30
MARCH/APRIL 2015
Low-Purine Diet and
Medication Used to
Treat Gout
Combination
helps reduce uric acid levels
by Jean Jeffers, Staff Writer
Emily is on a mission.
Her husband, Henry, has been
diagnosed with gout. With the
occurrence of a second attack
featuring a red, swollen great toe,
Emily moves to the kitchen to
change Henry’s diet. A low-purine
diet is indicated in the presence of
gout. This diet includes such foods
as whole grains, brown rice and
beans. Henry may do well on the
following foods: some particular
fresh vegetables, fresh fruits and
nuts. Coffee is said to lower uric
acid levels, as does vitamin C.
Cereals, breads and pastas are also
on the list, along with milk, cheese
and eggs. Foods to avoid while
on this diet include organ meats
high in purines, gravies, some-
times beef, pork and lamb, soda,
beer, some specific vegetables and
seafood.
Gout is one of the most common rheumatic diseases in the
United States, affecting about 8.3
million adults. It affects many
older men, especially those between the ages of 40 and 50 years.
Its prevalence is on the rise.
Gout is a type of arthritis in
which a joint or joints (usually the
great toe) become inflamed, red,
swollen and warm to the touch.
Gout is caused by a buildup of
uric acid in the blood (hyperuricemia). Uric acid levels rise
either because of excesses in the
diet or failure of the kidneys to
excrete the uric acid. Excess uric
acid forms crystals in the joints,
thus causing the inflammation
and pain. Over time, these attacks,
particularly if left untreated, may
become more severe, last longer
and happen more often. Lowering
uric acid levels to less than 6mg/
dl is part of the management of
chronic gout.
Some gout attack triggers include various medications, usually
those affecting kidney function;
low-dose aspirin; obesity; high
blood pressure; hyperlipidemia
(increased blood fats); and diabetes. Alcohol consumption also
may trigger gout attacks. Gout
generally runs in families.
An initial attack of gout may last
several days, then disappear. A second attack may be imminent or it
may occur only weeks or months
later. When gout becomes chronic, there are frequent attacks. More
than one joint may be affected
and crystals may collect and form
tophi or lumps under the skin.
At this stage, there is a danger of
developing kidney stones.
Diet alone is insufficient to
effectively treat gout. A lowpurine diet is combined with such
medications as colchicine, which
is most effective if given early in
the attack, and allopurinol, which
can decrease the uric acid level.
Non-steroidal anti-inflammatory
drugs (NSAIDs) are commonly
prescribed during an attack to
lower inflammation. Corticosteroids and adrenocorticotropic
hormone (ACTH) are also used.
Within 24 hours of a flare-up,
medications should be started.
If the first attack happens during the middle of the night, as it
frequently does, take an NSAID
and call your doctor in the morning for further instructions and an
appointment.
Other tips for caring for a gout
sufferer include:
• Maintain adequate fluid intake.
• Lose weight if overweight.
• Reduce alcohol consumption.
• Rest the affected joint(s).
• Apply ice to affected joint(s).
• Get regular exercise.
• Cooperate with your doctor in
the plan of care.
Unless the disease is properly
managed, it could affect your
quality of life and work productivity. Individuals with chronic gout
generally require lifetime treatment with drugs and diet in order
to keep uric acid levels low.
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