Gout 101 IN THIS ISSUE

Transcription

1 Gout 101 IN THIS ISSUE What is gout? What causes gout? Gout symptoms Foods that can cause or exacerbate gout Foods to help control gout symptoms Available treatments Lifestyle changes to help manage gout For more information, go to: and to participate in the conversation, go to Global Healthy Living Foundation, Upper Nyack, NY

2 What is Gout? Uric Acid Gout is an inflammatory type of arthritis caused by too much uric acid in the blood. Uric acid is a chemical that can form needle-like hard crystal deposits in the joints. Uric acid is created when the body breaks down substances called purines, which are found in some foods and drinks including liver, anchovies, mackerel, dried beans and peas, and beer. Gout can cause a sudden, severe attack of burning pain, stiffness, redness and swelling in a joint, usually a big toe. Over time, gout can harm the joints, tendons and other tissues. People with gout are at higher risk of hypertension, diabetes, metabolic syndrome, and renal and heart disease; however, the good news is that gout is one of the most treatable forms of arthritis.

3 What causes Gout? Gout is caused by either increased uric acid production in the blood or because the kidneys cannot remove uric acid from the body. While some people experience gout flare-ups that don t have a specific cause, it may also be triggered by diet and obesity. Certain medications like aspirin and diuretics, which reduce the amount of water retained by the body, can increase uric acid in the blood. Additional causes include surgery and having a major illness or medical condition like rapid weight loss and high blood pressure. Historically gout has been referred to as the disease of kings because of its association with rich foods and alcohol. The chances of getting gout are greater if you are male, overweight, and consume too much alcohol.

4 Symptoms of Gout? The symptoms of gout tend to happen suddenly and often at night. Gout can cause a sudden severe attack of burning pain, stiffness, redness and swelling in a joint, usually a big toe. You can also get attacks in the foot, ankle or knees, which can happen repeatedly unless treated. The pain tends to be at its worst in the first four to 12 hours after it starts. Even after the most severe pain goes away, some joint discomfort can remain for a few days to as long as a few weeks. If gout is allowed to progress untreated, the person s range of motion becomes increasingly limited. The skin around the joint may also start to peel and itch as the joint gets better. In some people, gout does not cause intermittent painful attacks. Rather, they have gout all the time. This form, called chronic gout, may not be as painful and may be confused with other forms of arthritis.

5 The Role of Diet Certain foods and supplements have been found to lower uric acid levels in the blood. These include vitamin C (one study showed that 500 mg or more per day decreased gout incidence in men), bromelain (an extract from pineapples) and cherries, particularly tart cherries and tart cherry juice, which have also been associated with reducing the number of gout attacks. Drinking plenty of fresh, filtered water is also important to help flush uric acid from your system, particularly if you eat a lot of the types of foods and beverages that increase gout risk. Chances of getting gout are greater if you are male, overweight, and consume too much alcohol as well as the foods listed above.

6 Foods to Avoid Alcohol and Caffeinated Beverages These cause increased dehydration and interfere with uric acid elimination. Red and Organ Meats The high uric acid content and saturated fat in red meats and organ meats like liver can lower the body s ability to eliminate uric acid. Fructose Fructose is known to increase uric acid in the body, so products sweetened with highfructose corn syrup should be eliminated from thediet. Instead, people with gout should choose complex carbohydrates like whole grains, fruits and vegetables and low-fat dairy products. Pay particular attention to how many sugary beverages you consume, including fruit juice, and try to limit or eliminate them. Shellfish Such as Shrimp and Lobster These have high levels of purines that cause uric acid to form when the body breaks them down.

7 Treatment Without treatment, an acute attack of gout usually goes away on its own after five to seven days; however, 60 percent of people have a second attack within one year. There is currently no cure for gout but the symptoms can be treated with a variety of medications. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen work to reduce pain and inflammation, as do corticosteroids. The pain reliever colchicine is sometimes given in a low daily dose to prevent future gout attacks. Corticosteroids are generally reserved for people who can t take either NSAIDs or colchicine.

8 There are also medications designed to prevent gout-related complications. These include xanthine oxidase inhibitors that are designed to lower uric acid levels, and probenecid, which helps the kidneys remove uric acid from the bloodstream. These drugs are typically not used until one to two weeks after a flare-up of gout has resolved, and are often used along with either an NSAID or colchicine for the first few months of use. Typically they are prescribed only for people who have had two or more flares. A medicine called pegloticase was approved by the FDA in 2010 to treat gout and is particularly useful for those who can t tolerate other medications. It is given intravenously every two weeks and has been shown to reduce uric acid levels.

9 Lifestyle changes to help Control Symptoms While no medication can cure the disease or prevent gout attacks, lifestyle changes can help control gout symptoms. Regular exercise and maintaining a healthy weight are important, as is avoidance of foods known to increase uric acid production like red meat, fructose and alcohol. Meanwhile, tart cherries, pineapple and vitamin C have been shown to lower uric acid production. If you are experiencing symptoms that you think may be gout or feel that you are at risk for the disease, it s important Studies to show see your that doctor for an accurate diagnosis. being even 10 pounds overweight will The contents herein are not intended to replace increase the advice the stress of a health provider. across the knee joint by 30 to 60 pounds Sources: WebMD Mayo Clinic Arthritis Foundation

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