Gout - Frequently Asked Questions

FAQs


Rheumatology Division,
Hospital for Special Surgery

  1. What causes gout?
  2. Does diet matter in gout? What should I eat or not eat?
  3. Will I need to take gout medication forever?

What causes gout?
Gout is caused by disordered metabolism of purines. You largely get purines from food, and they are essential to the working of the body. Excess purines are normally eliminated in the urine. But sometimes an excess can lead high levels of urate - a breakdown product of purines - in the blood, a condition called hyperuricemia. This can lead to the deposition of needle-like urate crystals in joints. Think of how small amounts of salt remain dissolved in water but, if too much salt is in the water, it breaks out into crystals; that same type of thing happens when too much uric acid is in the body, leading to crystal formation in the joints. For more information on the cause of gout, to read our full In-Depth Disease Overview on gout.

Does diet matter in gout? What should I eat or not eat?
In severe gout, dietary changes are usually not enough to prevent repeated attacks, and medications are needed to lower the uric acid. However, if you are not taking medication for your gout, and even if you are, it is reasonable to limit your intake of foods high in purines. For the first six months after starting allopurinol for gout, your diet is especially important in helping to prevent attacks. For more information on what purines are - and what foods to avoid, read our full In-Depth Disease Overview on gout.

Will I need to take gout medication forever?
That depends on the type and severity of your gout and how your doctor is treating it. Some patients just have one or two gout attacks; they may be treated only when attacks occur and take no medications when they are doing well. However, many patients need long-term medications, which work only while you are taking them. For example, if your doctor has prescribed colchicine to prevent gout attacks, the attacks will return if you stop the drug. If you are given allopurinol to reduce the uric acid in the blood (to reduce gout attacks) or to reduce the uric acid in the urine (to reduce the risk of uric acid-related kidney stones), the risk returns if you stop the drug. So many patients need to take gout treatments for the rest of their lives. For more information on the different drugs prescribed for gout and how they work, read our full In-Depth Disease Overview on gout.

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