Jessica Frizzell, PA-C
How to Manage Gout Flares with a Healthy Lifestyle
If you have a rheumatic disease, you most likely live with some form of arthritis.
While arthritis is a common term widely discussed amongst our rheumatology patients, not everyone has heard of gout.
What is Gout?
Gout is a type of arthritis.
This form of arthritis typically affects one joint at a time, such as the big toe, but is known to attack other toe joints, fingers, knees, ankles, wrists, and elbows.
As with other rheumatic diseases, individuals living with gout experience flare-ups as well as times of remission. Gout symptoms typically come on suddenly, especially during the middle of the night, and bring on intense pain, swelling, warmth, and redness.
Some even describe the rapid onset of symptoms to feel like the inflamed joint is on fire, making it impossible to bear weight or even touch that joint.
Stages of Gout
To understand the different stages of gout, it is best to learn why gout occurs.
Within all of us, we have purines. Uric acid is created when the body breaks down those purines. Gout is a result of too much uric acid.
Uric acid (urate) usually dissolves in our blood or travels to the kidneys to be released when we urinate. If your body does not filter out that uric acid properly and you develop high urate levels, a condition called hyperuricemia makes crystals form within the joints.
Hyperuricemia can lead to gout, and when gout goes uncontrolled for too long, you can develop tophus. Tophusi is part of advanced or late-stage gout when clusters of hardened urate crystals form visible bumps on the joints. These uric acid deposits can also develop in soft tissue, cartilage tissue, tendons, and bones.
A gout flare-up can last for hours, days, or even weeks. Some patients experience frequent flares, while others go years between attacks. In fact, many of our rheumatic patients can go extended periods of time without any symptoms between flares.
If gout goes untreated, the gout attacks tend to evolve. Patients often report an increased number of flares and those flares seem to last longer.
Complications From Gout
Gout can lead to other medical complications. The urate crystal formations can damage more than just your joints.
In particular, high urate levels tend to turn into heart and kidney conditions. The National Institutes of Health reports that individuals with gout are more likely to develop:
Hypertension (high blood pressure)
Chronic kidney disease
Nephrolithiasis (kidney stones)
Myocardial infarction (heart attack)
Congestive heart failure
Gout Risk Factors
Like with other rheumatic diseases, there are many contributing factors that can lead to a gout diagnosis, such as gender, genetics, family history, previous health complications, and lifestyle choices.
Gout impacts both men and women, young and old, but is more common in men. The Cleveland Clinic states: “Men can be three times more likely than women to get it because they have higher levels of uric acid most of their lives. Women reach these uric acid levels after menopause.”
And remember those purines mentioned above? Some foods and drinks have high levels of purines, which in turn, can raise your uric acid levels.
Treatments for Gout
There are several ways to treat gout. The treatments for gout vary depending on if you are trying to manage a flare versus trying to prevent a flare.
The goal of treatment is to (1) lower inflammation as well as (2) decrease the amount of uric acid in your body.
Some medications work by blocking uric acid production while other medications are designed to improve how well your body removes uric acid. When you lower your uric acid levels, you are reducing the chance of new crystals forming.
It’s all about getting that hyperuricemia under control. Gout medications help to stop the body from producing too much uric acid or do a better job at excreting it.
Many patients have discovered that a combination of prescribed medications alongside healthy lifestyle choices is the best way to treat gout, and research agrees.
A study released by BMC Medicine concluded:
“Healthy lifestyle was associated with a lower risk of gout and may attenuate the risk of gout related to genetic factors by almost a third …
It is well-accepted that both genetic and lifestyle factors play a role in determining an individual’s risk of gout …
Accumulating evidence suggests that lifestyle factors including alcohol consumption, smoking, diet, physical activity, and body mass index are associated with gout risk.”
Certain foods and beverages are known triggers for gout.
When a food or drink is rich in purines, the body is forced to try and metabolize those purines. Breaking down purines creates uric acid, and if your body does not manage uric acid well, then high-purine food or drinks become a problem.
All types of alcoholic drinks are high in purine. Beer and alcohol are the worst drinks to consume when battling gout. Next up? Beverages containing high fructose corn syrup, such as soda, energy drinks, tea, and flavored juices.
As for foods, products derived from animals tend to be purine saturated. Game meats, organ meats, and red meats are high in purines, so pork and chicken are better options for gout patients.
Seafood, shellfish, and some kinds of fish are high-purine foods too. Mussels, scallops, sardines, anchovies, trout, codfish, herring, and haddock should be avoided. Shrimp, oysters, crab, and lobster are not as high in purine, but should still be consumed with caution.
Being overweight or obese increases your risk of developing gout.
Studies have shown that adipose tissue (fat storage tissue) can produce uric acid, meaning extra body weight equals extra uric acid.
Managing your weight with diet and exercise is a critical component of managing your gout.
A Gout Specialist
Gout is nothing to mess around with and can lead to serious medical complications.
While you might be able to make it through a flare-up on your own, trying to care for your gout without the guidance of a healthcare professional is not a good idea.
Seeing a rheumatologist is the best move you can do for your long term health and wellness.
Here at Paducah Rheumatology, we see patients enduring all stages of gout.
Whether you are experiencing your first, fifth, or fifteenth flare, we want to be there for you!
We strive to help you manage your current symptoms and prevent future ones.
We are accepting new patients with a physician's referral. Give us a call today to set up an appointment.
Reach us at 270-408-6100. Our healthcare team looks forward to caring for you!