Pain, swelling/inflammation, redness and heat in the joints commonly in the big toes characterize gout. Lesser toes and ankles can also be affected. Repeated bouts lead to gouty arthritis.
Gout is a disorder of purine metabolism (digestion). Many foods contain purine which is actually needed in the making of building blocks in the body. When purines from food is digested, it produces uric acid. Normally, the body excretes uric acid with the urine. However, when so much purine is eaten or when the body cannot process so much such as when the kidney fails to excrete uric acid, then uric acid accumulates in the blood. With too much uric acid, a condition known as hyperuricemia, and prolonged retention, some uric acid can crystallize and build up in the soft tissues and joints after which the signs and symptoms of gout manifest.
Gout is managed using a low purine diet plus a combination of drugs. Some drugs may aim at controlling inflammation and pain. Some may control uric acid levels in the blood either by controlling production or facilitating excretion. Diet is aimed at controlling uric acid levels and attaining or sustaining a healthy body weight.
To help prevent gout attacks, limit intake of foods with moderate to high purine content. This includes sardines, anchovies, herring, mussels, tuna, codfish, scallops; bacon, organ meats like liver, spleen and heart; growing organisms like yeast which are highest in purine content followed by dried beans, meat like beef, chicken and some fish, seafood and shellfish including. crab, lobster, oysters and shrimp. It may be impossible to avoid all these considering the benefits derived from them. When it comes to dried beans, there are specific types with higher purine content. Weighing benefits and risks however, those of moderate purine content may be eaten once in a while or daily but in small amounts. Alcohol, particularly beer and spirits should be avoided or taken in moderation, as it can worsen uric acid levels.
It follows then that foods of low purine content are mostly vegetables, fruits and whole grains which are also recommended for general health. Complex carbohydrate-rich foods are emphasized thus sugary foods and beverages are not advised. Other recommendations include a low calorie diet if overweight or obese, reduced saturated fat, increased water intake, adequate vitamins emphasizing on vitamin C, adequate minerals. Weight reduction if overweight or obese, is also advised.
Patients with gout may be more prone to developing kidney stones. This and their medications along with other factors, predispose patients to kidney problems which in the long run, may necessitate dialysis.
