GOUT DIET

How To Treat Gout With Diet and Medication

How To Treat Gout With Diet and Medication
Gout Diet....

Typically, gout predominantly affects men, with approximately 95% of patients being male and 5% female. An initial gout attack, which often involves the big toe in 50% of cases, can last for several days and may resolve on its own without treatment. Subsequent episodes may not manifest for weeks, months, years, or may not occur at all. In severe instances, repeated attacks over an extended period can lead to joint damage and reduced mobility. The big toe is ultimately impacted in 90% of cases. Understanding how to manage gout is crucial for preventing future attacks.

Gout is frequently associated with a genetic predisposition that affects the body's ability to process uric acid. Elevated uric acid levels can result from a diet high in purine-rich foods, such as meats, excessive production of uric acid by the body, or inadequate elimination of uric acid by the kidneys.

The objectives of treatment include halting acute gout attacks, providing rapid and safe relief from pain and inflammation, preventing future episodes, and avoiding complications such as the formation of tophi, kidney stones, and joint damage.

While gout is typically managed successfully without complications, treatment can become more complex if other medical conditions coexist or if there is poor adherence to recommended lifestyle modifications or medication regimens.

Dietary changes are advised, including the avoidance of a purine-rich diet. Additional preventive strategies encompass ensuring sufficient fluid intake, weight loss, reducing alcohol consumption, and utilizing medications to lower hyperuricemia.

Medications used for gout include:

* non-steroidal anti-inflammatory drugs (NSAIDs)

* colchicine

* corticosteroids

* adrenocorticotropic hormone (ACTH)

* allopurinol

* probenecid

* sulfinpyrazone

NSAIDs, particularly indomethacin, are often the first line of treatment for acute gout. Other NSAIDs may also be equally effective. These medications are typically prescribed at maximum dosages initially and then tapered as symptoms improve. Treatment should continue until pain and inflammation have been absent for at least 48 hours. COX-2 inhibitor NSAIDs may also provide beneficial effects. for patients with gastrointestinal concerns but their use for acute gout has not been specifically reported yet.

Colchicine is utilized for the management of acute episodes of gouty arthritis and for the prevention of recurrent acute episodes. It is important to note that colchicine does not provide a cure for gout nor does it replace other medications that reduce uric acid levels in the body. Its mechanism of action involves the prevention or alleviation of gout attacks through the reduction of inflammation. Colchicine can be administered in two distinct manners: some individuals may take small doses consistently over months or years, while others may opt for larger doses over a brief duration (spanning several hours).

Corticosteroids or adrenocorticotropic hormone (ACTH) may be prescribed for patients who are unable to tolerate NSAIDs or colchicine. Typically, patients experiencing acute gout are given daily doses of prednisone (ranging from 20 to 40 mg) or its equivalent for a duration of 3 to 4 days, followed by a gradual tapering over one to two weeks. ACTH is delivered via intramuscular injection, with an initial dose followed by additional doses as required over several days.

Allopurinol (marketed under the brand name Zyloprim) is indicated for chronic gout or gouty arthritis and functions by influencing the system responsible for uric acid production in the body. It is intended for the prevention of gout attacks rather than for the treatment of attacks once they have occurred.

Probenecid (available under the brand names Benemid and Probalan) is prescribed for chronic gout and gouty arthritis. Its purpose is to prevent gout-related attacks, not to treat them once they manifest. Probenecid operates on the kidneys to facilitate the elimination of uric acid from the body.

Probenecid is classified as a uricosuric agent.

ColBenemid (also known as Col-Probenecid and Proben-C) is a medication for gout that combines Probenecid, a uricosuric agent, with Colchicine, which possesses anti-gout properties.

Sulfinpyrazone (branded as Anturane) is recognized as a uricosuric agent and is utilized in the treatment of gouty arthritis. It functions by decreasing the concentration of uric acid in the bloodstream, thereby preventing gout attacks. While it aids in the prevention of attacks, it is not intended for the treatment of an attack once it has commenced. Currently, sulfinpyrazone is not available in the United States.

Losartan, known commercially as Cozaar and Hyzaar, is not explicitly approved for the treatment of gout; however, it is categorized as an angiotensin II receptor antagonist and an antihypertensive medication that may assist in regulating uric acid levels. Fenofibrate, marketed under the brand name Tricor, is not a dedicated gout treatment but serves as a lipid-lowering agent that may also aid in managing uric acid levels.

Analgesic pain relievers are frequently employed to alleviate the severe pain associated with gout. The previously mentioned medications can be utilized in conjunction to manage symptoms, avert future episodes, and sustain optimal uric acid levels.

Gout Diet...
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Gout Diet : The Myths

How can an individual start distinguishing between myths and facts to make informed purchasing decisions at the grocery store? The University of Washington, Department of Orthopedics states:

* There is a correlation between obesity and elevated uric acid levels in the bloodstream. Individuals who are overweight are advised to consult their physician to establish a suitable weight-loss plan. Engaging in fasting or extreme dieting may inadvertently increase uric acid levels and exacerbate gout symptoms.

* Generally, individuals can consume a variety of foods within certain limits. Those who experience kidney stones caused by uric acid may need to completely remove purine-rich foods from their diet, as these can elevate uric acid levels.

* While drinking coffee and tea is generally acceptable, alcohol consumption can increase uric acid levels and trigger a gout attack. It is advisable for individuals, particularly those with kidney stones, to drink at least 10-12 eight-ounce glasses of non-alcoholic beverages daily to assist in flushing uric acid crystals from the system.

Gout diet....

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What Are Gout Attacks?

Gout Diet Gout usually attacks a single joint suddenly and intensely. Gouty joints show the most visibly red signs of inflammation of any type of arthritis. An initial attack of gout may last several days and disappear even if untreated. Subsequent attacks may not occur for weeks, months, years, or not at all. In severe cases, repeated attacks occurring over a long period may cause damage to the joints and loss of mobility. A definitive diagnosis of gout can be made by examination of aspirated joint fluid with a polarizinglight microscope for evidence of crystals.

Approximately one million people in the United States suffer from gout. It is nine times more common in men than women, predominantly after puberty with a peak age of 75. Gout attacks in women usually occur after menopause. Gout Diet

What Are Gout Attacks Video :

5 Good Foods for Gout Diet

5 Good Foods for Gout Diet

Traditionally gout diets have focused on what not to eat – namely foods rich in purines, nitrogen-containing compounds that are metabolized into uric acid in the body. But increasingly, research is showing what you do eat may be equally important to managing uric acid levels and reducing the risk of developing gout or suffering painful gout attacks.

Along with following a well-balanced diet to promote general health and achieve and/or maintain a healthy weight, here are five foods to focus on whether you are trying to control gout or prevent it.

Vegetables. A diet rich in vegetables is important to good health. While doctors once advised against vegetables with purines –including mushrooms, asparagus and spinach – for people with gout, research published in 2012 shows no correlation between the intake of these vegetables and gout risk. It may be because the beneficial compounds in these foods may offset the effects of the purine content, which is much lower than in meats.

Cherries.
At least a few studies suggest that cherries may be beneficial against gout. One small study presented at the 2010 annual meeting of the European League Against Rheumatism found that patients who took a tablespoon of cherry juice concentrate twice a day for at least four months experienced a greater than 50% reduction in gout attacks. In a 2012 study, people who ate cherries or used cherry extracts had fewer gout attacks in the two days following cherry ingestion than during the two days following periods when they didn’t ingest cherries or cherry extract. Research suggests cherries may help by reducing uric acid levels or working more directly on inflammation.

Water.
Research shows drinking more water means fewer gout flares. One study from 2009 revealed that with each glass of water consumed in 24 hours before an attack, the risk for recurrent gout attacks decreased. For example, those who drank five to eight glasses of water had a 40 percent reduced risk of a gout attack compared with those who drank only one glass of water or less in the prior 24 hours. The study’s authors could not make specific recommendations about the amount of water people should drink because it depends on their underlying medical conditions and physical activity levels. Talk to your doctor about how much water you should drink each day.

Dairy products.
Investigators have found that low-fat dairy products may improve excretion of uric acid in the urine. In an earlier study, those who consumed a serving or more of low-fat milk or yogurt a day had less uric acid in their blood than those who abstained. High protein and low purine content of milk may explain dairy’s protective effect.

Coffee.
Two separate studies reveal that drinking coffee reduces the risk of gout for men and women. Results of the larger study, which included 45,869 men older than age 40 with no history of gout, showed the risk of gout was 40 percent lower for men who drank four to five cups a day – and 59 percent lower for men who drank six or more cups a day when compared to men who never drank coffee. In the other study researchers reviewed food questionnaires from 14,000 men and women age 20 or older, and found that the more coffee (regular or decaf) the participants drank, the lower their uric acid levels were. Tea seemed to have no effect.

Gout Prevention

Gout Prevention

Prevention of acute gout involves the following actions:

* maintaining adequate fluid intake
* weight reduction
* dietary changes
* reduction in alcohol consumption
* medications to reduce hyperuricemia

Dout Diet

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Limit High Purine Foods

Limit High Purine Foods

High levels of uric acid can cause gout. High purine foods in a diet can increase uric acid levels in the body. Therefore, the gout diet usually limits food with high purine.

Gout Diet / Low Purine Diet

* Alcohol, especially beer, should be avoided. Limit alcohol consumption to 1 drink 3 times a week.
* Drink 2 to 3 L of fluid daily. Adequate fluid intake helps dilute urinary uric acid. Avoid High-Purine foods (see below)
* Consume a moderate amount of protein. Limit meat, fish and poultry to 4 - 6 oz per day. Try other low-purine good protein foods such as low fat dairy products, tofu and eggs.
* Limit fat intake by choosing leaner meats, foods prepared with less oils and lower fat dairy products.

What Causes Gout?

What Causes Gout?

Gout Diet
Gout is often related to an inherited abnormality in the body to process uric acid. Uric acid levels can become elevated by eating a lot of purine-rich foods such as meats, by the overproduction of uric acid by the body, or if the kidneys do not eliminate excess uric acid. When uric acid reaches a certain level in the blood it precipitates out in the form of monosodium urate crystals. In gout, the crystals are deposited in connective tissue and joint spaces evoking intense inflammation.

People with high levels of uric acid in the blood (hyperuricemia) do not always develop gout. Actually most people with hyperuricemia do not develop gout. Therefore it is not necessarily the high level of uric acid causing gout but perhaps a rapid change in its level. Gout attacks can be
precipitated by:

* dehydration
* injury
* fever
* heavy eating
* heavy drinking of alcohol
* recent surgery

Other contributory factors include:

* obesity
* weight gain
* high blood pressure
* abnormal kidney function
* certain medications
Gout Diet