Cassandra Tolver, 58, woke up in the middle of the night with excruciating pain at the base of her left toe. The area was so swollen, red and tender, the Charlotte, North Carolina resident, could not even touch it. The pain prompted Cassandra to seek the medical services of a nearby urgent care center the very next day. The diagnosis? Gout.

Gout is a leading form of inflammatory arthritis, affecting an estimated 8 million U.S. adults and accounting for nearly 4 million outpatient visits every year. Gout is characterized by severe joint pain and can lead to irreversible joint damage if untreated. African American men and women are at an increased risk of developing gout during middle and older ages more so than whites.

What is gout?

Gout is metabolic, and a flare-up can cause a joint to become red, swollen and tender to the touch. The base of the big toe is usually the first spot where gout can strike. The ailment can also affect the midfoot, ankle joints, knees, elbows, wrists and knuckles. Gout is rarely seen in shoulders or hips. If the gout is recurrent, the affected joint can become disfigured over time and stiff. Gout can come on suddenly, then disappear within a week or two. Most people get recurring attacks while others might get relief from the intense pain for longer periods of time like for months or even years. Unfortunately, if you’ve already had gout, you can probably expect more attacks down the line.

What brings on gout and what you should avoid

Gout is brought on by uric acid crystals that build up in the joints. The uric acid is produced when the body breaks down a chemical called purine. If you eat too many purine-rich foods, excess uric acid can build up in your joints causing an increase in the frequency and severity of your gout symptoms.

Eating foods that are high in purines can bring on an attack of gout, so you might want to steer clear of foods such as:

Seafood–Gout sufferers should avoid certain fish like anchovies, crab, lobster, sardines, herring, mussels, scallops, snapper, oysters, codfish, trout, tuna, haddock, and halibut. Shrimp, lobster, eel, and crab are safer seafood choices for patients with gout.

Meats—Red (beef, lamb, and pork) and organ meats like kidneys, liver are dangerous for gout sufferers.

Raisins– Folks suffering from gout should avoid raisins since they are produced from grapes which are purine-rich fruits.

Alcohol—Beer especially brewer’s yeast will affect those susceptible to gout. Drinking high-proof alcohol and beer while having a bout of gout can also increase its pain intensity. Wine is also high in purine.

Sugary drinks—Beverages that contain high amounts of fructose sugar will encourage uric acid accumulation.

Overweight—Being overweight can increase your chances of developing gout whether it runs in your family or not.

Drugs—Medicines like diuretics (water pills), aspirin, drugs that are prescribed for cancer, Parkinson’s and after an organ transplant can bring on gout.

Processed foods—Crackers, chips (especially flavored ones), deli meats, bacon, frozen dinners, mustard, ketchup should also be eliminated from a gout sufferer’s diet.

Does gout lead to kidney issues?

Those who have gout are more likely to get kidney disease – and likewise, those who have kidney disease are more likely to suffer from gout and elevated uric acid levels. Kidney stones form when uric acid crystals deposit in the kidneys. They are very painful and – if left untreated – can block the urinary tract and result in infection. Research has shown that one in five people with gout will develop kidney stones.

Over time, kidney stones and damage can lead to chronic kidney disease, which includes conditions that damage the kidneys. For those who have kidney disease, it is more difficult for their kidneys to get rid of uric acid. Untreated kidney disease can ultimately lead to kidney failure or loss of kidney function.

What kinds of foods can prevent gout attacks?

People who battle gout should eat heart-healthy foods that will help reduce uric acid levels. Studies have shown that gout also increases the risk of heart issues.

  • Water–at least 64 ounces daily which can help remove uric acid from the bloodstream
  • Low-fat dairy products–such as yogurt, low-fat milk, cottage cheese may actually provide some protection against gout
  • Whole grains
  • Eggs
  • Fruits–like bananas can help decrease the symptoms of gout due to their high levels of potassium, and vitamin C. Eat bananas to help deal with the pain caused by gout. Previous, small studies have suggested that cherries and cherry products may reduce uric acid levels and inflammation in the body.
  • Vegetables– a diet rich in non-green vegetables is good like red bell pepper, squash, mushrooms, and cauliflower
  • Vegetable oils–such as olive, canola, sunflower
  • Vitamin C–between 500-1,000 milligrams per day (gout appears to be lower in men who take this vitamin)
  • Coffee
  • Nuts–peanuts, walnuts, almonds

Treatment

Not everyone who has gout needs to take medicine to lower uric acid levels. In particular, people who have already had gout usually don’t need to take drugs. This is because some people don’t have any problems after an attack for years.

Anti-inflammatory medications like ibuprofen or naproxen are used if the attacks become more frequent or are very distressing. Steroid medicines (usually tablets with prednisolone) are recommended as well. Colchicine was once the go-to gout flares prevention medicine but was slow-acting and had many gastrointestinal side effects, so it is no longer recommended. Your doctor may prescribe other drugs such as Allopurinol and Febuxostat to reduce uric acid production or Indomethacin which is a stronger pain reliever.

Other ways to reduce gout pain are to ice, rest, and raise the joint.

Lifestyle changes, and meds, if needed, can help gout patients get through or prevent other attacks from striking.