How to keep gout under control

Marked by swelling, inflammation, and excruciating tenderness in the joints, gout most commonly affects the joints at the base of the big toe, other foot joints, knees, ankles, wrists, and fingers. The slightest touch—even that of a bedsheet—may be unbearably painful during an attack of gout.

QUICK TIP:
Avoid overheating
Recent research has found that external heat, such as warm summer days, may play a role in triggering gout attacks. So stay cool to stay pain-free.

Long known as “the disease of kings” or “rich man’s disease,” gout has been associated with overindulgence and high living, as well as obesity. But in actuality, gout is a type of arthritis that is caused by an inherited defect in the kidney’s ability to excrete uric acid.

Nutrition Connection
To reinforce the beneficial effect of drug treatment, people with gout should make dietary changes to help reduce their production of uric acid. The following are general guidelines:
-Avoid foods that are high in purines. Foods with a high content of naturally occurring chemicals called purines promote overproduction of uric acid in people with a tendency for gout. Steer clear of high-purine foods such as anchovies, sardines, liver, kidney, brains, herring, mackerel, scallops, and game.
-Limit foods with a moderate level of purines. Such foods include whole grain cereals, wheat germ and wheat bran, oatmeal, dried beans and peas, nuts, asparagus, cauliflower, and mushrooms. These may be taken in moderation. -Limit your intake of meat, fish and poultry. Because meat products are high in purines, you’ll need to more closely monitor the amount of these foods you eat. About 4 to 6 oz (113 to 170 g) is recommended per day. -Eat more plant-based proteins. Add more plant-based sources of protein such as soy. These foods contain the essential protein you need without the purines contained in meat products.
-Consume plenty of liquids. Try to drink at least 2 qt (2 L) a day to dilute urine and prevent kidney stone formation.
-Limit or avoid alcohol. Any alcohol can interfere with the elimination of uric acid. Gout sufferers should drink only distilled alcohols in small amounts.
-Avoid low-carb diets. High-protein, low-carbohydrate diets should be avoided since these diets encourage the formation of ketones, metabolic by-products that hamper the body’s ability to excrete uric acid.
-Lose weight gradually. Although losing weight—especially fat around the abdomen—often prevents future gout attacks, weight loss should be gradual because a rapid reduction can raise blood levels of uric acid and provoke gout. People with gout should avoid skipping meals; fasting also increases the blood levels of uric acid.

Beyond the Diet
Colchicine, a drug derived from the autumn crocus flower, is one of the most effective gout medications, but it can also cause severe nausea and diarrhea. Follow these suggestions to keep gout under control:
-Possibly modify your drug therapy. Sometimes gout is brought on by using aspirin or diuretics for high blood pressure. These medicines may interfere with normal kidney function and the elimination of uric acid. -Address other health issues. Gout sufferers also may have hypertension, heart disease, diabetes, and high blood cholesterol. Talk to your doctor about the best ways to manage your unique situation.