If you’ve ever experienced a gout attack, you're not likely to forget it. The sudden, severe inflammatory pain may have woken you up in the middle of the night or even sent you to the ER.
You may be at high risk for another attack if you haven’t made any changes to your diet, lifestyle, or medication regimen. Taking precautions against future attacks can spare you from gout pain and limit long-term damage to your joints.
Gout can go away...or return again and again
Gout attacks almost always result in stabbing pain, redness, and swelling in a joint. In men, about 50% of first-time gout attacks involve a big toe joint.1 Other commonly affected joints include the instep, heel, ankle, and knee.2
See Gout Symptoms
After the first gout attack, the condition can affect people differently:
- Some people will go months or even years without having another gout attack—or very rarely, they may never have another one again.
- Other people will begin to experience gout attacks regularly. Eventually, these flare-ups may become frequent and longer-lasting. Chronic gout can lead to permanent joint damage and result in disability. Thankfully, early and appropriate treatment of the underlying cause of gout—high levels of uric acid in the blood—can prevent joint damage.
Experts can’t predict who will have a one-time attack versus chronic gout. If you’ve had an attack, it’s worth your time and effort to make changes that can help you avoid another painful flare-up.
5 steps you can take to prevent a gout flare-up
Making one or more of these lifestyle and dietary changes can reduce your risk of another gout attack and the joint damage it can cause. A doctor can help advise you based on your unique health circumstances.
1. Adjust your diet
A healthy diet to help prevent gout will include vegetables, fruits, low-fat dairy, and complex carbohydrates, such as whole grains and beans.
A gout prevention diet also involves avoiding certain foods, particularly:
- Meat, particularly organ meats, like liver, and game meats, like venison
- Seafood, including fish and shellfish
- Alcohol, including wine, spirits, and especially beer
These foods and drinks contain a high level of a substance called purines that increase the chances of a gout attack.
2. Swap soda for water (coffee and tea are okay in moderation)
Sugary foods and drinks, such as soda, increase purine intake and the risk of a gout attack.3-5 On the other hand, drinking plenty of water may lower your risk of gout flares.6 Experts typically recommend drinking 48 to 64 ounces of water (about 6 to 8 glasses), each day. Staying hydrated may help flush uric acid from the body.
Coffee and tea do not seem to increase the level of uric acid in the body, and coffee may even lower it.7-8 However, I generally recommend my patients avoid excessive amounts of coffee or tea. While scientists don't know for sure, some evidence suggests that drinking several cups of coffee or tea can make you a little dehydrated.9
3. Get moving
Most experts recommend losing excess weight, which is a risk factor for gout. What is less widely known is that avoiding a sedentary lifestyle and getting regular exercise—even if you don’t lose weight—may help reduce your risk of a gout attack.10,11
4. Get tested for sleep apnea
Untreated sleep apnea can increase the risk of gout.12,13 Sleep apnea is a sleep disorder that causes the body to take in less oxygen while sleeping, which in turn causes the body to produce more purines.12,14 Sleep apnea is typically treated with a continuous positive airway pressure (CPAP) machine or other device that increases oxygen intake while sleeping.
5. Take your gout medication regularly
In addition to the strategies described above, a doctor will usually recommend taking a prescription medication, such as allopurinol, that is proven effective in preventing gout attacks.
Allopurinol and other medications that lower the uric acid can have several benefits, including reducing gout flares, improving function and quality of life, increasing productivity at work, decreasing sick-days from work, and reducing gout-associated cost. Like most drugs, the long-term use of prescription gout medications carries a small potential of side effects and health risks.9 You should discuss the potential benefits and risks with your provider.
See Gout Treatment