Foods with high levels of purines to avoid include:
- Alcoholic beverages (any kind)
- Seafood, including anchovies, sardines, herring, mussels, codfish, scallops, trout, haddock, mackerel, and others
- Some meats, such as duck, beef, veal, pork, bacon, ham, venison
- Organ meats like liver, kidney, and tripe
- High fat foods such as red meats, fatty poultry (dark meats and skin), and high-fat dairy products
- Shellfish, such as crab, lobster, oysters, and shrimp
- Sodas with high-fructose corn syrup
Foods with moderate levels of purines to limit in the diet include:
- Poultry such as turkey and chicken
- Crab, lobster, oysters, and shrimp
- Lunch meats, especially high-fat versions
- Beans, peas, and lentils
- Certain vegetables, such as spinach, cauliflower, asparagus, and mushrooms
- Oatmeal and oats
Foods with low levels of purines that are a good diet for gout include:
- Peanut butter and nuts
- Low-fat and fat-free dairy products, such as milk, cheese, and yogurt
- Fat and oil
- Other vegetables
- Potatoes, bread, rice, and pasta
- Fruits and fruit juices
- Eggs (in moderation)
- Wine (in moderation)
- Coffee (in moderation)
What Are Symptoms of Gout?
Symptoms of gout can start quickly, over a few hours, and can last about three to 10 days.
When symptoms of gout worsen it is called a gout attack or flare. Symptoms of gout attacks (flares) include:
- Sudden episodes of severe joint pain
- Redness, swelling, tenderness, and heat in the joint is common
- Usually affects a single joint, but inflammation can occur in several joints at the same time
- Commonly occurs in the big toe, and also in lesser toe joints, ankles, and knees
- Flares start more often during the night and early morning than during the day, though attacks can occur any time
- Pain and inflammation peak within 12 to 24 hours and usually go away completely within a few days to several weeks, even if not treated
- May be accompanied by fever
Flares are usually followed by periods of remission where patients have no symptoms that can last weeks, months, or years.
What Causes Gout?
Gout is usually caused by too much uric acid in the body (hyperuricemia). Excess uric acid in the body causes uric acid crystals (monosodium urate) to accumulate in the body’s joints, fluids, and tissues. Hyperuricemia does not always cause gout, and hyperuricemia without symptoms of gout does not require treatment.
Risk factors for developing gout include:
- Certain health conditions, including:
- Overeating or prolonged fasting
- Certain medications that affect blood levels of urate, such as diuretics (water pills)
- A diet high in purines, which the body breaks down into uric acid
- Consuming large amounts of meat or seafood
- Consuming beverages containing high fructose corn syrup (such as regular sodas)
- Excessive and regular consumption of alcohol (especially beer, vodka, gin, whiskey, or rum)
- Being male
What Is the Treatment for Gout?
The goal of treatment for gout flares is to reduce pain and inflammation. Treatment is usually short-term and limited to the duration of the flare.
Anti-inflammatory medications used to treat gout flares include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Colchicine (Colcrys)
Patients who develop clumps of uric acid crystals around a joint (tophi) and kidney stones be prescribed medications such as:
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