Learn how to keep at bay the painful condition called gout.

“I had my first gout attack 10 years ago. The episodes became more and more frequent, and went from my big toe to my knees,” reveals Pakri, 52, an architect. “The pain is excruciating. When it happens, it feels as if my foot is on fire and someone is constantly stabbing it! I can’t even put on my shoes. Even though I have given up alcohol and taking high doses of allopurinol, my gout just keep coming back.”

What is gout?

Gout causes sudden and severe pain in your joints. It usually affects joints in the feet (usually the big toe), ankle, knees, hands and elbows. Whenever a flare-up occurs, the affected joint becomes red, warm, swollen and, of course, excruciatingly painful. As a result, you may find it difficult to put even very light pressure on or move the affected joint. It usually takes about a week for the pain and swelling to subside.

What causes gout?

Your joint becomes painfully inflamed when your body deposits a waste product called uric acid in the form of hard crystals into your joints. Much of the uric acid in your body is the result of consuming foods rich in purine, although high uric acid level can be due to inherited genetics.

Besides eating a lot of purine-rich foods, such as meat, beer and nuts, other contributing factors include being overweight, diabetic, having high cholesterol level, suffering from high blood pressure, taking certain medication for high blood pressure, and not drinking enough water.

Generally, gout is more common among men, and they usually get their first attack between the ages of 30 and 55. Women are more likely to get gout after menopause.

How does gout affect drivers?

Driving can be impossible during an attack. If only your left toe is affected, and the right foot still normal, you may feel well enough to still drive an automatic car — if you are fit enough to drive, please exercise extra vigilance.

If driving is your occupation and you are on the road for long hours at a stretch, you may avoid consuming water because you don’t want to stop for toilet breaks. However, that mindset needs to change as it is important to stay hydrated if you suffer from gout.

If you are on high blood pressure medications, ask your doctor to prescribe those that are safe for your condition. Some of these medications can actually increase uric acid levels, making you more prone to getting a gout attack or even a kidney stone. Blood pressure-lowering agents that may increase uric acid levels include diuretics, β blockers, angiotensin-converting enzyme (ACE) inhibitors, and non-losartan angiotensin II receptor blockers.

Keep your doctor’s phone number ready in case of any emergency. Always have some painkillers, such as Ibuprofen, on hand. In addition, going for a pair of loosely fitting shoes with good support would be helpful.

Living with gout

A gout attack is a dreadful experience. It usually begins quickly and suddenly, and reach the most painful stage within 12–24 hours, and can last for up to two weeks.

You may have to take a break from work, and miss out on family activities and social events. It feels like your life has to be put on hold. Walking can be very painful and you are likely to feel awkward using crutches.

Hence, the most important point about gout is prevention. To do so, it is vital to avoid certain foods and stay hydrated.

 Diet tips to prevent gout

Avoid foods with high purine content
Purine is metabolised by the body into uric acid. Consequently, this raises your body’s uric acid level and puts you at risk of a gout attack. Notably, examples of food high in purine are organ meat (liver, kidney, brain), red meat (lamb, pork, beef) and numerous kinds of seafood (deep-sea fishes, sardines, mackerel, tuna, anchovies, crab, shrimps, shellfish).

Keep fructose and refined sugar to minimum
Although fructose and added sugar do not contain uric acids, they were found to increase your body’s uric acid level. So limit your intake of sugar and foods high in sugar, such as sweetened beverages, cereals desserts, pastries candies, fructose-rich corn syrup, fructose-containing artificial sweetener, honey, sweetened fruit juices and soda.

Eat enough fruits
Although fruits vary in fructose content, they are suitable for people with gout. For example, cherries contain high levels of fructose but is found to lower uric acid level and reduce inflammation during a gout attack.

Limit your alcohol intake
Drinking huge amount of alcohol immediately raises your uric acid level. Limit your alcohol intake to not more than two servings per day for men and one serving per day for women.

Eat lots of vegetables and whole grains
Generally, nearly all vegetables are fine for people with gout. However, avoid or limit your intake of mushroom, spinach, cauliflower, asparagus and beans such as fava, edamame and soy — these items contain a moderate amount of purine. Example of whole grains are oats, barley and brown rice.

Eat in moderation fish and meat with lower purine content
Chicken and salmon generally have lower purine content. However, these items still contain purine and have to be taken in moderation. Limit your intake to 120g–180g a few times a week.

Go for low-fat or non-fat dairy products
Instead of full fat dairy products, having low-fat or non-fat dairy products can help lower your risk of getting a gout attack. Do consider replacing all your dairy products, such as milk and cheese, with low-fat versions.

Coffee or tea? No harm!
Drinking coffee and tea does not make you more prone to gout attacks, so enjoy your morning brew without any worries! However, make sure you control the amount of sugar and milk that goes into it.

A gout attack can be an agonising experience. As such, do take some time to tweak your diet to include and exclude food items as suggested above.

Don’t get discouraged if another attack occurs. Instead, be patient and kind to yourself. Your doctor and dietitian are there to help!

This article is contributed by GetDoc.