Coping With Gout

Tips to Deal With an Attack and Prevent Future Ones

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While gout can be controlled to a large extent with the use of uric acid-reducing drugs and other anti-gout medications, there are a number of self-management tools you can turn to if you suffer from recurrent or severe attacks. They involve everything from managing the foods you eat to the little, everyday "fixes" that may even help you prevent future attacks.

Lifestyle

In the same way that lifestyle factors can increase your risk of gout, a modification of unhealthy behaviors can greatly reduce your risk. To this end, the three biggest modifiable risk factors include your diet, your weight, and the alcohol you consume.

Diet

Gout symptoms are often triggered by eating food rich in purine. Purine is an organic substance found in many foods that, when broken down by the body, becomes uric acid. Uric acid is the cause of gout and the enemy to anyone who suffers from it.

To reduce your risk:

  • Become familiar with the high-purine foods you need to avoid or limit, such as beer and shellfish. 
  • Increase intake of gout-healthy foods, such as fresh fruit, fresh vegetables, whole grains, nuts, and low-fat and non-fat dairy products like yogurt and skim milk.
  • Eat vitamin C-rich foods, which are believed to help reduce uric acid.
  • Coffee in moderation may also help.
  • For a sweet treat, eat fresh cherries, which also have a uric acid-reducing effect.
  • Avoid any beverages sweetened with fructose, including sodas and fruit drinks, as this can slow the excretion of uric acid by the kidneys.

Weight Loss

Being overweight or obese increases your risk of a gout attack, probably by increasing your uric acid levels. The risk is further increased if you have excessive visceral (abdominal) fat associated with metabolic syndrome.

To decrease your risk, focus on not only weight loss but an exercise plan designed to gradually burn fat. This requires a slow-but-steady approach, ideally with a nutritionist experienced in gout and a physical trainer experienced in metabolic syndrome.

Embarking on an overly aggressive workout plan can sometimes trigger a gout attack, especially if you place undue stress on the affected joint or get dehydrated. Similarly, launching yourself into a crash diet can trigger symptoms.

Alcohol

Alcohol is problematic as even modest amounts can cause uric acid to soar. By far, the worse of the lot is beer, which is made with brewer's yeast, one of the highest sources of purine. If you are prone to frequent gout attacks, it is advisable to quit or strictly limit beer, as well as whiskey and all other forms of distilled alcohol.

But, does this mean you have to give up drinking entirely? Maybe yes and maybe no. Studies remain largely split on whether wine is linked to gout attacks, and some have even shown that women may be less likely to suffer than men.

Since not everyone suffers gout in the same way, you need to take a sensible approach to drinking. Among some of the strategies to consider:

  • If you're out with friends for cocktails, most bars and lounges today offer non-alcoholic options. But, again, watch the ingredients and avoid fruity drinks which are often made with fructose-sweetened juice.
  • If you do opt to have a drink, limit yourself to one and water it down so that you consume less alcohol over the course of an evening. You should also snack or have a meal to soak up some of the excess alcohol.
  • Also, have a glass or two of water after a drink. Not only will this dilute the alcohol in your system, it can make you feel fuller and less likely to order another drink. It will also promote urination and keep your kidneys working.

On the other hand, if you suffer severe or recurrent attacks and find it difficult not to drink, speak with your doctor and ask about treatment options.

Practical

If ever you experience an acute gout attack, there are immediate steps you can take to treat your condition. As symptoms tend to increase in the early part of an attack, quick action can save you a whole lot of pain and suffering.

Among some of the go-to tips:

  • Start by taking a nonsteroidal anti-inflammatory drug (NSAID) like Aleve (naproxen) or Advil (ibuprofen).
  • If your foot is involved, elevating the foot above your hip can alleviate some of the throbbing pain and discomfort.
  • Use an ice pack on the affected joint, but be sure to cover the pack with a thin towel and keep it on the skin for no longer than 15 to 20 minutes at a time to prevent frostbite.
  • Try to relax as much as possible, either by watching a movie, talking with a friend, reading a book, or listening to calming music.
  • If your big toe is affected (and it likely will be), get an old pair of socks and cut out a hole big enough for your toe to stick through. This little fix can keep your foot warm while keeping pressure off the toe.
  • Make your bed so that your foot can stick out at the bottom of the bed sheets. During an acute attack, even the weight of a sheet can cause extreme agony.
  • If you need to walk, use a cane or get a pair of crutches from your doctor or a home health care supply store.
  • Avoid driving as you may end up hurting your foot or even causing an accident. Instead, take a cab or ask a friend to drive you.
  • If you are on uric acid-reducing medications like Zyloprim or Uloric, do not stop. Some of these drugs can trigger attacks in the early stages of treatment. Even if they do, you need to push through.
  • Stay positive. If anything, remind yourself that an attack is not forever, and there are steps you can take to avoid future attacks.

With that being said, if your symptoms don't improve after 48 hours or last for more than a week, call your doctor and schedule an appointment.

If you are on treatment, you may need to make changes to your therapy or explore other lifestyle interventions. If you are not, it may be time to explore treatment options.

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