Stress, overeating and alcohol have been linked to gout attacks in some people, making Christmas and New Year potentially problematic for those living with gout. An attack can appear suddenly, often overnight, which is especially difficult in the holiday period when health services are limited.
Gout is caused by high levels of uric acid, a waste product that is usually removed by our kidneys. It occurs more frequently in men, but can also affect women. Long-term gout can lead to permanent damage of cartilage and bone, as well as other complications.
High levels of uric acid can cause small crystals (urate) to form in and around joints, often in the big toe. These crystals cause joints to become extremely painful, red, hot and swollen. If left untreated, gout attacks may become more frequent and take longer to resolve.
Here are a few things people can do to help reduce their risk of a gout attack.
Diet: Everything in moderation
There is no scientific proof that certain foods can cause gout, or that avoiding certain foods will eliminate gout. However, foods that are high in a substance called purines have been reported to trigger gout attacks. Purine-rich foods include red meat and offal, shellfish, mussels and beer – a typical festive smorgasbord.
People with gout need not avoid these foods completely, but it is important to be mindful of the amount of these foods you eat and avoid overindulging. Completely cutting out these foods from your diet may deplete your body of important nutrients and vitamins.
Drinking too much alcohol can lead to dehydration, which in turn can reduce the kidney’s ability to remove uric acid, leading to a build up in your body. Drinking beer in particular can lead to increased uric acid levels.
It is therefore important to drink plenty of water so you stay hydrated. Drinking water regularly throughout the day can also help you avoid overindulging on food and alcohol.
Due to medical reasons, some people may have to restrict the amount of fluids they have. If you have a heart or kidney condition, or are taking diuretics (‘fluid tablets’), speak to your doctor about how much fluid you should drink throughout the day.
Avoid ‘crash diets’ or fasting
Being overweight is a risk factor for gout but trying to lose excess weight rapidly or fasting can reduce the kidney’s ability to remove uric acid, which can trigger a gout attack. For people with gout who are overweight, weight loss should be gradual and achieved by adopting a healthy diet and regular exercise.
Most people with gout will also need to take prescribed medications to resolve symptoms or lower uric acid levels in the body. Your doctor or specialist will select the most appropriate treatment and dose for you.
Medical treatments to resolve pain and swelling related to an attack include anti-inflammatories, colchicine and corticosteroids. These medications often work best when started as soon as possible, so be sure to check that you have a small supply at home.
Always speak with your doctor or pharmacist before you start taking any medicines.
For further information, you may like to read:
> Arthritis Australia (2007). Gout and diet fact sheet
> Arthritis Australia (2014). Taking control of your Gout brochure.
> Arthritis Research UK (2014). Calcium crystal diseases fact sheet.
This article originally appeared in
Arthritis Matters magazine (Issue 51, 2015).