

Lifestyle Changes

Additional lifestyle changes that can help reduce your risk of experiencing further attacks of gout include:

• Maintaining a healthy weight – follow a balanced diet
• Exercising regularly – try activities that don’t put too much strain on your joints, such as swimming
• Drinking plenty of water – keeping yourself well hydrated will reduce the likelihood of crystals forming in your joints. Aim for 8 glasses of water a day: the 8×8 rule (around 64 oz)

There is also some evidence to suggest that regular vitamin C supplements, taken in the 500 to 1000mg per day range, can help reduce gout attacks.

If you’re struggling with gout and can’t seem to curb the associated pain, get in contact with Dr. Vikki and Dr. Connie at the Superior Foot & Ankle Center.