Frequently Asked Questions
Gout
| Q. What are the most important foods to avoid if I have a bad case of gout? |
|
A. Excessive alcohol intake is the most commom culprit. It is usually hard to eat enough foods loaded with purines to elevate the uric acid and trigger a gout attack. The most commonly associated food sources of purines come from organ meats, such as liver, brain, kidneys and sweetbreads. Sardines and anchovies also are high in purines. |
| Q. Why should I take medicine every day if I only get an occasional attack of gout? |
|
A. You may not need medicine every day if you only get a rare or occasional attack of gout that completely resolves. Certainly, if frequent attacks occur, there is then the risk of permanent joint damage and disability. Further attacks could be prevented by going on regular long-term medication. The other important factor is the need to prevent any kidney disease, which is often asymptomatic. Kidney stones along with kidney failure can be complications of too much uric acid going through the kidneys. By checking the amount of uric acid output through the kidneys over a 24 hour period, one can know if there is risk of kidney involvement. If the total urine uric acid over 24 hours is above 800 mg, then long-term medication may be necessary. |
| Q. Is gout curable? |
| A. Gout can be fairly easily controlled on a regular medication program. It can be put in remission with the right medication and treatment so that no further attacks or complications occur. Failure to take the proper medication may place the patient at risk for further episodes. There is no cure but just the potential to totally control this disease with a long-term permanent treatment program. |
| Q. What things might cause me to have an attack of gout? |
| A. Among the most common reasons for attacks of gout is non-compliance with the medication and treatment program. Dehydration can be a precipitating cause, especially during summer months when one might be outside and sweating a lot. Injuries may predispose one to an attack of gout, as may surgery. Acute illnesses or infections may also prompt a gouty episode. Diuretic therapy can also increase uric acid levels and cause a risk of a gout flare-up. Certainly, a big factor in promoting gout attacks is overindulgence in alcohol. |
| Q. Do I need to stop sports and exercise if I have gout? |
|
A. Fitness and exercise programs are always good for anyone with arthritic or rheumatic disorders. As long as one remains on the correct treatment program for gout, sports are fine to participate in as tolerated. During an acute flare-up of gout, however, resting the joint is important until the swelling and inflammation subside. |
| Q. Are women immune from gout? |
| A. Women are not immune from gout. 5% of gout does occur in women, especially after the menopause or in those on diuretics or suffering from certain other medical illnesses. |
| Q. My blood uric acid level is high. Should I be on treatment? |
| A. Treatment is not always necessary for elevated uric acid levels. There is a condition of asymptomatic hyperuricemia that is not associated with attacks of gout and is not associated with a high load of uric acid through the kidneys. This condition can be watched over time to see if any symptoms develop. |
| Q. I have episodes of severe arthritis but my blood tests are negative for rheumatoid arthritis and lupus. Also my uric acid level is normal. What could be causing this? |
|
A. Up to 10% of cases of gout can have a uric acid level in the normal range. Therefore it is important to try to obtain some joint fluid and analyze it for the presence of uric acid crystals. The diagnosis still could be gout even though the blood uric acid level is normal. Other conditions should also be looked for, especially pseudogout, which is due to a type of calcium crystal that could mimic the symptoms of gout. |