What is Gout?

Gout is characterized by acute, painful symptoms – usually in the joints. These symptoms are caused by an overabundance of uric acid in the bloodstream, uric crystals develop and deposit in the articular cartilage of the tendons, joints, and adjacent tissues that causes inflammation. The crystals are most commonly found in the large toe. However, Gout can spread to the ankles, arch, heel, wrist, fingers, elbow, spine, ear, and knees. Usually the pain is described as sharp, quick and similar to walking on broken glass. Other symptoms of Gout include, but are not limited to, sudden, burning pain, light fever, swelling, redness, stiffness, and a severe sensitivity of the affected area/s.

Chronic Gout can lead to decreased kidney function, kidney stones, chalky nodules (tophi) that may break through the skin (that require surgery for removal).

Treatment for Gout:

Acute Attacts-

• Medications (colchicines, indocin, corticotrophin);
• Bedrest – from acute attack until 24 hours after subsiding of symptoms);
• Pain medications;
• Hot or cold compresses may help;
• Force fluids – to reduce precipitation of urate in the kidney and to combat dehydration;

Between Attacks-

• Aim of treatment to reduce the frequency and severity of recurrent acute attacks
• Lowering the serum urate level by medication and diet.

Dietary Management:

Dietary control is important, however, proper ingestion of uricosuric medications with increased amounts of fluids is essential. Clients should avoid acidity and dehydration. Once medication control is accomplished clients should maintain a gout prevention diet which consist of low purine or moderate purine foods. This diet puts emphasis on dairy products, vegetables protein and water intake and a decrease in high purine foods.

Avoid these foods that are high in purine include:

Bullion, brains, broth, consommé, dried legumes, goose, gravy, heart, herring, liver, kidney, mushrooms, mackerel, partridge, roe, scallops, shrimp, yeast, sweetbreads, anchovies, sardines, and meat extracts. Avoid alcoholic beverages.

These foods should be eaten in small amounts:

Poultry, fish, and shellfish.

These food are good to eat on a gout diet:

Butter, carbonated drinks, cereals and cereal products, cheese, cocoa, corn, cornbread, eggs, fruit juices, fruits, ice cream, milk, noodles, nuts, refined wheat flour, tapioca, vegetables, white bread and crackers and white rice. For a purine-moderate diet it is OK to have some protein foods not to exceed 100 grams per day. (bread and grains have about 3 grams of protein per serving). One serving is one slice of bread or ½ cup of grain. Protein can be obtained by eating milk, eggs and cheese because these foods are high in protein and low in purines. Clients should eat cherries and strawberries daily – and drink lots of water.