Gout Primary Prevention Guidelines: Tips on How to Prevent & Control Painful Gout Flare Ups

Gout is an excruciating and painful type of arthritis that has been increasing in prevalence over the last 20 years. According to a study conducted in 2011, hyperuricemia and gout has significantly increased, affected more than 8.3 million American adults, of which men are 4 times more likely to develop the disease than women.

Gout Prevention

Despite the pain, discomfort and inconvenience Gout causes, it can easily be treated, managed and prevented. Prevention of gout requires small lifestyle considerations that help keep uric acid levels at normal levels and that ensure long term joint health.

If left untreated or allowed to incur chronic flare ups, gout can cause several health complications that can severely lower your quality of life. Complications such as permanent joint deformity or damage and kidney disease and failure are some of the major complications that gout can cause if left untreated for a long period of time.

Prevention of gout is relatively straight forward and for the most part 'easy'. It doesn't require special medications or expensive therapy. All it takes is effort to ensure one's highest quality of life.

Follow an Anti-Gout Nutrition Plan

Gout is caused by the elevated levels of uric acid in the blood. Uric acid is created in the body when the body metabolizes purines. Purines are substances that occur naturally in our body, but can also be found in certain foods and drinks. For the most part, the purines that occur naturally in our bodies are at moderate levels that the body can easily manage. It's when a diet that is high in purine rich foods is consumed on a daily basis that complications can occur where hyperuricemia is developed and subsequently, gout occurs.

The most important action to make in gout prevention is changing your eating habits. This can sound very overwhelming, but an anti-gout nutrition plan is completely feasible and can be well balanced. It requires the careful consideration of foods that trigger or exacerbate gout. These foods include:

• Beer and other alcoholic beverages
• Wild game poultry (such as goose, duck and quail)
• Organ meats (such as liver, kidney, heart and gizzard)
• Red meat
• Seafood
• Sweetbread
• Wild game
• Dried legumes
• Certain fruits and vegetables
• Grains

In addition to avoiding foods that are high in purine, it's important to also decrease the amount of sugar and low quality carbs that are consumed on a day-to-day basis. Many clinical observations have found an association between patients with excessive sugar intake and gout flare ups. This means cutting foods that:

• Contain high fructose corn syrup or any other processed form of sugar
• Are high in sugar (this includes pastries, candy, and chips)
• White breads and pasta
• Processed foods
• Foods with additives (such as sweeteners, 'natural flavors' or food colorings)

Following an anti-gout nutrition plan can not only help prevent gout, but can also lead to other benefits such as weight loss or maintenance, promote better health and overall increase your quality of life.

Stay Hydrated

Drinking water not only satisfies your thirst, but it is also a product your body uses to help flush your system. Most waste products, such as uric acid are transported out of the body in your urine. Urine is typically created when your body has an adequate or excess amount of fluids. Think of this process like a train: the uric acid or passengers collect in the urine or train and when signaled, the urine leaves your body when you relieve yourself. When you don't drink enough water, there aren't enough trains (urine) for the passengers (uric acid), so gradually the uric acid begins to accumulate and when that occurs it undergoes its crystallization process that ultimately leads to a gout attack.

Staying hydrated is simple, drink at least 8 to 10 eight ounce glasses of water a day. A good indicator to see if you are drinking enough water is by observing your urine. If it's slightly yellow to clear, then you're doing a good job. If it's dark yellow and somewhat acidic feeling when it exits, you need to drink more water. In addition, your quality of beverage counts. Water is your best option when it comes to stay hydrated and preventing gout. If you would like to drink juice, make sure you're drinking 100% juice with no added sugars and try to limit your consumption to only 2 cups a day. Finally there are certain beverages to steer clear from, both to their high purine content and their influence on uric acid levels:

• Beer
• Caffeine products
• High sugar juices

An easy way to stay hydrated throughout the day is by purchasing glass water bottles. They're reusable and can keep you accounted for your hydration if you leave a few full bottles in front of you throughout the day.

Maintain a Healthy Weight

A common characteristic among gout sufferers tend to share is being overweight or obese. Research has suggested that holding excess fat contributes to gout attacks by stimulating the body to create more uric acid and inhibiting kidney function, thus blocking uric acid excretion. A combination of a sensible diet and moderate exercise can help you achieve and maintain a healthy weight.

If losing weight, it's important to recognize that gout attacks can increase or occur frequently during your weight loss period. This is because the fat in your body holds onto uric acid and when the fat tissue is broken down, the stored uric acid is released causing a spike in uric acid levels in the body. While the transition period can be painful, it will ultimately lead to a guaranteed better quality of life and the decreased risk of recurring gout attacks.

Reconsider Medications

Certain medications have been recognized to contribute to the increased risk of gout. These medications include:

• Low dose aspirin - has been linked to the increase of uric acid levels and the frequency of gout attacks
• Niacin - is a waste product that competes with uric acid for elimination
• Diuretics - causes dehydration and raises uric acid levels
• Blood pressure medication - has been shown to increase uric acid levels

If you are concerned about your risk of developing gout and are in consideration for these medications, speak with your doctor on alternative options.

Gout Pain Management

Gout pain is often described as one of the worst pain ever experienced. It's said to feel like tiny, hot needles constantly stabbing the affected area. Gout pain is also very sudden, developing overnight and seemingly out of nowhere. If you have been diagnosed with gout, there is a lot you can do your own to manage the pain. You doctor can also provide options for short term relief if home remedies are not effective for your pain management.

• Drink Water

Staying hydrated is an important step to gout prevention. It's also a crucial step in pain management. Water acts as an apparatus that uric acid travels in during the elimination process by your body. During a gout attack it's important to work towards lowering uric acid levels as the continued accumulation of them causes the creation of monosodium urate crystals that cause the painful inflammation and swelling of gout. Decreasing your uric acid levels can help manage the pain and can also decrease the duration of your gout attack by essentially ridding of the 'fuel causing the fire'.

• Rest

During a gout attack, it's important to rest the affected joint until the attack eases and for at least 24 hours after the attack. That means avoiding physically demanding activities and performing less movement than usual. The pain will leave you bedridden anyway, but it's still important to remember to not stress the joint during this very sensitive period.

• Take Anti-Inflammatory Relief

Pain during a gout attack us usually caused by your body's inflammatory response to the monosodium urate crystals. It's the buildup of pressure and swelling in the joint, along with the needle-like crystals attacking the soft tissue between the joint that makes gout unbearable. Taking anti-inflammatory supplements or drugs can help alleviate the pain from inflammation and also help reduce swelling and redness. Some forms of anti-inflammatory relief include:

• Over-the-Counter nonsteroidal anti-inflammatory drugs (NSAIDs) (such as Advil, Motrin and Aleve. Avoid taking aspirin as an anti-inflammatory as it can contribute to uric acid levels.)
• Prescription nonsteroidal anti-inflammatory drugs
• Anti-Inflammatory supplements (supplements that include ingredients such as alpha-lipoic acid, bromelain, turmeric, and quercetin are known to be as effective as NSAIDs)
• Eat Anti-Inflammatory Foods

Aside from drugs or medications, you can also get anti-inflammatory relief from certain foods. These foods are also widely accepted in an anti-gout nutrition plan, so you essentially get to kill two birds one stone. Anti-inflammatory foods include:

• Foods rich in Omega-3's (such as walnuts, flaxseeds, chia seeds, walnuts, fish oil)
• High Fiber Foods (such as oats, broccoli, apples, strawberries, blueberries, celery, carrots, barley)
• Cherries
• Berries
• Ginger
• Green Tea
• Leafy greens
• Garlic
• Take Medications (as directed)

Depending on your uric acid levels, your doctor might suggest you go on anti-gout medications. Most medications available for gout function by lowering the uric acid levels in your body. This is performed by inhibiting the enzyme (xanthine oxidase), and preventing the creation of uric acid in the body. Your doctor may prescribe:

• Febuxostat
• Allopurinol
• Colchicine
• Probenecid

Be sure to take your medications as directed otherwise you can risk worsening your current gout attack or causing more gout attacks. In addition, certain medications have side-effects or interactions with other drugs, so consult with your doctor to address these concerns.

• Home Remedies

Home remedies are a popular option for those who opt for a more natural approach to recovery and relief or who cannot take certain medications. Gout is a treatable disease that has amassed a library of options for home therapy. Four popular home remedies for gout include:

• Apple Cider Vinegar

Consuming an apple cider vinegar tonic has been a popular remedy for many. Apple cider vinegar helps to neutralize your urine, making it easier for uric acid to be eliminated from the body.

• Cherries

Tart Cherries are a long standing remedy for gout and arthritis patients. Studies have been conducted to support its efficacy against gout and the final verdict is that at least a cup and a half a day can help to reduce inflammation and lower uric acid levels.

• Baking Soda

Baking soda is another remedy that is consumed through an 'anti-gout' drink mixture. It helps by neutralizing the pH of your urine, helping to eliminate uric acid more quickly from your body.

• Ginger Root

Ginger is an easily available and easy to do home remedy. Its anti-inflammatory properties are excellent for reducing swelling and providing pain relief. You can consume ginger in its powder form or boil the sliced root and drink it as tea.

Home remedies are not meant to treat gout, but are excellent complementary therapy to gout prevention and management.

Frequently Asked Questions

Is there any homeopathic prevention?

A homeopathic approach to gout prevention includes, changing your eating habits where you consume less purine rich foods, losing and maintaining a healthy weight, staying hydrating and avoiding overconsumption of beer, alcohol, and high sugar drinks, and eating less sugar and processed foods. There are home remedies available for gout relief and prevention as well.

Is allopurinol recommended to prevent flareups?

Allopurinol is effective in lowering uric acid levels, thus reducing your risk of a gout flare up.

Is diet an important factor to prevent gout?

Diet is an essential factor to gout prevention. Eating a diet that is free of purine rich foods, sugars, and processed foods can be effective in preventing gout.

Can I use baking soda for prevention?

Baking soda is a popular home remedy that is known to be effective in gout relief and prevention.

Are cherries or cherry juice a good option to prevent recurring gout attacks?

Cherries are recognized to contain chemicals and antioxidants that can help reduce uric acid levels and provide relief from gout attacks.

Is colchicine good to take for prevention?

Colchicine is a commonly prescribed medication that is used to prevent and treat gout attacks.

Are there any gout prevention diet recipes available on goutdiet.org?

Goutdiet.org is proud to provide a free resource of anti-gout recipes that can be found here.

What other drugs or over-the-counter treatments are available for prevention?

Commonly prescribed drugs include:

• Febuxostat
• Allopurinol
• Colchicine
• Probenecid

Ibuprofen and dietary supplements with anti-inflammatory properties are over-the-counter treatments available for the relief of gout.

Can exercise prevent attacks?

Exercise helps the body's waste management process and can help keep your joints healthy.

What herbs are useful to prevent gout attack?

Adaptogenic herbs can be effective in providing relief and preventing gout attacks, they include:

• American ginseng root
• Ashwagandha root
• Asian ginseng root
• Eleuthero root

Can you recommend some natural home remedies for on-going flareups?

Gout is a treatable disease that has amassed a library of options for home therapy. Four popular home remedies for gout include:

• Apple Cider Vinegar

Consuming an apple cider vinegar tonic has been a popular remedy for many. Apple cider vinegar helps to neutralize your urine, making it easier for uric acid to be eliminated from the body.

• Cherries

Tart Cherries are a long standing remedy for gout and arthritis patients. Studies have been conducted to support its efficacy against gout and the final verdict is that at least a cup and a half a day can help to reduce inflammation and lower uric acid levels.

• Baking Soda

Baking soda is another remedy that is consumed through an 'anti-gout' drink mixture. It helps by neutralizing the pH of your urine, helping to eliminate uric acid more quickly from your body.

• Ginger Root

Ginger is an easily available and easy to do home remedy. Its anti-inflammatory properties are excellent for reducing swelling and providing pain relief. You can consume ginger in its powder form or boil the sliced root and drink it as tea.

Home remedies are not meant to treat gout, but are excellent complementary therapy to gout prevention and management.

Are there any gout prevention supplements?

Refer to our comprehensive gout supplements page.

What about vitamin c? Is it a good option to use as prevention?

Studies have shown that daily vitamin C intake has been linked to a lower risk of gout attack.

I have read that water can help prevent flare ups is there any reason why? Any research to back it up or is it just a myth?

Water acts as an apparatus that uric acid travels in during the elimination process by your body. During a gout attack it's important to work towards lowering uric acid levels as the continued accumulation of them causes the creation of monosodium urate crystals that cause the painful inflammation and swelling of gout. Decreasing your uric acid levels can help manage the pain and can also decrease the duration of your gout attack by essentially ridding of the 'fuel causing the fire'.

Think of this process like a train: the uric acid or passengers collect in the urine or train and when signaled, the urine leaves your body when you relieve yourself. When you don't drink enough water, there aren't enough trains (urine) for the passengers (uric acid), so gradually the uric acid begins to accumulate and when that occurs it undergoes its crystallization process that ultimately leads to a gout attack.

Is losartan a better option for preventing gout flare ups?

Iosartan is used to treat high blood pressure (hypertension), why would you take that for gout.

What is the best tip to prevent recurring gout flareups?

Following a healthy diet that is free of purine rich foods and that helps to maintain a healthy weight is the absolute best way to prevent recurring gout flare ups.

Is Gout Prevention even Possible or its inevitable?

Gout prevention is possible if you make the necessary lifestyle and dietary changes needed to prevent the accumulation or uric acid in your blood.

I heard FDA approved colcrys for gout flare ups is that a good option?

Colcrys is the brand name for Colchicine, a commonly prescribed medication that is effective in the prevention of acute and chronic gout attacks.

How these medications help prevent gout from flaring up?

Medications such as febuxostat and allopurinol function by inhibiting xanthine oxidase, the enzyme responsible for uric acid creation. Colchicine is a short-term medication that is designed to block inflammation caused by uric acid crystals and prevent future acute gout attacks from occurring. A detailed list of medications for gout prevention and relief can be found here.