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Your Gout Triggers

Know Your Gout Triggers

These gout triggers are common in most people who have gout, but not every one of them will set off an attack in every person with gout. Some people may have an attack after limited exposure, while others only react in extreme cases.

"Everybody has their own little nuances," says Robert T. Keenan, MD, MPH, assistant professor of medicine at Duke University School of Medicine. "For some people, certain foods will trigger it -- like a seafood and beer binge. Others will have their first gout attack when they go into the hospital or for stress or hydration reasons."

There's no test that lets gout patients figure out what triggers will cause their uric acid to rise. But nearly everyone with gout is able to determine the source the very first time they have an attack, says Keenan.

"Most patients will figure it out on their own relatively quick," he says. "Maybe it's, 'I was watching the game last night and drank six beers and at 3in the morning I woke up and my toe's killing me.'"

Avoid Gout Flare-Ups

Once you’ve had a painful gout flare-up, you’ll never want to experience another one.

"We really think of it as an explosive arthritis, where you go from zero to 60 in 24 hours," says rheumatologist Rebecca Manno, MD, MHS, assistant professor of medicine at Johns Hopkins University School of Medicine. "People say gout can be some of the most severe and worst pain they’ve ever experienced."

But there are other reasons for gout prevention than just pain, says Manno.

"Gout can be more than just a nuisance. It can cause destruction in the joint itself," she says. "Once there’s been damage done to the joint from gout -- that we cannot reverse."

You don't have to sit around and wait for a gout attack in order to treat it. You can help avoid gout flare-ups by lifestyle changes and medication. Here are some tips for gout prevention.

  • Avoid gout triggers. Although it’s impossible to completely avoid all purines in your diet, if you know which foods tend to set off your gout attacks, try to avoid them. You may still be able to enjoy foods with fewer purines such as beans, lentils, and asparagus. 
  • Preventive medication. If you have two or three gout flares in one year, many doctors will suggest daily medicine -- such as feboxostat (Uloric), allopurinol (Lopurin, Zyloprim), and probenecid (Benemid) to lower uric acid level in the blood, and colchicine (Colcrys), to help prevent future attacks. In the first few months that you take the medicine, be aware that the gout prevention drugs may actually cause an attack. Your doctor will prepare you for this possibility by giving you medicine to take in the event you have a flare.
  • Healthy lifestyle. Eating a healthy diet, reducing or eliminating alcohol, and exercising regularly can help prevent gouty arthritis attacks and keep your uric acid level stable. Remember to drink water when exercising to avoid flare-ups due to dehydration.
  • Lose weight. If you are overweight, work with your doctor to develop a weight loss plan. Being overweight can contribute to elevated levels of uric acid and lead to gout attacks. "When we talk to patients about foods they should avoid, we also talk about weight," says Manno. "There's definitely a risk factor with being overweight."
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Reviewed on October 31, 2011

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