What are the most effective medications for treating gout flare-ups. How can lifestyle modifications help prevent future gout attacks. Which dietary changes can reduce uric acid levels and minimize gout symptoms. What complementary therapies show promise for managing gout.

Understanding Gout and Its Impact on Health

Gout is a form of inflammatory arthritis characterized by sudden, severe attacks of pain, swelling, and redness in joints. It typically affects the big toe but can occur in other joints as well. Gout develops when there’s an excess of uric acid in the body, leading to the formation of urate crystals in joints and surrounding tissues.

The impact of gout on a person’s quality of life can be significant. Acute gout attacks can be incredibly painful and debilitating, often making it difficult to perform daily activities. Moreover, if left untreated, gout can lead to joint damage and other complications.

What causes gout?

Gout is primarily caused by an accumulation of uric acid in the blood. This can occur due to several factors:

• Overproduction of uric acid by the body
• Underexcretion of uric acid by the kidneys
• Consumption of foods high in purines
• Certain medical conditions
• Genetic predisposition

Medications for Treating Acute Gout Attacks

When a gout flare-up occurs, prompt treatment is crucial to alleviate pain and reduce inflammation. Several types of medications can be used to manage acute gout attacks:

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are often the first line of defense against gout attacks. They work by reducing inflammation and pain. Common NSAIDs used for gout include:

• Ibuprofen (Advil)
• Indomethacin (Indocin)
• Celecoxib (Celebrex)

For optimal effectiveness, NSAIDs should be started within 48 hours of symptom onset. However, they may not be suitable for everyone, particularly those with kidney or liver disease, stomach ulcers, or cardiovascular issues.

Colchicine

Colchicine (Colcrys) is another medication used to treat gout attacks. It’s particularly useful for patients who can’t take NSAIDs. Colchicine works best when taken within 6 to 12 hours of a gout attack. However, it can cause side effects such as diarrhea, nausea, vomiting, and abdominal cramps.

Corticosteroids

In some cases, corticosteroids may be prescribed to manage gout attacks. These can be taken orally or injected directly into the affected joint. Common corticosteroids for gout include:

• Prednisone (Deltasone)
• Prednisolone (Orapred)
• Methylprednisolone (Medrol)

Long-Term Medications for Gout Management

For individuals experiencing recurrent gout attacks, long-term medication may be necessary to reduce uric acid levels and prevent future flares. These medications are typically taken daily and include:

Uric Acid-Lowering Medications

• Probenecid (Benemid)
• Losartan (Cozaar)
• Allopurinol (Zyloprim)
• Febuxostat (Uloric)
• Pegloticase (Krystexxa)

These medications work by either reducing uric acid production or increasing its excretion from the body. The choice of medication depends on various factors, including the patient’s overall health, kidney function, and the severity of their gout.

Lifestyle Modifications for Gout Prevention

While medication is crucial in managing gout, lifestyle changes can play a significant role in preventing future attacks and improving overall health. Here are some key modifications that can help:

Dietary Changes

Certain foods and beverages can trigger gout attacks or increase uric acid levels. Limiting or avoiding these can help manage gout:

• Alcoholic beverages, especially beer and spirits
• Sugar-sweetened drinks
• Red meat and organ meats
• Certain types of seafood high in purines

On the other hand, some dietary choices may help reduce gout risk:

• Drinking coffee (although its effect on uric acid levels in chronic gout is limited)
• Consuming cherries or cherry extract
• Increasing intake of dietary fiber
• Ensuring adequate folate intake

Weight Management

Maintaining a healthy body weight is crucial for gout management. Excess weight is associated with higher uric acid levels in the blood. Studies suggest that losing about eight pounds or more can lead to long-term reductions in uric acid levels and gout attacks in overweight or obese individuals.

Hydration

Staying well-hydrated helps the kidneys flush out excess uric acid. Aim to drink plenty of water throughout the day, especially if you’re prone to gout attacks.

Complementary and Alternative Therapies for Gout

While conventional medical treatments remain the cornerstone of gout management, some individuals explore complementary and alternative therapies. These may include:

• Dietary supplements (e.g., cherry extract, vitamin C)
• Herbal remedies
• Acupuncture
• Massage therapy

It’s important to note that the effectiveness of these therapies for gout is not well-established. A study of 276 gout sufferers in New Zealand found that those using complementary and alternative therapies reported similar numbers of gout flares after one year compared to those who didn’t use such therapies.

The Importance of Prompt Treatment and Long-Term Management

When it comes to gout, timely intervention is crucial. Prompt treatment of gout attacks can help:

• Reduce pain and discomfort
• Shorten the duration of the attack
• Prevent joint damage
• Improve quality of life

For individuals with a history of gout, it’s essential to keep appropriate medication on hand in case of a flare-up. This preparedness can make a significant difference in managing the condition effectively.

Long-term management of gout often involves a combination of medication and lifestyle changes. Working closely with a healthcare provider to develop a comprehensive treatment plan is key to preventing future attacks and maintaining overall joint health.

Emerging Research and Future Directions in Gout Treatment

The field of gout research is continually evolving, with scientists exploring new treatment options and refining existing ones. Some areas of current interest include:

Novel Uric Acid-Lowering Therapies

Researchers are investigating new medications that can more effectively lower uric acid levels or target the underlying mechanisms of gout. These may offer alternatives for patients who don’t respond well to current treatments or experience side effects.

Personalized Medicine Approaches

There’s growing interest in tailoring gout treatments to individual patients based on their genetic makeup, lifestyle factors, and other characteristics. This personalized approach could lead to more effective and targeted therapies.

Gut Microbiome and Gout

Recent studies have explored the potential role of the gut microbiome in gout development and progression. This research could lead to new therapeutic strategies, such as probiotic interventions or dietary modifications that target the gut microbiota.

Advanced Imaging Techniques

Developments in imaging technology may improve the diagnosis and monitoring of gout. For example, dual-energy CT scans can detect urate crystal deposits in joints, potentially allowing for earlier intervention and more precise treatment.

As research progresses, it’s likely that our understanding of gout and its management will continue to improve, offering hope for better outcomes for those affected by this painful condition.

Gout Treatment and Prevention | Everyday Health

Treatment for gout aims to reduce pain and inflammation as quickly and safely as possible.

By Lindsey KonkelMedically Reviewed by Samir Dalvi, MD

Reviewed: September 24, 2022

Medically Reviewed

A number of different drugs can be used to treat or help prevent gout flare-ups.Thinkstock (2)

There are several treatment options for gout. Your doctor will help you find the regimen that’s right for you.

If you have a history of gout, it’s important to keep the right medication on hand in case of a flare-up.

Prompt treatment will help reduce the pain and the severity of the attack. It will also help to prevent damage to your joints. (1)

Gout Medication and Treatment

A number of drugs can be used to treat flare-ups, or attacks, of gout.

Many of these medicines are anti-inflammatory, which means that they help reduce painful swelling and inflammation caused by a gout flare.

Common anti-inflammatory medicines for gout include:

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

You’ll need a prescription for some NSAIDs, while others are available over the counter.

Common NSAIDs for gout include ibuprofen (Advil), indomethacin (Indocin), and celecoxib (Celebrex).

NSAIDs are most effective when started within 48 hours of the onset of gout symptoms. (2)

Colchicine

Your doctor may recommend this medicine if NSAIDs aren’t a good option for you. (NSAIDs may not be recommended for people with a history of kidney or liver disease, stomach ulcers, or bleeding problems and cardiovascular disease.) (2)

Colchicine (Colcrys) can be used to treat gout attacks, or it can be taken on a daily basis to reduce the frequency of attacks. Colchicine works best when taken within 6 to 12 hours of a gout attack. Side effects of the drug include diarrhea, nausea, vomiting, and abdominal cramps.

Corticosteroids

These drugs can be taken orally or injected directly into the joint.

Common corticosteroids for gout include: prednisone (Deltasone), prednisolone (Orapred), and methylprednisolone (Medrol).

Gout Medications to Reduce Uric Acid Levels

In addition to the medications above, these are taken daily and used long-term to help prevent flares. Your doctor may recommend long-term therapy with one of these drugs if you’re having recurrent gout attacks.

Some uric acid–lowering medicines for gout include:

• probenecid (Benemid)
• losartan (Cozaar)
• allopurinol (Zyloprim)
• febuxostat (Uloric)
• pegloticase (Krystexxa)

How to Prevent Gout and Future Gout Symptoms

After your gout flare has subsided, your doctor may recommend that you continue long-term therapy with a uric-acid lowering medicine or colchicine to prevent future gout attacks.

Home Remedies for Gout Management

Medication is the most effective way to treat gout symptoms, but there are a number of steps you can take at home to reduce your risk of future attacks.

Actions that may help prevent gout include:

Limiting Alcoholic Beverages and Sugar-Sweetened Drinks These beverages, when consumed in excess, raise your risk of a gout flare-up.

Maintaining a Healthy Body Weight People who are overweight or obese often have higher levels of uric acid in the blood. (3)

Losing weight may help lower your uric acid levels and reduce your risk of future gout attacks.

How much weight should you lose? A 2017 review of studies suggested that a weight loss of about eight pounds or more led to long-term reductions in uric acid levels and gout attacks in overweight or obese people. (4)

Avoiding Foods That Trigger Gout Attacks Red meat, organ meats, and certain types of seafood contain high levels of a substance called purine, which may trigger gout attacks in some people.

Drinking Coffee A large study suggested that men who drink four to five cups of coffee a day may have a lower risk of developing gout than men who don’t. (5)

Subsequent studies, however, suggest that drinking coffee (even several cups a day) does little to lower uric acid levels in people with chronic or recurrent gout. (3)

Other Dietary Supplements Some researchers have looked at supplementing with cherries, dietary fiber, or folate to help prevent gout attacks, though study findings are inconclusive at this time. (3)

Complementary and Alternative Medicines for Gout

Nearly a quarter of people with gout reported using some kind of complementary or alternative medicine in one study of 276 gout sufferers in New Zealand. That includes things like dietary or herbal supplements, vitamins, acupuncture, and massage therapy.

According to the study, gout sufferers who used complementary and alternative therapies reported just as many gout flares after one year as patients who didn’t use complementary or alternative medicine. (6)

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Editorial Sources and Fact-Checking

1. Gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases. February 2020.
2. Gaffo AL. Treatment of Gout Flares. UpToDate. April 7, 2022.
3. Neogi T. Lifestyle Modification and Other Strategies to Reduce the Risk of Gout Flares and Progression of Gout. UpToDate. August 31, 2022.
4. Nielsen S, Bartels E, Henriksen M, et al. Weight Loss for Overweight and Obese Individuals With Gout: A Systematic Review of Longitudinal Studies. Annals of the Rheumatic Diseases. October 9, 2017.
5. Choi HK, Willett W, Curhan G. Coffee Consumption and Risk of Incident Gout in Men: A Prospective Study [PDF]. Arthritis & Rheumatism. June 2007.
6. Chan E, House ME, Petrie KJ, et al. Complementary and Alternative Medicine Use in Patients With Gout: A Longitudinal Observational Study. Journal of Clinical Rheumatology. January 2014.

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Can You Eat Ice Cream If You Have Gout

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If you have gout, you may be wondering if you can still enjoy your favorite ice cream. The good news is that you can! However, it is important to be mindful of the type and amount of ice cream you eat, as certain flavors and ingredients may trigger a gout attack.

What is gout?

Gout is a form of arthritis that occurs when uric acid builds up in the body. This can happen for a variety of reasons, including diet, genetics, and certain medical conditions. When uric acid crystallizes, it can deposit in the joints and cause inflammation, pain, and swelling.

What causes gout attacks?

There are a number of things that can trigger a gout attack, including certain foods and drinks. Some of the most common triggers are alcohol, red meat, and foods high in purines. Purines are a natural compound found in many foods, and when they are broken down, they form uric acid.

Can ice cream trigger a gout attack?

While ice cream itself is not a trigger for gout, some of the ingredients in ice cream can be. For example, many ice creams contain high fructose corn syrup, which has been shown to increase uric acid levels in the body. Other ingredients, such as chocolate, nuts, and coffee, can also trigger gout attacks.

What are the best ice cream choices for people with gout?

If you have gout, it is important to choose an ice cream that is low in purines. Some good choices include vanilla, strawberry, or coffee ice cream. You should also avoid ice cream that is high in fat, as this can make gout worse.

What is the best way to eat ice cream if you have gout?

If you have gout, it is important to eat ice cream in moderation. This means limiting yourself to one or two servings per week. It is also important to choose an ice cream that is low in purines and other gout triggers.

Can you eat ice cream if you have gout?

Yes, you can eat ice cream if you have gout. However, it is important to be mindful of the type and amount of ice cream you eat, as certain flavors and ingredients may trigger a gout attack.

Understanding Gout and Dietary Considerations

Gout is a form of arthritis that can cause severe pain, swelling, and inflammation in the joints. Although gout can affect any joint in the body, it most commonly affects the big toe.

There are many different dietary considerations to take into account when managing gout. For example, purine-rich foods (such as red meat, seafood, and organ meats) can increase the risk of developing gout. Similarly, alcohol consumption can also trigger gout attacks.

Therefore, it is important to limit or avoid these foods and beverages if you are trying to manage gout. However, this does not mean that you have to completely eliminate them from your diet. Instead, moderation is key.

In addition to purine-rich foods and alcohol, there are other dietary factors that can contribute to gout. For instance, eating a diet high in refined carbs (such as white bread and pastries) can increase the risk of gout. Conversely, eating a diet rich in whole grains, fruits, and vegetables may help to reduce the risk of gout.

There is no one-size-fits-all diet for gout, as everyone’s individual needs will vary. However, following a healthy and balanced diet is generally a good idea for anyone, regardless of whether or not they suffer from gout.

If you are struggling to manage your gout, it is important to speak to a doctor or registered dietitian. They will be able to offer tailored advice that is specific to your needs.

Impact of Ice Cream on Gout Symptoms

If you have gout, you may be wondering if you can still enjoy your favorite ice cream. After all, isn’t ice cream full of sugar and other ingredients that can trigger gout flares?

The good news is that you can still enjoy ice cream if you have gout, but you need to be mindful of the type of ice cream you eat and how much you consume.

Ice cream is typically made from milk, cream, sugar, and flavorings. Some ice cream also contains eggs. While most of these ingredients are not problematic for people with gout, the sugar and dairy can contribute to gout flares.

That’s why it’s important to choose ice cream that is low in sugar and made with skim milk or another low-fat milk alternative. You should also limit your portion size to ½ cup or less.

If you are concerned about the impact of ice cream on your gout symptoms, talk to your doctor or a registered dietitian. They can help you create a gout-friendly diet that includes your favorite foods.

Purine Content in Ice Cream

Though gout is often thought of as a “man’s disease,” it can affect anyone. It is a form of arthritis that is caused by the buildup of uric acid in the joints. This can lead to pain, inflammation, and swelling.

While there is no cure for gout, there are ways to manage it and reduce the risk of flares. One important way to do this is by paying attention to the foods you eat.

Certain foods are high in purines, which can increase the level of uric acid in the body and trigger a gout flare. Ice cream is one such food.

Most ice cream is made with milk and cream, which are high in a type of purine called lactose. Lactose is broken down into glucose and galactose, which can raise uric acid levels.

In addition, many ice creams are also high in fructose. Fructose is a sugar that is found naturally in fruits and honey. It is also used as a sweetener in many processed foods.

Like lactose, fructose can also raise uric acid levels. So, if you have gout, you may want to limit your intake of ice cream and other foods that are high in fructose.

Of course, ice cream is just one food that you should be aware of if you have gout. There are many other foods that are high in purines, including red meat, organ meats, and seafood.

If you have gout, talk to your doctor or a registered dietitian about the best diet for you. They can help you create a plan that includes foods that are low in purines and helps you manage your gout flares.

Managing Gout with Ice Cream Consumption

Gout is a form of arthritis that can be extremely painful. The main symptom of gout is a sudden, severe attack of pain, swelling, redness and warmth in a joint, usually in the big toe.

While there is no cure for gout, there are ways to manage the condition and minimize the symptoms. One way to do this is by watching your diet and avoiding foods that can trigger an attack.

Ice cream is a food that is often thought to be off-limits for people with gout, but this isn’t necessarily the case. While you may need to be careful about the type and amount of ice cream you consume, it is possible to enjoy this treat without triggering an attack.

Here are a few tips for eating ice cream if you have gout:

Choose a low-fat or non-fat variety. Ice cream that is high in fat can trigger an attack.

Go for a small portion. Eating a large amount of ice cream at one time can also trigger an attack.

Avoid ice cream that is high in sugar. Sugar can worsen gout symptoms.

Choose ice cream that is made with natural ingredients. Some ice cream brands use artificial sweeteners and other ingredients that can trigger gout.

Be sure to monitor your intake of ice cream and other foods that contain purines. Purines are a compound that can contribute to gout.

If you have gout, it’s important to work with your doctor to develop a treatment plan that works for you. This may include medication, lifestyle changes and diet modification.

Alternatives to Traditional Ice Cream for Gout Sufferers

If you have gout, you may be wondering if you can still enjoy ice cream. While traditional ice cream is off-limits for gout sufferers, there are plenty of alternative options that can help you satisfy your sweet tooth.

Gout is a form of arthritis that occurs when uric acid builds up in the body. This can lead to the formation of urate crystals, which can deposit in the joints and cause pain and inflammation.

Diet plays a role in gout, and high-purine foods can trigger gout attacks. Purines are found in animal-based foods, such as red meat, organ meats, and seafood. They’re also found in some plant-based foods, such as legumes and mushrooms.

While ice cream doesn’t contain purines, it is high in fructose, a type of sugar that can also trigger gout attacks. Fructose is found naturally in fruits, but it’s also added to many processed foods, including ice cream.

If you have gout, it’s important to limit your intake of fructose. You can do this by avoiding processed foods and opting for fresh fruits instead. You can also find alternative ice cream options that are lower in fructose.

One alternative is sorbet, which is made with fruit juice or pureed fruit instead of milk or cream. Sorbet is lower in fat and calories than traditional ice cream, and it’s also lower in fructose.

Another option is frozen yogurt. Like sorbet, frozen yogurt is made with milk or cream and fruit. However, it also contains live and active cultures, which can have health benefits. Frozen yogurt is also lower in fructose than traditional ice cream.

If you’re looking for a dairy-free option, there are several brands of vegan ice cream that are available. These ice creams are made with plant-based milk, such as almond milk or coconut milk. They’re also lower in fructose than traditional ice cream.

No matter what type of ice cream you choose, it’s important to limit your portion size. Ice cream is a high-calorie food, and overeating can lead to weight gain. If you’re watching your weight, opt for a smaller size or share a scoop with a friend.

If you have gout, you don’t have to give up ice cream completely. There are several alternative options that can help you enjoy this treat without triggering a gout attack.

Consulting with a Healthcare Professional

Gout is a form of arthritis that can cause severe pain, swelling, and inflammation in the joints. It is most commonly seen in the big toe, but can affect other joints as well. While there is no cure for gout, there are treatments that can help to manage the symptoms and prevent flares.

One of the most important things that people with gout can do is to maintain a healthy weight. This can help to reduce the amount of pressure on the joints and prevent further damage. Diet is also important, as certain foods can trigger gout flares. These triggers include alcohol, red meat, and foods high in purines.

While some people with gout may need to avoid certain foods altogether, others may be able to enjoy them in moderation. Ice cream is a food that is often thought of as being off-limits for people with gout, but this isn’t necessarily the case.

Ice cream is generally safe for people with gout to eat, as long as it is consumed in moderation. However, there are a few things to keep in mind. First, ice cream is high in calories, so it should be consumed in moderation. Second, some ice creams contain high levels of purines, which can trigger gout flares. Third, some ice creams contain artificial sweeteners, which can also trigger gout flares.

If you are unsure about whether or not you can eat ice cream, it is best to consult with a healthcare professional. They can help you to create a diet plan that is right for you and can help you to avoid triggering foods.

Personalized Approach to Ice Cream and Gout Management

Gout is a form of arthritis that can cause severe pain, swelling, and inflammation in the joints. Although gout can affect any joint in the body, it most commonly affects the big toe. People with gout often experience a sudden, severe attack of pain, swelling, and inflammation in the affected joint.

While there is no cure for gout, there are treatments that can help to relieve the symptoms and prevent future attacks. One important part of gout management is diet. Some foods, such as purine-rich foods and foods high in saturated fats, can trigger gout attacks or make them worse.

Ice cream is a food that is often thought to be off-limits for people with gout. However, this is not necessarily the case. While ice cream does contain some of the triggering foods, such as purines and saturated fats, it is also a source of important nutrients, such as calcium, protein, and vitamin D.

The key to enjoying ice cream while managing gout is to eat it in moderation and to choose a variety that is lower in purines and saturated fats. For example, ice cream made with skim milk or soy milk is a good choice. Other good choices include ice cream that is low in fat and sugar, such as frozen yogurt, or ice cream that is made with natural ingredients.

If you have gout, talk to your doctor about the best way to manage your condition. They can provide you with individualized advice on diet and lifestyle changes that can help to relieve your symptoms and prevent future attacks.

• Mary Catherine White

  Mary Catherine White is a 29-year-old nutritionist who specializes in helping people eat healthier and feel better. She has a passion for helping others, and she firmly believes that good nutrition is the key to a happy, healthy life. Mary Catherine has a degree in nutrition from the University of California, Berkeley, and she has been working as a nutritionist for the past six years. She has experience helping people with a variety of nutritional needs, including weight loss, sports nutrition, and digestive health.
  
  In her free time, Mary Catherine enjoys spending time with her friends and family, cooking, and practicing yoga. She is a firm believer in the importance of a healthy lifestyle, and she hopes to help as many people as possible achieve their health and fitness goals.

  View all posts

what is it, causes, signs, symptoms, diagnosis, tests, treatment, diet in women, men

Gout is a systemic disease characterized by a violation of the metabolism of purines in the body and the deposition of urate crystals in the joints. The main manifestation of the disorder are recurring attacks of arthritis with intense pain in the joints and the occurrence of tophi – gouty nodules. Also, with this disease, the accumulation of salts in the kidneys with the development of urolithiasis and renal failure is possible.

The prevalence of the disease among the adult population in Europe ranges from 0.9 to 2.5%, and in the United States reaches 3.9%. Gout is most commonly diagnosed in men over 40 years of age. Among women, pathology occurs 6-7 times less frequently.

Causes of gout

The main reason for the development of gout is a violation of the metabolism of uric acid, leading to its excess in the blood – hyperuricemia. This condition occurs with an increase in the intake of purines with food, when their metabolites simply do not have time to be excreted in the urine, or if the excretory function of the kidneys is impaired, as well as in the case of accelerated destruction of cells containing adenine and guanine nucleosides in RNA and DNA, from which urinary is formed. acid in the human body. At the same time, uric acid salts (urates) accumulate in the soft tissues of various organs, mainly in the joints, provoking their inflammation.

Gout is also known as the disease of feasting kings. It received this name due to the fact that the main source of its occurrence was considered excess in food and alcoholic beverages.

Now the disease has been studied in more detail and the following factors predisposing to the development of pathology have been identified:

• eating foods rich in purines – meat, fatty fish, legumes, caffeinated products, offal (kidney, liver, brain), seafood, and alcohol in large quantities;
• consumption of carbonated, sugary drinks and fruit juices;
• obesity;
• hemolytic anemia, leukemia, lymphoma;
• genetic defects (usually in men) and decreased enzymes involved in the metabolism of uric acid;
• use of drugs such as diuretics, cytostatics, salicylates.

In women, gout usually develops in postmenopause, so the disease is also associated with hormonal changes in the body.

Symptoms of gout

From Greek, gout is translated as “foot in a trap”, since the patient is mainly concerned about intense pain in the first metatarsophalangeal joint of the foot, knee or ankle. It is also possible to involve the hand in the form of oligo or polyarthritis (inflammation of two or more joints). In this case, the joint becomes edematous, the skin over it acquires a red tint, begins to shine. This form of the disease is called acute gouty arthritis.

The first clinical manifestations of the pathology may be preceded by a long asymptomatic period of hyperuricemia, when violations are detected only in a laboratory blood test.

The first attacks of pain occur suddenly, mostly in the early morning or at night, tend to increase on the first day and completely disappear in a few hours or within a day. During an exacerbation of gout, there may also be signs of intoxication – fever, chills, weakness. After the inflammation subsides, gouty arthritis reappears, usually within a period of six months to two years. As the disease progresses, the duration of periods of its asymptomatic course is reduced, joint pain occurs more often and is more difficult to bear.

In the transition to a chronic form, gouty arthritis is accompanied by deformity and limitation of movement in the joints, pain of varying intensity becomes permanent. Later deposits of uric acid crystals become visible. Under the skin, more often in the area of ​​​​the joints, tophi appear – nodules of white or yellow color with a crumbly, cheesy content. Above them, the formation of ulcers, purulent wounds is possible.

Hyperuricemia is accompanied by frequent exacerbations of concomitant diseases – ischemic disease, diabetes mellitus, arterial hypertension, atherosclerosis. In the case of the development of complications of gout, the symptoms characteristic of them are added. For urolithiasis, this is a pulling pain in the lower back, the periodic appearance of blood in the urine, frequent urination at night. With a prolonged course of chronic tophi gout, the articular cartilage is destroyed, the restriction of joint mobility is preserved outside periods of exacerbation, complete infection of the joint space with the formation of ankylosis (complete immobility of the joint) is possible. Depression can also be a consequence of persistent pain.

Gout diagnostics

Gout is diagnosed and treated by a rheumatologist, internist or general practitioner (family doctor). Most often, the patient does not apply at the onset of the disease, since the symptoms of acute gouty arthritis quickly disappear, which can be regarded by a person as a recovery, but during one of the subsequent exacerbations. The doctor conducts a conversation with the patient, during which the fact of an acute joint attack in the past, the presence of characteristic complaints, as well as risk factors for the development of pathology are established. The phenomena of bursitis and tophi – the main objective manifestations of gout – are more often found on the leg. Confirm the diagnosis allows a comprehensive examination of the body using laboratory and instrumental methods.

If gout is suspected, the following tests are performed:

• Clinical blood test. During an attack of gouty arthritis, an acceleration of COE, an increase in the number of leukocytes and a shift of the leukocyte formula to the left are possible.
• Determination of urates in blood serum. About 70% of patients with gout flare have high uric acid levels – more than 0.42 mmol/l in men and 0.36 mmol/l in women.
• Determination of uric acid in daily urine. The method is used to assess the risk of kidney stones.
• Urinalysis. It is carried out in order to diagnose diseases of the urinary system that contribute to the development of gout or are its complication.
• Examination of synovial fluid. The sampling of biomaterial for analysis is carried out by puncture of the affected joint. The presence of sodium monourate crystals in the joint fluid makes it possible to confirm gout, and its sterility during bakposev to exclude infectious causes of arthritis.
• Microscopic study of tophi biopsy. Urates, when viewed through a polarizing microscope, look like needle-shaped crystals with a pointed end. This method is also highly specific in the diagnosis of gout, like the previous one.

Instrumental diagnosis of gout may include research methods such as:

• Ultrasound of affected joints;
• MRI and CT;
• x-ray diagnostics.

X-ray at the onset of the disease is carried out for the purpose of differential diagnosis with other arthropathies, while there are no specific signs of gout. Only when the pathology passes into a chronic form in the pictures can one see intraosseous tophi, marginal bone erosions.

Ultrasound examination of the joints before the development of chronic gout is effective only during exacerbations.

MRI can detect tophi inside the joints even before they appear under the skin, which makes it possible to start specific therapy for hyperuricemia earlier. The method is used in differential diagnosis with other diseases, as well as to monitor the effectiveness of treatment. Compared to other imaging modalities, CT allows more accurate differentiation of tophi masses.

Treatment of gout

The main principle of treatment of the disease is the reduction of hyperuricemia. This is facilitated by changing the patient’s lifestyle and reviewing the diet. Correction of hyperlipidemia, arterial hypertension, hyperglycemia, weight loss and smoking cessation are recommended.

The diet for gout involves the exclusion of foods rich in purines or retaining them in the body:

• carbonated soft drinks;
• seafood;
• meat;
• spicy, spicy and smoked foods;
• chocolate, ice cream;
• salted cheeses;
• caffeine, cocoa, strong tea;
• alcohol.

Endogenous purines increase with the use of a large amount of protein of animal origin, therefore, its daily norm for a patient with gout is considered to be no more than 1. 5 g per 1 kg of the patient’s body weight. Dairy products with low fat content, such as kefir, cottage cheese, yogurt, help to remove uric acid from the body. Polyunsaturated fatty acids, for example, in the composition of olive oil, have a similar effect. Also, with gout, it is necessary to observe the drinking regime – at least 2.5 liters of water per day.

It is advisable to start drug treatment of gout on the first day of the onset of acute arthritis. Non-steroidal anti-inflammatory drugs, colchicine and glucocorticosteroid drugs are used locally or systemically to stop an attack. Hypouricemic therapy is prescribed after laboratory and instrumental confirmation of the diagnosis. It is aimed at:

• reduction of uric acid to the target level of 0.36 mmol/l;
• reduction of urate accumulation foci in the body;
• tophus size reduction;
• reduction in the frequency of attacks of gouty arthritis.

Allopurinol is considered the drug of choice for this. If it is intolerant, it is possible to use a selective xanthine oxidase inhibitor – febuxostat. Losartan, Amlodipine and Fenofibrate also have a moderate uricosuric effect. Diuretics are used with great care, only for health reasons. Surgical removal of tophi is carried out only with the appearance of severe complications, for example, carpal tunnel syndrome, spinal compression.

Diet for gout

Every twentieth man has been attacked by gout. The pains are so severe that they are compared to “hellish agony.” Those who have experienced this pain at least once, immediately make an appointment with a doctor and try to follow all his recommendations. In the acute stage, rest, cooling and pain medications help. But traditional treatments for gout have always been based on a strict diet. Modern recommendations are not so categorical. Experts say there is no need for a special diet. The same general principles of a balanced and healthy diet that are important for every person apply to patients. However, it is desirable to eat less food rich in purines, because they form microcrystals that settle in the structures of body tissues.

The goal of dietary selection is to keep uric acid levels as low as possible of six milligrams per deciliter.

Healthy food is an important pillar of therapy and, at best, helps to use less medication. The doctor should regularly check the level of uric acid in the blood to be sure of the success of the therapy.

1. Less purines in food.

To use this tip, you need to have an idea of ​​the purine content of foods that are often on the menu. There are special tables of nutrients that should be used periodically. These tables are very useful for patients and are necessary in the daily preparation of the diet.

Patients should not take more than 500 mg (milligram) of uric acid per day and not more than 3000 mg per week. In the event of an attack, the doctor often prescribes even more stringent upper limits – up to 300 mg of uric acid per day or 2000 mg per week.

In any case, the dose is set by the doctor individually and depends on the severity of the process and the patient’s well-being.

2. Fluid intake

Patients suffering from gout should pay attention to a sufficient intake of two to three liters of fluid per day, unless medically contraindicated. You can drink tap and bottled water, coffee, mineral water, unsweetened herbal and fruit teas (at least two to three liters per day). Sugary sodas and alcohol are not recommended.

3. Severe alcohol restriction

Extreme restraint with alcoholic beverages required! Alcohol affects metabolism and increases uric acid levels. Beer (even non-alcoholic) and whiskey are especially harmful to patients because they are rich in purine. One glass of quality wine per day outside of the attack is acceptable.

4. Down with extra pounds

Obesity is a major risk factor for hyperuricemia. Therefore, weight loss should be a conscious goal of treatment – this alone can reduce uric acid parameters. But be careful: severe fasting can cause an attack of pain and inflammation, so it is prohibited. Ideal weight should be achieved gradually through plenty of exercise and a healthy, low-fat diet, with occasional fasting days. It is necessary to lose weight very carefully – a maximum of one kilogram per month – otherwise you can expect an attack of gout.

Abundant food is as unfavorable as hunger or prolonged periods of thirst. Those suffering from gout should try to avoid such extremes.

5. Sweet

Studies have found that simple sugars are just as unfavorable for people with hyperuricemia as alcohol. Should gout patients avoid fruits and fruit juices? No, experts say. Patients should even eat fruits to take advantage of their positive properties, but no more than two pieces per day (preferably in the morning). Sugary drinks and multivitamin juices sweetened with fructose syrup should be avoided. Also in cereal bars, filled yoghurts, in any ice cream and other sweet foods, fructose is often present and you need to be aware of this!

6. Coffee

The beneficial effects of coffee have not yet been adequately researched, but recent data clearly show that it is no longer necessary to ban coffee in patients with gout

• less meat – it contains purines that break down to uric acid, meat and sausage a maximum of two times per week, offal, broth, meat extract, poultry meat completely excluded;
• certain types of fish should be avoided – eat one low-fat (about 100 g) and fatty sea fish (about 70 g), exclude or consume in small quantities – sardines, sprats, anchovies, crustaceans
• restraint in legumes (such as peas, lentils, white beans) and yeast products is required;
• dispense with the menu without offal, sausages, poultry (especially its skin),
• high fat intake is unfavorable, therefore it is necessary to prepare dishes with a minimum fat content, its breakdown products slow down the excretion of acid, one should be careful with fatty sausages, fatty meats and fatty cheeses,
• Grilling, steaming, cooking in foil, clay pot or pan with a special coating is ideal;
• good sources of protein are milk, dairy products, and eggs, as little as 250 ml of skimmed milk or natural yogurt a day helps to remove uric acid;
• do not exclude vegetables, salads, potatoes, some fruits, just limit their consumption;
• remember that vitamin C has a weak uric acid lowering effect;
• meat is best boiled: during cooking, the purines are partially released from it into the broth, which is drained, then the meat can be used separately.

Latest Dietary Recommendations for Gout

Doctors are not pushing for a strict diet these days. Their short advice is that food should be complete, varied, but excesses should be avoided. The recommendations for people at risk of gout remain the same – eat less purine-rich foods, such as reducing the percentage of meat, offal or seafood in the diet. But, in general, nutritional recommendations are not specific diets, but what can be recommended to someone as a healthy and balanced diet.

Doctors have concluded that purines from plant foods need to be re-evaluated. More recently, it was said that the purine saturation of spinach and Brussels sprouts makes them unfavorable foods. Researchers from the USA have shown that these components do not provoke hyperuricemia with a balanced diet. Thus, there is no reason to refuse celery, cauliflower, etc. Due to the richness of their protein and other unique ingredients, they are more likely to have a positive effect on metabolism.