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Gout and Alcohol: Symptoms, Treatment and Home Remedies

Jo has been an ITU nurse at the London North West NHS Trust for 14 years. She obtained her RN at University College London Hospital.

gout-and-alcohol-symptoms-treatment-and-home-remedies
gout-and-alcohol-symptoms-treatment-and-home-remedies
gout-and-alcohol-symptoms-treatment-and-home-remedies
gout-and-alcohol-symptoms-treatment-and-home-remedies

About Gout

Gout comes from the Latin word gutta and the old French gote, meaning “a drop.” Hundreds of years ago gout was believed to be caused by viscous humor (sticky body fluids) that leaks from the blood and into the joints.

Gout is a complex disorder, the proverbial pain in the....joints of man since time immemorial.There are many myths about gout.

The condition was once known as “the disease of Kings” this myth took root because historically, gout only appeared to affect the rich. The gentry, people with money and influence were the ones who could best afford to eat a diet rich in foods associated with gout.

Some people believed that gout was handed down by God as divine punishment for an immoral lifestyle.

Drinking alcohol and eating rich food are closely associated with gout. However; gout can be caused by other factors such as genetics, and does not discriminate between saints and sinners. Pope Pius and Pope Clement Xll are both known to have suffered from this condition.

Hippocrates wrote about gout, as far back as the 5th-century BC, where he related the condition to excessive alcohol use and rich foods.

Many notable historical figures are known to have suffered from gout; they include; Queen Victoria, Queen Ann, Alexander the Great, Charlemagne, Columbus, Thomas Jefferson, Ben Franklin, William Waldorf Astor, Benjamin Disraeli and Bluff King Hal himself, Henry Vlll.

King Henry Vlll, was famously plagued by gout, the portly Tudor king is known for his excesses and many wives, is seen as the quintessential image of typical gout suffer. However; times have changed, almost everyone can now eat like ancient kings. Almost everyone in the industrial world now has access to the rich diet of red meat, seafood and alcohol that research shows can increase uric acid levels in the body to cause gout. The prevalence of gout has increased in recent years; it currently affects 1.4% of the adult population. Research shows that 8.3 million adults in the US suffer from gout.

What Causes Gout Attack

Gout is inflammatory arthritis caused by crystallization of uric acid in the blood. Uric acid is a waste product created when the body breaks down the protein compound known as purines.

Uric acid is excreted mostly by the kidneys. When the body produces too much uric acid, or when the kidneys are unable to excrete sufficient amounts of uric acid efficiently; this can result in a build up of tiny needle-sharp crystals in and around joints. Gout usually affects the joints of the big toe, but can develop in any joint.

The hard, sharp crystals can accumulate over several years without noticeable symptoms.

Some of it may spill over into the soft tissue and the joint lining (synovium) to cause the pain and inflammation associated with gout.

Gout is a common type of arthritis, it is painful and can affect the joints of both men and women, it is the most common inflammatory arthritis occurring in men. Women are protected from gout by the production of the female hormone 'oestrogen' when young; oestrogen increases the excretion of uric acid through the kidneys to reduce levels in the body.

However; uric acid levels increase after the menopause, and women become more liable to getting the condition at this time of life.

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Symptoms of gout

The most common symptoms of gout are often a sudden and severe pain in the affected joint which can include:

  • Swelling and warmth in and around affected area
  • Inflamed red shiny skin
  • itchy, peeling flaky skin over the affected area, as the inflammation recedes
  • Mild fever in some cases

Where gout recurs over an extended period, more symptoms may occur. A firm white lump develops beneath the skin. These lumps are made of uric crystals and are known as tophi, which can become inflamed and painful. Tophi can breakdown to leak a white paste like substance.

gout-and-alcohol-symptoms-treatment-and-home-remedies
gout-and-alcohol-symptoms-treatment-and-home-remedies

Facts about Gout

  • Everyone is potentially at risk of gout
  • Rarely seen in men before adolescence
  • Rarely seen in women before the menopause
  • Oestrogen protects women from developing gout before the onset of menopause
  • An elevated uric acid level does not necessarily mean that an individual has gout
  • Uric acid levels can be normal during a gout attack

    Medication can contribute to gout include, Diuretics, Immunosuppressant drugs, Theophylline, Methyldopa, Acetylsalicylic such as Aspirin, some Antibiotics, excessive use of over the counter medication like niacin (B-vitamin) Ascorbic acid (vitamin C)

  • Alcohol consumption can increase the risk of gout


Food Associated with causing Gout

Alcohol and Gout

Although there has been a lot of anecdotal evidence connecting alcohol use to gout, recent research studies show a clear link between gout and the use of alcohol.

In a study published in the Lancet medical journal, 47,000 male medical professionals with no history of gout were followed over a period of up to 12 years. When the study ended, researchers found that almost 2% of the men had had an attack of gout.

Men who drank the most alcohol daily had twice the risk of developing gout, as those who did not drink alcohol.

Beer drinkers increased their risk by 50% for every daily serving, while those who drank hard liquor increased their risk by 15% for each drink. Men who drank wine did not appear to increase their risk of developing gout. However, this result was somewhat inconclusive since few men had more than two glasses of wine daily.

Beer not only increases the uric acid levels, but it also makes it hard for the body to clear the build up of uric acid from the system, wine is a safer option. But heavy alcohol use can harm the body, and doctors will usually recommend that gout suffers abstain from drinking alcohol during a flare of gout altogether.

While sea foods are often the healthy choice in most diets, when it comes to gout, some sea foods are best left off the menu. Foods such as sardines, fish roe, mussels, scallops, herring, tuna, and anchovies.

Red meat, turkey, goose and wild game are higher in purine content than other types of food. Therefore; gout suffers should try to keep their intake to a minimum, according to rheumatologists.

Sugary drinks sweetened with high fructose corn syrup like non-diet sodas, and fruit drinks can stimulate the body to produce more uric acid.

Research has shown, drinking fructose-sweetened drinks every day, compared to drinking one a month increases the risk of gout in women.

Asparagus, cauliflower, spinach, and mushrooms are all higher in purine than other vegetables, and although need not be avoided entirely, should be used sparingly.

Liver, kidneys, and sweetbread should be completely avoided.

Gout Attack Treatment

The treatment plan for gout consists of two primary goals

  1. Relieving the symptoms of the gout attack
  2. Preventing further attacks

During a gout attack, certain self-caring techniques may help to relieve some of the symptoms.

Rest is necessary, the affected limb can be elevated, care should be taken to avoid accidentally knocking or damaging the limb.

Keep joint cool by applying the ice pack, however; there are two schools of thought about cold compress. Warm heat should not be used on swollen joint, as this can worsen the inflammation.


Some Low Purine Food for Gout diet

  • Eggs, nuts, peanut butter
  • Low-fat cheese
  • Skim milk
  • Soup made without meat extract or broth
  • Vegetables low in purine, like artichokes, broccoli, sprouts, cabbage, carrots, celery, cucumber, eggplant, tomatoes, pumpkins to name but a few.
  • Fruits and fruit juices (not sweetened with fructose)
  • Bread, pasta, rice, corn bread,
  • coffee
  • All fruits but particularly cherries
gout-and-alcohol-symptoms-treatment-and-home-remedies

Treatment for Gout

Medication

Initial treatment for gout usually consists of pain relieving drugs such as non-steroidal-anti-inflammatory drugs (NSAID) which work by reducing the pain and inflammation and include:

  • Diclofenac
  • Indometacin
  • Naproxen

When prescribed by a doctor to prevent an attack of gout, NSAID medication should be kept close at hand.

The medication should be taken throughout the attack, and for 48 hours after the attack has ended.

NSAID should be taken with a Proton pump inhibitor (PPI) this will reduce the possibility of the drugs causing gastric problems like indigestion, bleeding, and stomach ulcers.

People with poor or reduced kidney function, with stomach ulcers or bleeding, should not take NSAIDs.

Colchicine

This drug can be used as an alternative to NSAID; it is a derivative of autumn crocus plant. Colchicine is not a painkiller; it works by reducing the ability of the uric acid crystals to inflame the joint lining to reduce some of the inflammation and pain associated with gout. Colchicine should be used in small doses; it can cause nausea, abdominal pain and diarrhoea.

Corticosteroids

Corticosteroids are a type of steroid that is sometimes used to treat severe cases of gout that is resistant to other treatment. A short course can give relief, but should only be used in the short term as they can cause major side effects.

Preventing Gout Attack

The prevention of a gout attack consists of two methods, medication and lifestyle changes:

  • Medication is used to reduce uric acid levels, the main treatment for gout is urate-lowering therapy (ULT). The aim of this treatment is to reduce the levels of uric acid to below a level required for the formation of crystals; this level is called the saturated point.
  • To lessen the frequency of attack, treatment should be started as soon as a diagnosis is made. The benefits and disadvantages should be discussed with GPs or health care providers. The first line of medication is allopurinol. This drug helps to lower uric acid levels by inhibiting the enzyme responsible for converting purines into uric acid. Allopurinol is not a painkiller and will have no effect on pain during a gout attack. However; taken once daily, it can take up to two years to dissolve all the crystals.
  • Lifestyle changes
  • Avoid foods high in purines; uric acid levels can be reduced by avoiding the consumption of large quantities of foods that are high in purine content. Individuals who are overweight or obese are often found to have elevated levels of uric acid in the blood. Losing weight by following a well-balanced calorie-controlled diet, can help to reduce uric acid levels significantly, joints will also benefit from the reduced stress.
  • Regular exercise can help to reduce uric acid levels and thereby reduces the risk of gout.

    Water to maintain hydration, 6 to 8 glasses of water is the daily recommendation, more if also exercising.

  • Avoid some types of alcohol, beer, and stout contains high quantities of purine, wine in moderation doesn't seem to increase the risk of gout. However, binge drinking of any alcohol can cause an attack in people who have had an episode of gout.

Home Remedies for Gout

  • Exercise helps to reduce uric acid in people suffering from gout by normalising insulin.
  • Cherries or cherry extract, studies from 2012, suggests that people with gout who eat cherries over a two-day period showed a lower risk of a gout attack by 35% when compared to those who did not eat cherries. Findings from this study that published in a journal of the American College of Rheumatism suggests, that the risk of gout flares, was 75% lower when cherries were consumed in combination with uric acid reducing drugs like allopurinol, than in periods without exposure to cherries or treatment. Eating 10 to 12 cherries per day may help to prevent gout flares.
  • Baking Soda solution, can help to reduce uric acid in the body. Do not use if taking medication for high blood pressure, discuss all medication with your doctor.
  • Ginger Root, eaten raw in small pieces or cooked, can also help to relieve inflammation and pain. Also, effective used as a paste and applied to the affected joint.
  • Vitamin C, evidence shows, vitamin C can reduce uric acid.
  • Apple Cider Vinegar can help to reduce inflammation and relieve acute gout pain.
  • Lemon Juice contributes to neutralising the excess uric acid, can be taken with baking soda.
  • Apple and apple juice can help to neutralise the uric acid.
  • Beet juice prevents acidosis, stimulates the liver to cleanse bile ducts.
  • Epsom salt in a warm bath can help to relieve pain, and contains magnesium for a healthy heart.
  • Activated Charcoal can absorb uric acid in the treatment of gout.
  • Bananas' high potassium content can help to convert uric acid crystals into the liquid that can be excreted and flushed from the body by the kidneys.

Facts about Gout

  • Everyone is at risk of developing gout
  • Rarely seen in men before adolescence
  • Rarely seen in women before the menopause
  • Oestrogen protects women from developing gout before menopause
  • An elevated uric acid level do not necessarily mean that an individual has gout
  • Uric acid levels can be normal during a gout attack

    Medication can contribute to gout, and include, diuretics, immunosuppressive drugs, theophylline for asthma, methyldopa, acetylsalicylic such as aspirin, some antibiotics, excessive use of over the counter medication like niacin (B-vitamin) ascorbic acid (vitamin C)

  • Alcohol consumption can increase the risk of gout.



gout-and-alcohol-symptoms-treatment-and-home-remedies

Conclusion

Gout is associated with other health problems such as diabetes, hypertension, obesity and uric acid kidney stones. Although gout is partly due to genetics and may not be entirely preventable, the occurrence and severity of flare-ups can be reduced with proper management. It is imperative to work closely with your doctor and other health care providers to manage any health issues.