How to Live with Gout

While gout is one of the more painful forms of inflammatory arthritis out there, living with the disease does not have to be debilitating or miserable for those who suffer from it. Gout is due to elevated levels of uric acid in the blood, which are brought about by a combination of lifestyle, diet, and genetics, and is unfortunately a lifelong condition. Although gout is difficult to permanently cure, it is not impossible to live with. By taking proactive steps to prevent gout flare-ups from occurring, and rapidly treating flare ups when they do occur, persons living with gout can still live relatively normal and pain-free lives.^{[1]XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source}

Part 1

Part 1 of 2:

Preventing Gout Flare-Ups

1
Take medication to keep uric acid levels in your blood low. Because gout is directly caused by elevated levels of uric acid, keeping these levels within an acceptably low range is the best way to prevent gout. Take acid lowering drugs daily to prevent flare-ups.^{[2]XResearch source}
- Some of the more common medications for controlling blood uric acid levels are allopurinol, lesinurad, and probenecid. These will need to be prescribed by a doctor.
- Be sure to make follow-up appointments to have your blood uric acid levels checked by your doctor while taking your medication. Have your liver enzymes checked if you’ve taken any of the mentioned medication. You should have your acid levels checked at least once or twice a year, or more depending oh how severe the illness is.
2
Eat a healthy diet that avoids foods rich in purine or fructose.^{[3]XExpert SourceSiddharth Tambar, MD
Board Certified RheumatologistExpert Interview. 25 August 2020.} What you eat (or don’t eat) can have a significant impact on your gout symptoms! Following a balanced diet that cuts out purine-rich and high-fructose foods will help reduce the likelihood of future gout flare ups.^{[4]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
- High-purine foods to avoid include red meat, shellfish, pork, beer, and organ meats (e.g., liver).
- Cut out foods and beverages with high-fructose corn syrup, such as soft drinks, artificial fruit juices, refined carbohydrates (e.g., white bread), and most processed foods.
- Consume more foods rich in antioxidants, such as cherry juice and pineapple juice, as these will help prevent inflammation that leads to gout flare-ups.^{[5]XExpert SourceSiddharth Tambar, MD
  Board Certified RheumatologistExpert Interview. 25 August 2020.}
- Avoid leafy greens that are high in uric acid since these could cause the gout to inflame.
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3
Stay hydrated by drinking plenty of water every day. Drinking enough water is essential for flushing out excess levels of uric acid, as well as transporting nutrients in the body and cushioning joints. A healthy amount of water to drink each day is 15.5 cups (3.7 L) for men and 11.5 cups (2.7 L) for women.^{[6]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
- Be sure to drink more water if you regularly engage in intense physical exercise.
- Avoid drinks sweetened with high-fructose corn syrup, such as Gatorade.
- Increase your water intake at the first sign of a possible gout flare-up, which could be swollen joints, mobility changes, or pain.
4
Maintain a healthy body weight through diet and exercise. In addition to eating a diet that limits your intake of purine and fructose, follow a healthy regimen that will help you lose weight if you are overweight or keep it at a normal level.^{[7]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
- This is especially important for overweight individuals, as they are 4 times more likely to develop gout than someone with a normal body weight.
- Talk to your doctor about what the best plan for achieving your ideal body weight is. This will depend on a holistic array of factors such as age, sex, and physical health.
- If you need to lose weight, do so gradually and sensibly. Losing a lot of weight in a short amount of time will not help you prevent gout in the same way.
5
Exercise 4 or more days a week for at least 30 minutes. Engaging in regular moderate-intensity exercise will help you lose excess weight, maintain a healthy weight level, and reduce stress, all of which help prevent gout flare-ups.^{[8]XTrustworthy SourceHarvard Medical SchoolHarvard Medical School's Educational Site for the PublicGo to source}
- Do not perform vigorous exercises if you are experiencing a gout flare up. Wait until symptoms have subsided before engaging in rigorous physical activity. Walking and stretching could help during a gout flare up.
- If you’re new to exercising, start off on a routine of short sessions on a regular basis, then gradually increase your sessions in time and intensity. Exercising too intensely too soon can result in very damaging muscle strain.^{[9]XResearch source}
- Consider joining a sports or leisure club to make regular exercise a more fun and social activity.
6
Avoid smoking or drinking alcohol. Drinking alcohol, especially beer and grain liquors, can lead to higher levels of uric acid in the blood, while smoking can interfere with your metabolism. Cut these activities as much as possible to most effectively prevent gout.^{[10]XTrustworthy SourceNational Health Service (UK)Public healthcare system of the UKGo to source}
- It is debated whether drinking wine in moderate amounts contributes to gout. For maximum safety, avoid wine as well as beer if possible.^{[11]XResearch source}
- If completely abstaining from alcohol is difficult or impossible, limit your intake of wine and spirits to no more than two standard drinks a day. A standard drink amounts to 100 millilitres (3.4 fl oz) of wine and 30 millilitres (1.0 fl oz) of spirits.^{[12]XResearch source}
7
Get 8 hours of sleep each night. Getting enough sleep each night will help keep your body in optimal health and manage stress throughout the week. Aim for at 8 hours of sleep each night to best prevent gout.^{[13]XResearch source}
- It’s important to also stay rested to prevent gout flare-ups. Don’t hesitate to sit or lie down when you experience joint fatigue or soreness.
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Part 2

Part 2 of 2:

Treating Gout Flare-Ups

1
Take anti-inflammatory pain medication as soon as possible.^{[14]XExpert SourceSiddharth Tambar, MD
Board Certified RheumatologistExpert Interview. 25 August 2020.} If your doctor has prescribed anti-inflammatory medication to take in the event of a gout flare ups, take it as your doctor has directed. Otherwise, begin treating your flare-ups immediately with over-the-counter ibuprofen or naproxen.^{[15]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source}
- Be sure to always follow dosage instructions when taking medication.
- Do not take aspirin, as this could raise uric acid levels and actively worsen your flare-ups.
- Taking non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen in the first 24 hours of a flare-up can significantly reduce the length of the flare up.^{[16]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source}
- Switch the pain medications you use to avoid dependencies or harmful side effects like stomach ulcers.
2
Apply ice to the affected joint and keep it elevated.^{[17]XExpert SourceSiddharth Tambar, MD
Board Certified RheumatologistExpert Interview. 25 August 2020.} Icing your joint can help decrease inflammation and dull pain signals emanating from the area. Elevating your joint will also help reduce painful swelling.^{[18]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source}
- Only use an ice pack if the pressure of the pack on your joint is tolerable. Do not apply an ice pack to the joint if it’s painful to do so.
- Wrap a bag of crushed ice in a dishcloth and apply it to the joint for 20-30 minutes, repeating this process several times throughout the day. A bag of frozen peas can also be used in lieu of crushed ice.^{[19]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source}
3
Rest in a position where the affected joint is protected. Rest your joint and keep pressure off of it once the flare-up starts and continue to rest until the pain subsides.^{[20]XExpert SourceSiddharth Tambar, MD
Board Certified RheumatologistExpert Interview. 25 August 2020.} Make sure to rest the joint in a room or area where it won’t be accidentally struck or bumped into.^{[21]XResearch source}
- Avoid using the joint during the flare up and minimize stress as much as possible. If they are available, ask friends or family to stay with you for the first day. You may need their help treating your joint or traveling to see your doctor.^{[22]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source}
4
Call your doctor and let them know about the flare-up. They may want to make an appointment for you to see them or prescribe a stronger pain medication, depending on the severity of the flare-up.
- Your doctor may also choose to give you an injection of a corticosteroid to the most affected joints to reduce inflammation quickly if the flare-up is particularly painful.^{[23]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source}
- Do not avoid treatment when a gout flare-up starts. Receiving treatment within the first 24 hours will significantly determine the length and intensity of your flare up.
5
Keep taking your medication and stay hydrated throughout the flare up. Do not stop with preventative measures during a flare up(other than physical exercise). Staying hydrated will help flush uric acid out of your system, while medication will help manage the pain and inflammation in your joint.^{[24]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source}
- If you are taking medication to reduce uric acid levels in the blood, continue taking this medication throughout the flare-up unless otherwise directed by your doctor.^{[25]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source}
6
See your doctor immediately if you don’t improve after 24 hours. If your condition hasn’t noticeably improved after treating it at home, you may need more serious treatment.^{[26]XResearch source}
- If you called your doctor at the beginning of the flare up and made an appointment for a later date, call and ask if your appointment can be moved up. Explain the situation and why it’s necessary for you to see your doctor sooner rather than later.
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Tips

Minimizing stress in your daily life will also help prevent future gout flare-ups and alleviate the pain from an ongoing flare up.
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Taking vitamins, especially Vitamin C, every day may also help to prevent gout flare-ups in men.
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Talk to a rheumatologist to see if there are any treatments that will work best for you.
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Warnings

Gout flare-ups can be triggered by certain foods, like tomatoes, or medications, like drugs that reduce potassium in the body. Talk to your doctor about your diet and medications to ensure you’re not exposed to common triggers of gout flare-ups.
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Avoid drinking coffee left in the pot for a long time or red wine since these could raise uric acid levels.
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