non pharmacological modifications if patient with gout

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non-pharmacological recommendations for patients with gout

In patients with milder cases of gout, non pharmacological modalities could be of great benefit (1). Patients should be educated about:

  • the importance of lifestyle changes
    • in overweight patients - dietary modification to achieve ideal body weight should be recommended (‘crash dieting’and high protein/low carbohydrate (Atkins-type) diets should be avoided).
    • reduction of high purine foods and red meat
      • however there is some clinical data has shown that consuming purine-rich vegetables does not increase the risk of gout (1)
    • avoiding dehydration
    • reduction in alcohol intake - beer, stout, port and similar fortified wines are best  avoided
    • inclusion of skimmed milk and/or low fat yoghurt, soy beans and vegetable sources of protein and cherries, in the diet  should be encouraged
    • moderate physical exercise (2)  
  • keeping  the affected  joints elevated  in a cool environment (avoiding clothing and using an ice pack)
  • avoiding trauma to the affected joint and intense physical exercise.
  • compliance with long-term therapy
  • prevention of flares early in the course of urate-lowering therapy (ULT)
    • initiating ULT will change SUA levels, the therapy itself may cause a gout attack (called a mobilization flare). (1).


Last reviewed 06/2018