Gout is a form of arthritis, or joint inflammation. It is associated with uric acid crystals collecting in the joints. The uric acid crystals damage the joint space and attract cells of the immune system, which can cause further damage to the joints. Gout is treated medically and with lifestyle modifications, including the avoidance of certain foods and drugs. All diagnoses and treatment regiments should be made with the consultation a healthcare professional.
Foods
Certain foods may make gout attacks more likely. Foods that are high in a chemical group called purines may contribute to gout. Low purine diets have bee suggested to lower levels of uric acid, but the effect is modest. According to a study in "Annals of the Rheumatic Diseases" it was more effective to emphasize weight loss with a restriction of calories. In addition, limiting the number of carbohydrates and replacing refined carbohydrates, especially fructose, with complex carbohydrates. Restricting saturated fats and replacing them with protein and unsaturated fats also helped to decrease the number of attacks. Regarding protein intake, fish and meat products increase gout attacks, while dairy proteins do not. As for alcohol, gout attacks seem to be most frequent with beer, less so with spirits, and wine does not appear to increase gout attacks.
Medications for Non-Gout Conditions
Certain medications also increase the frequency of gout in people prone to the disorder. Diuretics are drugs given to increase urine output, typically to decrease the fluid volume in the body. They are often given for hypertension or high blood pressure. The class of diuretics most implicated is the thiazide diuretics, which includes hydrochlorthiazide. Loop diuretics such as furesmide are also implicated. However, this is not true in every case, and high blood pressure is also implicated in gout, so lowering the blood pressure with these or similar drugs may decrease the frequency of attacks. Other drugs include immune system depressants used frequently in people who have received organ transplants, and aspirin.
Gout Medications
One classification of gout medications include those that treat the attacks and those that prevent them. If a gout medication normally used to prevent attacks is taken during an attack, it can actually make the attack worse or longer lasting. Some examples of these preventative drugs include probenecid, allopurinol and febuxostat.
References
- "Annals of the Rheumatic Diseases"; "Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study"; Dessien et al; July 2000
- "Harrison's Principles of Internal Medicine"; Anthony S Fauci; 17th Ed 2008
