By Kevin K. Anbari, MD, MBA
People prone to gout want to avoid a painful gout attack in the first place. There are several lifestyle and dietary changes that can reduce the risk of gout. When these changes are not enough to prevent gout episodes, a doctor may recommend daily prescription medications.
Avoid or limit alcohol. Alcohol impedes the body's ability to excrete uric acid. However, not all alcoholic drinks are the same. Beer and some red wines are especially high in purine content and should be avoided or very limited. White wine, on the other hand, is not as highly associated with gout and an occasional glass or two does not pose a problem for some people prone to gout.
Drink plenty of water. Increasing water intake will help keep the kidneys healthy and help them flush out uric acid from the body. Experts recommend at least eight 8-ounce glasses of water per day.
Lose weight or maintain a healthy weight. Obtaining and maintaining a healthy weight through diet and exercise helps reduce the risk of gout. However, people trying to lose weight should do so gradually, because dramatic weight loss can trigger a gout episode.
Eat a healthy, low-purine diet. Those who are prone to gout can prevent uric acid buildup in the bloodstream by avoiding foods high in purines. Foods with high purine content include seafood, meats, certain vegetables, lentils, and dried beans. Most vegetables, low-fat dairy, eggs, plant-based proteins, and complex carbohydrates, such as fruits, are low in purines and may even decrease uric acid production.
Prescription medication. If gout attacks are becoming more frequent or severe, if gout has caused joint damage, or if tophi or kidney stones are present, a doctor may recommend regularly taking prescription medications to reduce the amount of uric acid produced by the body. These medications, most commonly allopurinol and probenecid, effectively prevent gout attacks but do not treat a gout attack once it has started. Starting and stopping allopurinol use is known to trigger gout attacks; changes in dosage should not be made without consulting a doctor.
References
PubMed Health. Allopurinol. Revised February 11, 2012. www.ncbi.nlm.nih.gov.
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