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Had painful swelling in wrist. Blood test showed Uric Acid 8.2. Prescribed Zyrolic. On low protein diet. Will both medication and diet help?

Jul 2013
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
Hi. I had a painful swelling in my left wrist 15 days back. I was unable to sleep through the night. It all of sudden developed without me physically hurting me. (Later an x-ray confirmed this).
Went to a orthopedic to show him the pain in the wrist. And, he suggested me to get a blood test done (CBC + Uric Acid Levels). The ESR was 07 and the Uric Acid was 8.2. So, the doctor immediately advised Zyrolic (100mg) 2 tablets per day for 5 days. And, low protein diet.
I followed his medication. And, although the wrist pain subsided, there was still a pinching feeling now and then. So, I did another blood test (CBC + + ESR+ Uric Acid). Although the ESR has now come down to 06, the Uric Acid (serum) has increased now to 8.9. What would you advice? Both by medicine and also diet plan to reduce my uric acid levels? Will this limit my physical activity like going to gym and playing tennis?

Also, since the last 4 months, I have been infrequently having a pain on the right lower abdomen side when I sit on the floor and get up. But, if I sit on a chair, I do not experience any such pain. Is this related to my high uric acid levels. There is no such pain when I play tennis or do any physical activity. What would you advice?

My height is 5 ft 6 inch and weight is 90 KGs (obese).
Posted Fri, 11 Oct 2013 in Bones, Muscles and Joints
Answered by Dr. K. Naga Ravi Prasad 8 hours later
Brief Answer:
Use Uric acid lowering agents.

Detailed Answer:
Hi, thanks for writing to XXXXXXX

It is always advisable and preferable to keep the uric acid levels less than 6mg/dL. So you have to use a uric acid lowering agent like FEBUXOSTAT (the dosage and duration has to be determined by your treating doctor).

Acute attacks of gout can be effectively treated with NSAID's (non steroidal antiinflammatory drugs) and Corticosteroids at times.

Alcohol (especially BEER) should not be consumed as it worsens the gout. Also, you should avoid High protein diet (Nonvegeterian diet).

A few dietary tips which help in keeping your uric acid levels low are -
* Foods high in dietary fibre may help lower uric acid levels in your blood.Increase the consumption of dietary soluble fibres such as Isabgol, Oats, Spinach, Broccoli etc
* To help reduce the amount of uric acid in your system, regularly taking 500 milligrams of vitamin C will decrease your uric acid levels in a month or two.
* Avoid cakes, pastries, cookies and other sugary delights which are XXXXXXX in saturated fats and trans fats.
* Fruits and vegetables such as red bell peppers, tomatoes, blueberries, broccoli and grapes are XXXXXXX sources of antioxidant vitamins. Antioxidants which are vitamins that prevent free radical molecules from attacking your organ and muscle tissue cells may help lower uric acid levels.
* Cherries contain chemical compounds that may help neutralise uric acid allowing your body to eliminate this acid as waste. Some researchers recommend consuming 30 to 40 cherries every four hours during an attack.
* Avoid Saturated fat, trans fat, sugar and alcohol as all these affect your triglycerides, a type of fat that can clog your arteries and increase your risk for heart attacks and strokes.
* Drink plenty of fluids to help flush uric acid from your body.Drink a minimum of 3 liters of water daily. Water is a medium that aids the kidney to 'strain' the impurities from your body.
* Limit meat, poultry and fish - animal proteins are high in purine and this will result in high uric acid levels in the body.
* Alcohol interferes with the elimination of uric acid from your body. Drinking beer in particular has been linked to gout attacks. If you are prone to uric acid attacks, limit alcohol consumption to one drink three times a week.
* Eat more whole grains, fruits and vegetables and fewer refined carbohydrates such as white bread, cakes and candy. Because foods XXXXXXX in complex carbohydrates promote feelings of fullness, and prevent overeating and are useful in maintaining a healthy weight.

I personally feel that your infrequent pain in the right lower abdomen is unrelated to gout. Get an examination by a General surgeon for the same.

It is not advisable to involve in sporting activities during acute attacks of gout as it more irritate the already inflamed joints leading to more damage. Once the pain subsides, you can again start playing but with caution by not exerting too much strain on the involoved joints.

Hope I have addressed your query. Happy to help further.

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