High levels of uric acid in the blood cause gout in some people. Gout is a painful joint condition that classically affects the large toe, often starting in the middle of the night. However, it can affect many other joints and can also cause kidney stones. Foods do not contain much uric acid. Instead, our bodies make uric acid, and some foods encourage the body to make more of it or interfere with its excretion, causing it to build up in the blood. Dietary changes and medications can help with high uric acid and gout. Ask your doctor about a diagnosis and treatment if you have gout symptoms.
Solid Foods
Obesity is a risk factor for gout. So, excess calories in any form can indirectly contribute to the frequency of gout attacks by promoting weight gain. Protein is generally healthy, but also can contribute to attacks of gout. Therefore, don't eliminate protein, just eat it selectively. Meat and fish tend to increase gout attacks. Dairy proteins are a better alternative. Replace high-fat foods with low-fat choices, and refined carbohydrates with complex carbs.
Beverages
Sugary foods and beverages such as carbonated drinks with high fructose corn syrup can lead to gout attacks. Wine may not increase the risk of gout; however, other forms of alcohol, particularly beer, increase the risk of gouty attacks.
Acute Anti-Inflammatory and Pain Medicines
The pain of gout is caused by deposits of crystals of uric acid into the joints, as well as the resulting inflammatory response. Colchine is a drug that can be given for a short time to some people to slow uric acid deposition and fight inflammation. Nonsteroidal, anti-inflammatory drugs such as ibuprofen or indomethacin can be helpful. These drugs all aim to counter the acute pain and inflammation of gout.
Uricosurics
Two classes of drugs, uricosurics and xanthine oxidase inhibitors, are aimed at preventing gout. Uricosurics are most effective when gout is caused by the decreased excretion of uric acid through the kidneys. Uricosurics cause the kidneys to deposit more uric acid into the urine. Probenecid is commonly used for this purpose.
Xanthine Oxidase Inhibitors
Xanthine oxidase inhibitors prevent the body from making as much uric acid by inhibiting the enzyme xanthine oxidase. Febuxostat and allopurinol are two drugs that inhibit xanthine oxidase, resulting in lowered blood levels of uric acid and less frequent attacks of gout. It is important for uricosurics and xanthine oxidase inhibitors to not be taken during an attack, because they can actually make the attack worse.
References
- "Harrison's Principles of Internal Medicine"; Anthony S. Fauci et al.; 2008
- "Robbins and Cotran Pathologic Basis of Disease"; Vinay Kumar et al.; 2009
- "Nutrition: Concepts and Controversies"; Frances Sizer et al.; 2007
- UptoDate.com: "Prevention of Recurrent Gout"; Michael A. Becker; 2010
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