Gout : Diagnosis, Risk factors and diet plan

What is Gout

Gout is inflammatory arthritis that develops as a result of high uric acid levels in the body. Uric acid is a waste material resulting from the breakdown of purines. Purines are part of all human tissues and are found in many foods especially those high in protein.

If there is hyperuricemia (high levels of uric acid in the blood), it means that uric acid is overly produced or not excreted in the body. This excess uric acid can accumulate, crystalize and then deposit in certain joints. It deposits most commonly in the big toe, and this can lead to an attack of inflammation.

This inflammation causes sudden, severe pain, tenderness, redness and swelling in the affected joints which can last for a few days if untreated. The higher the level of the uric acid, the greater the incidence of gout. 

Diagnosis

Gout diagnosis includes heaving an acute joint swelling, demonstration of elevated uric acid levels in the blood. And detection of uric acid crystals in affected joints through joint aspiration.

What is joint aspiration for gout

A joint aspiration is a procedure that obtains fluid from the swollen joints. This fluid is then analyse if there are any uric acid crystals. This is confirmatory for gout and can help exclude other possible causes for joint swelling, such as infection. At the same time when we remove the fluid, steroids can also be given into the joint itself to resolve the attack of swelling much more rapidly. Removal of fluid as well relieves the joint.

Risk factors

Are there any risk factors for gout? the answer is yes. These are essential risk factors or causes for elevated uric acid levels.

The first one is diet. Eating foods high in purine content such as high fructose corn syrup containing foods, meats and seafood. Alcohol can also increase uric acid levels and lead to gout. 

Gender and age are another risk factors. Men tend to have higher uric acid levels and develop gout at an earlier age than women. Women tend to develop gout after menopause, due to the protective effect of estrogen. 

Ethnicity and family history is also a risk factor. Studies have shown that hyperuricemia is highly hereditable. If family members have gout, you are more likely to develop it. 

Obesity and other medical comorbidities are risk factors. Medical conditions like high cholesterol, high blood pressure, diabetes and kidney issues tend to accompany gout. These conditions can all increase the risk of high uric acid levels as well as tend to decrease the clearance of uric acid through the kidneys. 

A serum uric acid level above 6.8 milligrams per deciliter is also known as hyperuricemia.

How to better manage your gout

  1. Take your medications as prescribed. 
  2. Do not stop your medications without telling your doctor. 
  3. Check your uric acid levels twice a year.
  4. The goal should be a uric acid level below 6 milligrams per deciliter.
  5. Maintain healthy body weight. Someone at an ideal body weight is at lower risk of gout.
  6. Get regular exercise. Exercise 30 minutes a daily for at least 5 days of the week. You do not have to join a gym for this. good walking can do better for you. 
  7. Drink plenty of water. Water may help remove your uric acid from your bloodstream. 
  8. Stay away from drinks made from high fructose corn syrup.
  9. Maintain a healthy and balanced diet. eat foods that are low in purines.

Gout attacks can come on suddenly and result in a very painful, red, swollen joint. It is important to understand what factors can put you at risk for this condition. As well as how to manage your gout attacks a little better. 

The gout diet

A gout diet is basically the same as a balanced healthy diet. If you are overweight, you increase the risk of developing gout. Losing weight will help lower your risk. 

  • Try to eat more complex carbohydrates rather than more processed foods. 
  • Eat more fruits, vegetables and whole grains. Avoid foods such as white bread, cake, candy, soda and drinks with high fructose corn syrup.
  • Cut back on saturated fats from red meats, fatty poultry and high-fat dairy products. 
  • Drink plenty of water. Increasing the amount of water you drink may help lower the numbers of gout attacks you have. Drink eight to 16 cups of fluid a day and half of that should be water. 
  • Eat only 4 to 6 ounces (113 to 170 grams) of lean meat, fish or poultry a day. You can get additional protein from low fat or fat-free dairy products, beans and nuts.
  • Low-fat dairy products like yoghurt and skim milk are linked to lower uric acid levels. Low-fat yoghurt can be very satisfying as a mid-afternoon snack. 
  • While some vegetables are high in purines, they do not raise the risk of gout attacks. Your diet should contain lots of fruit and vegetables. Try vegetables raw and cooked. there are a number of vegetables that make a great snack.

There are certain foods you should avoid

  • Stay away from meats such as liver and kidney. They are high in purine.
  • Stay away from oily fish such as sardines, trout, paddock, mackerel and tuna.
  • You should also avoid shellfish like mussels, shrimps, lobsters and crab. 
  • Avoid all alcohol if you have frequent gout attacks or your gout is not under control.
  • Stay away from beer. beer is known to put you at a higher risk of gout attacks.
  • Whiskey and other hard liquors may be linked to gout attacks but not as much as beer. Wine may be a better choice but you should discuss this with your doctor. 

In short, there is evidence that following a well balanced diet can decrease your risk of gout attacks. Always keep in mind that a well balanced diet does not mean that it takes the place of your medications. 1

 

 

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