Newswise — Drinking water might be a simple, safe and effective way of preventing recurrent gout attacks, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Philadelphia, Pa.
Gout is a painful and potentially disabling form of arthritis that has been recognized since ancient times. Initial symptoms usually consist of intense episodes of painful swelling in single joints, most often in the feet (especially the big toe). Treatments are already available to prevent or control the arthritis associated with gout, but managing this disorder can be difficult, and treatment plans often have to be tailored for each person.
Dehydration has been thought to be a possible trigger for acute gout attacks. Researchers recently set out to determine whether water consumption would reduce the risk for recurrent gout attacks by conducting an Internet-based study that aimed to assess a set of potential risk factors thought to trigger recurrent gout attacks.
The researchers recruited 535 people with gout who had experienced a gout attack within one year of the study and asked them to provide access to their medical records to confirm their gout diagnosis. During the study, participants provided information about the amount of water consumed over the 24-hour period prior to each gout attack as well as during periods when they were free of an attack. Researchers studied the relationship between the amount of water consumed—which were recorded as zero to one, two to four, five to eight and over eight glasses per 24-hour period—and the risk of recurrent gout attacks.
Among participants—of which 78% were men, with an average age of 53—water intake in the prior 24 hours was associated with a significant reduction in risk for recurrent gout attacks, even when accounting for other fluid intake. This led researchers to believe that drinking water might be a simple, safe and effective way for people with gout to reduce their chance of recurrent gout attacks, and this can easily be recommended to patients by health care providers.
“Persons with gout often continue to experience recurrent gout attacks despite being on therapy. It is thought that a number of factors can trigger recurrent gout attacks,” explains Tuhina Neogi, MD, PhD, FRCPC; assistant professor of medicine, Boston University School of Medicine, Boston, Mass., and lead investigator in the study. “Using a novel study design, we found that higher amounts of water intake in the prior 24 hours was associated with a significantly lower chance of having a gout attack, even while taking into account other fluid intake. This suggests that dehydration may indeed be an important trigger for gout attacks, and that persons with gout should consider ensuring adequate water intake in addition to appropriate medical management as directed by their physician.”
Management of gout can be challenging, despite available treatments. People with gout should consult with their physician for appropriate medical management of their gout, and bear in mind that a number of lifestyle factors can have an effect on their recurrent gout attacks.
The ACR is an organization of and for physicians, health professionals, and scientists that advances rheumatology through programs of education, research, advocacy and practice support that foster excellence in the care of people with or at risk for arthritis and rheumatic and musculoskeletal diseases. For more information on the ACR’s annual meeting, see www.rheumatology.org/annual.
Editor’s Notes: Dr. Neogi will present this research during the ACR Annual Scientific Meeting at the Pennsylvania Convention Center at 12:15 PM on Wednesday, October 21 in Room 203 B. Dr. Neogi will be available for media questions and briefing at 1:30 PM on Monday, October 19 in the on-site press conference room, 109 A.
Presentation Number: 2038
Drinking Water Can Reduce the Risk of Recurrent Gout Attacks
T. Neogi, FRCPC, MD, PhD , Clinical Epidemiology, BUSM, Boston, MA C. Chen, MPH , Data Coordinating Center, BUSM, Boston, MA C. Chaisson, MPH , Data Coordinating Center, BUSM, Boston, MA D.J. Hunter, MBBS, PhD , Division of Research, NEBH, Boston, MA Y. Zhang, DSc , BUSM, Boston, MA
Purpose: Dehydration is thought to be one possible trigger for acute gout attacks. We therefore examined whether water consumption may reduce the risk for recurrent gout attacks.
Methods: We conducted an internet-based case-crossover study to assess a set of putative risk factors thought to trigger recurrent gout attacks. This methodology uses each participant as his/her own control by comparing the frequency of a particular risk factor during periods of gout attacks with that during periods during which they are not having an attack, thereby eliminating between-person confounding. Subjects with gout who had an attack within the past year were recruited online and asked to provide access to medical records pertaining to their gout diagnosis. Data were obtained on the amount of water consumed over the 24-hour period before a gout attack and over the 24-hour period during an intercritical period. We examined the relation of amount of water intake (0-1, 2-4, 5-8, >8 glasses per 24-hours) and the risk of recurrent gout attacks using conditional logistic regression adjusting for diuretic use, alcohol consumption, and purine intake.
Results: 535 participants (78% male, mean age 53) provided information during both times of a gout attack and an intercritical period (median # of attacks/person=2; median # of intercritical period questionnaires/person=2). Increasing water intake was associated with decreased risk for recurrent gout attacks (Table).
Conclusions: Water intake in the prior 24-hours was associated with a significant reduction in risk for recurrent gout attacks. Drinking adequate water may be a simple, safe, and effective way for individuals with gout to prevent recurrent gout attacks, and can easily be recommended to patients with gout by healthcare providers. Future work will examine the effects of other concurrent beverage intake.
Table: (View the press release with full abstract at www.rheumatology.org).
Disclosure: T. Neogi, None; C. Chen, None; C. Chaisson, None; D. J. Hunter, None; Y. Zhang, None.
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