Gout attacks are painful and needs medical treatment to reduce the pain, swelling and redness. However, when the symptoms of the attack passes, it does not mean that you no longer have gout. Many people make this mistake. Gout is a chronic condition and often remains asymptomatic (without symptoms) for long periods of time – weeks, months or even years. The joint symptoms are just acute attacks that arise now and then and are short lived. While chronic medication is an important part of managing your gout, so is your diet and lifestyle choices.
Too Much Uric Acid
Many gout sufferers do not fully understand their condition. Gout is a problem with the way your body handles uric acid. Normally your kidney excretes uric acid from the body. It is filtered out of the bloodstream by the kidneys and passed out in urine. The body is able to balance the production of uric acid with its excretion and in this way too much of uric acid does not accumulate in the body. But people with gout do not have the same efficient balancing mechanism. Uric acid accumulates in the bloodstream.
Eventually it is deposited in the joint space that is normally filled with a lubricating fluid. When the uric acid concentration is high, it may precipitate and form uric acid crystals. The presence of these crystals triggers inflammation in the joint (arthritis). Gout is a condition of high uric acid levels in the blood (hyperuricemia) leading to uric acid crystal formation. Gouty arthritis is the term for the joint pain, swelling and redness that is seen with gout attacks.
Living With Gout
Based on this basic understanding of gout, the goal of management is to reduce uric acid intake and increase urine output. Most uric acid in the body is produced as a result of breaking down purine – a major component of proteis. Humans lack an additional enzyme known as uricase which would break down uric acid further. Therefore it has to be excreted. The kidneys excrete uric acid along with other wastes, electrolytes and water that the body does not need in the form of urine.
Apart from reducing the amount of uric aid that is produced and increasing the excretion of uric acid, there are other factors that play a role in gouty arthritis.
Drink More Water
By drinking more water you will increase your urine output. The more you urinate, the more uric acid you pass out. But drinking water also prevents uric acid crystal formation in another way. When you drink less water, there is a lower water content in your body fluids. Most people are mildly dehydrated and may not experience any symptoms. Less water means that the concentration of uric acid crystals are higher than normal. Precipitation is more likely to occur. If you are a gout sufferer then increase your water intake to 2 to 4L (liters per day).
It may be difficult to move around when you are having a gout attack. But exercise is an important part of gout management. Exercise has a host of health benefits and also reduces urine retention. This simply means that you urinate more when you are active, and less when you are sedentary. It increases uric acid excretion accordingly. Exercise is also beneficial in controlling your body weight as studies have shown that a lower body weight decreases uric acid levels in the body. Always speak to your doctor before you starting any exercise program. Remember that exercise is only beneficial if you workout regularly – at least 3 to 4 times per week.
Reduce Protein Intake
Uric acid buildup in the body is a consequence of protein breakdown. While small amounts of protein that make up the body tissue may be broken down, the main culprit is the protein that you eat. High protein diets are therefore a problem in gout management. You will have to reduce your protein intake and this means cutting down on meat, fish, eggs, dairy, soya and other major protein sources. It does not have to be excluded from the diet entirely since protein is an essential nutrient. But rather moderate the amount of protein you eat and increase the fresh fruits and vegetables in your diet.
Avoid Alcoholic Drinks
Alcoholic beverages are one of the major triggers of gout. While it may increase your urine output, it causes you to lose water without the associated uric acid loss. Furthermore the byproducts of alcohol consumption can contribute to the development of gouty arthritis. Most alcohol drinkers would rather reduce their intake of alcohol instead of stopping it altogether. However, even small amounts of alcohol can be a problem for gout sufferers. Rather abstain from alcohol altogether, especially when you are having a gout attack.
Control Your Body Weight
Losing weight is an important part of gout management if you are overweight or obese. People who are overweight or obese are more likely to have higher uric acid levels than people with a normal body weight. But this can be changed. Studies reveal that by losing weight, you will reduce the uric acid levels in your body. Adopting a healthier eating plan, reducing your calorie intake and exercise will help you lose weight gradually. Avoid strict fasting and fad diets for rapid weight loss. By losing weight too fast, you can actually worsen your gout.
Reassess Your Medication
Certain drugs can increase your uric acid levels and trigger gouty arthritis. Never change the dose of your medication or stop any drug without first speaking to your doctor. Some of these medication can be life-saving drugs that prevent serious complications. Low doses of aspirin and diuretics are the two main drugs that pose a problem in people with gout. These are commonly used drugs for people with cardiovascular conditions or those who are at high risk of these diseases.
Low doses of aspirin are used to prevent blood clot formation and is widely used by people at risk of heart attacks and strokes. Diuretics promote fluid loss thereby decreasing your blood pressure. It is used for hypertension (high blood pressure). Your doctor may look at alternative drugs to manage these medical conditions without aggravating your gout. Anti-rejection drugs used by patients who receive an organ transplantation may also be a problem for gout sufferers. These drugs are essential and cannot be stopped. Your doctor will advise your accordingly.