non pharmacological modifications if patient with gout
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).
- (1) Hamburger M. 2011 Recommendations for the diagnosis and management of gout and hyperuricemia. Postgrad Med. 2011;123(6 Suppl 1):3-36.
- (2) Jordan KM et al. British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout. Rheumatology (Oxford). 2007;46(8):1372-4
Last reviewed 06/2018