By Glenn Ellis
(Trice Edney Wire) – The holiday season comes with little indulgences. But when you have gout, you must be smart to make sure those little indulgences do not turn into big flare-ups.
If the joint of your big toe is hot, swollen, red and it’s unbearable to allow anything to touch it…there’s a chance you could have Gout.
Gout is a common form of arthritis that usually affects one joint at a time (often the big toe joint) and is very painful. Men and obese adults are more likely to have gout. There are times when symptoms get worse, known as flares, and times when there are no symptoms, known as remission. Repeated bouts of gout can lead to gouty arthritis, a worsening form of arthritis. There is no cure for gout, but you can effectively treat and manage the condition with medication and self-management strategies.
Gout flares start suddenly and can last days or weeks, followed by long periods of time—weeks, months, or years—without symptoms before another flare begins. Gout usually occurs in only one joint at a time. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.
Without question, alcohol raises the top question I get from patients this time of year: “What can I drink?”
I get it. The holidays are a social season. But I also must point out that, no matter the time of year, alcohol can raise the uric acid levels in your body and lead to gout attacks. That’s why I tend to advise people not to drink at all, especially if they are newly diagnosed or starting new medications to control gout.
That said, if you’re going to have a drink at that holiday party or family dinner, make it red wine. Beer and liquor are much more likely to trigger a flare-up than red wine.
The holiday season is full of sweets. Realistically, people are going to indulge a bit – but when you do, choose items that don’t contain high-fructose corn syrup.
“If you’re going to have a drink at that holiday party or family dinner, make it red wine. Beer and liquor are much more likely to trigger a flare-up than red wine.”
Why? Because high-fructose corn syrup raises uric acid levels in your body, too. When you are making homemade desserts, or even glazes for savory items, check closely for ingredients that include high-fructose corn syrup, corn syrup and fructose. Read the label of any pre-packaged foods, too; high-fructose corn syrup is in more items than you might think.
If you are eating food prepared by others, ask about the ingredients if you are comfortable doing so. If not, just be mindful of the risks and limit your intake. And by all means, avoid drinking sodas, which are usually full of high-fructose corn syrup.
Don’t reach for the salt shaker; if you have gout, you don’t need any more sodium than what is already in cooked food. The salt itself may not be an issue, but loading up on sodium can lead to dehydration, and dehydration can increase uric acid in your body.
In addition to not adding salt, limit your consumption of foods you know are high in sodium. Depending on how it’s prepared, the turkey (go light on any gravy) may be a better option for you than the ham, for instance. The ham is likely higher in purines, as well.
And keep drinking water – more than you normally would, at least eight 8-ounce glasses per day – to keep yourself thoroughly hydrated. It’s amazing what a difference simply drinking enough water can make.
Picture this: It’s Christmas day, and your diet over the past week has not been ideal. You reach for the medicine cabinet but realize you are out of your allopurinol. Your doctor may be hard to contact, and pharmacy hours will be limited, so this situation is not ideal.
Avoid it by making sure you fill any prescriptions you may need – whether they are ongoing or “just in case” medications – before the holidays are in full swing. It’s better to have what you may need and not need it than to need it and not have it.
While a simple blood test will reveal an elevated Uric Acid level, Gout is technically diagnosed by a procedure called joint aspiration. In this procedure, your doctor will use a needle to draw fluid out of the affected joint cavity, which will then be analyzed for urate crystals as well as bacteria to rule out infection of the joint as the cause for pain. X-Rays are also utilized to determine the extent of Gout and monitor both bone and joint damage.
Remember that Gout not only affects the great toe, but often occurs in other joints in both the foot and the rest of the body. First time attacks usually occur in the great toe, and secondary attacks may go to other joints in the foot and ankle or other areas of the body.
If Gout is left untreated, consequences may be chronic Gout pain or destruction of the joint where the Gout occurred resulting in permanent arthritis pain.
‘Tis the season to be surrounded by family and friends – and lots of food that could trigger a gout attack. But with a little planning, you can still enjoy seasonal treats while keeping your gout risk low.
Remember, I’m not a doctor. I just sound like one. Take good care of yourself and live the best life possible!
The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Glenn Ellis, is a Health Advocacy Communications Specialist.