SHARES
“I had my first gout attack ten years ago. Then it became more and more frequent, and went from my big toe to my knees. When it got worse, the pain was excruciating. I felt like as if my foot is on fire and someone is constantly stabbing it! I couldn’t even put on my shoes. Right now, I’m taking high dose allopurinol, had given up alcohol but my gout just keep coming back.” says Pakri, 52, an architect.
What is gout?
Gout causes very severe pain in your joints (usually the big toe) that comes suddenly, affecting joints in the feet, ankle, knees, hands and elbows. Whenever that happens, the affected joints become red, hot, very painful and swollen. As a result, you may find it difficult to move or stand on your painful joints. Generally, it usually takes about a week for the pain and swelling to reduce or go away.
“The worst nightmare of my gout, is to have it again!” Photo by Marcus Thompson on Flickr
What causes gout?
Your joint becomes painfully inflamed when your body deposits a waste product called “uric acid” in the form of hard crystals into your joints. A large amount of these uric acid are as a result of consuming food rich in purine. Sometimes, a high level of uric acid runs in families because of inherited genes.
Lifestyle and diet is not all that is to gout, but they certainly have a significant impact. If you eat a lot of purine-rich foods, such as meats, beer, nuts etc, these are contributory factors. So is being overweight, diabetic, having high cholesterol, suffering from high blood pressure, taking certain medicines for high blood pressure and not drinking enough water.
Generally, gout is most common among men, first gout attack usually happens from age 30-55. Women are more likely to get gout after menopause
Living with gout
Having a gout attack can be a dreadful experience. An attack usually begins quickly and suddenly, reach the most painful stage within 12-24 hours, and lasts for up to two weeks.
You stop working, miss out on family activities and social events. It feels like your life is put to a halt. Walking is very painful and you feel awkward in your crutches.
The most important point with gout is prevention. Firstly it is vital to avoid certain foods and to stay hydrated.
Tips for Drivers
Driving can be impossible during an attack. Sometimes, you feel lucky because amidst your misery, only your left toe is affected. With the right foot still normal, you may feel you can still drive your automatic car. If you decide you are fit enough to drive, do be careful. For instance, keep your doctor’s phone number ready just in case of emergency. Furthermore always have with you a painkillers on hand (eg Ibuprofen). In addition, going for a pair of loosely fitting shoes with good support would be helpful.
We can imagine drivers driving for long hours don’t want to drink a lot of water because you don’t want to stop and pee! If you have gout, change that mindset since you need to be well hydrated.
Secondly, you should check your high blood pressure medications too. The reason is some medications can actually increase uric acid levels, making you more prone to getting a gout attack or a kidney stone. Blood pressure lowering agents which may increase uric acid levels include diuretics, β blockers, angiotensin converting enzyme (ACE) inhibitors, and non-losartan angiotensin II receptor blockers. Talk to you doctor about using a different medication so that you won’t have the problem.
What to eat or avoid to prevent gout attack?
1. Avoid food high in purine
When purine present in food is taken into our body, it is broken down into uric acid. Consequently, this raises your body uric acid level and puts you at risk of gout attack. Notably, examples of food high in purine are organ meat (liver, kidney, brain), deep-sea fish and seafood (sardines, mackerel, tuna, anchovies, crab, shrimps, shellfish) and red meat (lamb, pork, beef).
Caption: Foods to avoid in Gout
2. Keep fructose and refined sugar to minimum
Although fructose and added sugar do not contain uric acids, they were found to increase your body uric acid level too. So, sweetened beverages, desserts, fructose-rich corn syrup, fructose-containing artificial sweetener, honey, sweetened fruit juices and soda should be limited in our daily intake.
3. Limit your alcohol intake
Specifically, drinking huge amount of alcohol can immediately raises your uric acid level. Limit your alcohol intake to not more than 2 servings per day for male and 1 servings per day for female. As a rule, never save up your servings and consume alcohol exceeding your daily limit.
4. Eat a lot of vegetables and whole grains
Generally, all vegetables are fine for people with gout. Particularly, dark leafy vegetables, beans (except fava, edamame and soy), lentils, potatoes etc. are examples of vegetables and legumes that can be consumed. Example of whole grains are like oats, brown rice, cereals, barley etc. Avoid mushrooms, spinach, cauliflower, asparagus and certain beans such as fava, edamame and soy beans
Caption: Eat a lot of vegetables and whole grains (Photo by y duoc tam an on Flickr)
5. Eat enough fruits
Although fruits varies in fructose contents, generally all fruits are suitable to be taken by people with gout. Cherries contain high level of fructose but is found to lower uric acid level and reduce inflammation during gout attack.
6. Eat fish and meat with lower purines in moderation
Chicken and salmon generally have lesser purine content when compared to other fish and meat. However, these food still contains purine and have to be taken in moderation. Limit your intake to 4-6 ounces few times per week.
7. Go for low-fat or non-fat dairy products
Low-fat or non-fat dairy products are found to be beneficial in preventing gout attack. Therefore, consider replacing all your dairy products like milk and cheese to low-fat today!
8. Coffee or tea? No harm!
Drinking coffee and tea does not relate to your gout attack. Thus, you can enjoy your morning brew without any worries!
Conclusion
Gout attack can be an agonising experience. With this in mind, do take some time to explore and adjust to your new eating habit and diet. It is important to remember, don’t give up just yet if your gout relapses. Instead, give yourself some time and be gentle and patient to yourself. Your doctor and dietician will be there to help you!
Find a GP/Family Doctor and Dietician in Malaysia, on GetDoc
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References:
- Best diet for gout: what to eat, what to avoid [Healthline]. Healthline Media. 2005. [Available from: https://www.healthline.com/nutrition/best-diet-for-gout; assessed on 2019 May 5]
- Jonathan K. Prophylaxis, treatment and foods to avoid in gout [Medscape]. WebMD LLC. 2013. [Available from: https://www.medscape.com/viewarticle/777243#vp_2; last updated on 2013 Jan 9; accessed on 2019 May 5]
- Juraschek SP, McAdams-Demarco M, Gelber AC, Sacks FM, Appel LJ, White KJ, et al. Effects of lowering glycemic index of dietary carbohydrate on plasma uric acid levels: the OmniCarb randomized controlled trial. Arthritis Rheumatol. 2016 May;68(5):1281-9.
by Chang Xian
View all articles by Chang Xian.
