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Watch diet to prevent painful gout attacks

Copyright 2002 President Fellows Harvard College behalf HMS MediServices Phoby LizGreen HMS MediServices Anthony Leader Komaroff MD Harvard Health Publications

Copyright 2002 President and Fellows of Harvard College on behalf of HMS Media Services, Photo by Liza Green, HMS Media Services, Anthony Leader Komaroff, MD, Harvard Health Publications

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Updated: July 14, 2012 6:09AM

Dear Doctor K: Could my diet be triggering my gout? If so, what foods and beverages should I avoid to prevent future episodes?

Dear Reader: Your diet absolutely can trigger attacks of gout. Gout causes redness, swelling and extreme tenderness in one or more joints. Very often the attack occurs in the big toe, and when an attack hits, it really hurts.

Some people have gout attacks every few weeks. Others go years between attacks.

Gout occurs when there is too much uric acid in the blood and tissues. Crystals of uric acid form in the joints. They also can form in the kidneys, where they can cause kidney stones.

There are three main causes of the high levels of uric acid that lead to gout:

Your diet is rich in chemicals called purines, which the body breaks down into uric acid.

Your body chemistry produces more uric acid than that of most people.

Your kidneys do not get rid of enough uric acid, so it builds up in the blood. This can happen with any kind of kidney disease. Also, drinking a lot of alcoholic beverages and taking certain blood pressure medicines can reduce the amount of uric acid that the kidneys expel.

To decrease your risk of gout, avoid purine-rich foods. These include anchovies, sardines, oils, herring, organ meats (liver, kidneys and sweetbreads), legumes (dried beans and peas), mushrooms, spinach, asparagus, cauliflower, and baking or brewer’s yeast.

Also limit how much meat you eat at each meal. Avoid fatty foods. Stay hydrated. Don’t drink too much alcohol, and especially avoid binge drinking.

There are effective medicines for preventing and treating attacks of gout.

Treatment usually starts with a prescription-strength nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, and another anti-inflammatory drug called colchicine. Avoid aspirin, which can raise the level of uric acid in your blood — but if you are taking low-dose aspirin for another medical condition, it’s OK to continue taking it.

If your gout attacks are frequent or severe, your doctor may prescribe medication to prevent future attacks. These include drugs that make your body produce less uric acid or excrete more uric acid. Either type of drug must be taken indefinitely. But don’t forget about diet.

Write to Dr. Komaroff at

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