Guest guest Posted December 8, 2008 Report Share Posted December 8, 2008 Increased dairy products has been shown to provide some decrase in the occurance of gout attacks. If he can get a lot of his protein from dairy sources, it may help. Also, avoiding seafood and alcohol (obviously). From: Tarra <jedmonds14@...> Sent: Monday, December 8, 2008 9:05:47 AMSubject: Gout Hello all,I received the following email from a patient, and could use some help in answering his questions. I do have several handouts on gout, as well as lists of foods that are moderate to high in purines. Also, the general recommendation for gout seems to be follow low-fat diet and weight loss. Thanks in advance for any help you can provide! Tarra MS, RDSan Diego, CAFrom patient: I recently have had 2 gout episodes (new diagnosis) within the past 2 months. Currently on Allopuronol to lower the uric acid level but the medicine to help me when having a gout attack is from my understanding a very powerful nsaid (Colchicine and Indomethacin) . 1. The diet you prescribe is high in protein. Very bad idea for a person with gout. How do you get around this? Sounds like a bad idea if a high protein diet would most likely cause more gout attacks since that is once potential cause for the gout attack in the first place.2. The 2 drugs used to reduce pain and swelling are powerful NSAIDS. Problem with this type of surgery. With everyone concerned about ulcers and bleeding, this could be a problem when trying to remedy the problem. How does a doctor alter for this?? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 8, 2008 Report Share Posted December 8, 2008 We have also been seeing this quite a bit in our RNY patients. But, if you think about it we really aren't asking them to eat a high protein diet - 70g of protein a day is probably less than what an average American consumes in a day. Also many of the guidelines used for a purine-restricted diet are in line with what a gastric bypass patient should be following - it's my experience that the gout is not necessarily a result of what the patient is eating, but a result of the ketone production and is not impacted by the amount or type of protein consumed. Be sure the patient is consuming adequate fluids, and possibly focus on getting the majority of their protein from low-fat cheese, dairy, and eggs. Good Luck! From: Swilley Dana <danaeswilley@...>Subject: Re: Gout Date: Monday, December 8, 2008, 12:10 PM Increased dairy products has been shown to provide some decrase in the occurance of gout attacks. If he can get a lot of his protein from dairy sources, it may help. Also, avoiding seafood and alcohol (obviously). From: Tarra <jedmonds14msn (DOT) com>BariatricNutritionD ietitiansSent: Monday, December 8, 2008 9:05:47 AMSubject: [bariatricNutrition Dietitians] Gout Hello all,I received the following email from a patient, and could use some help in answering his questions. I do have several handouts on gout, as well as lists of foods that are moderate to high in purines. Also, the general recommendation for gout seems to be follow low-fat diet and weight loss. Thanks in advance for any help you can provide! Tarra MS, RDSan Diego, CAFrom patient: I recently have had 2 gout episodes (new diagnosis) within the past 2 months. Currently on Allopuronol to lower the uric acid level but the medicine to help me when having a gout attack is from my understanding a very powerful nsaid (Colchicine and Indomethacin) . 1. The diet you prescribe is high in protein. Very bad idea for a person with gout. How do you get around this? Sounds like a bad idea if a high protein diet would most likely cause more gout attacks since that is once potential cause for the gout attack in the first place.2. The 2 drugs used to reduce pain and swelling are powerful NSAIDS. Problem with this type of surgery. With everyone concerned about ulcers and bleeding, this could be a problem when trying to remedy the problem. How does a doctor alter for this?? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 8, 2008 Report Share Posted December 8, 2008 I agree with this....I have found the best thing to do is get lots of fluids in and focus on dairy/eggs for protein. I am always telling my patients this is NOT a high protein diet...the focus is on protein because we want them to get the minimum in and protein foods are hard to eat adequately after surgery. It is important to reinforce this with the PCPs and surgeons as they like to blame lots of things (eg renal issues) on the "high" protein diet. Diane Olson MS RD CDE UW Health Bariatric Surgery Program University of Wisconsin Hospital and Clinics (608) 265-1718 dolson3@... [bariatricNutrition Dietitians] Gout Hello all,I received the following email from a patient, and could use some help in answering his questions. I do have several handouts on gout, as well as lists of foods that are moderate to high in purines. Also, the general recommendation for gout seems to be follow low-fat diet and weight loss. Thanks in advance for any help you can provide! Tarra MS, RDSan Diego, CAFrom patient: I recently have had 2 gout episodes (new diagnosis) within the past 2 months. Currently on Allopuronol to lower the uric acid level but the medicine to help me when having a gout attack is from my understanding a very powerful nsaid (Colchicine and Indomethacin) . 1. The diet you prescribe is high in protein. Very bad idea for a person with gout. How do you get around this? Sounds like a bad idea if a high protein diet would most likely cause more gout attacks since that is once potential cause for the gout attack in the first place.2. The 2 drugs used to reduce pain and swelling are powerful NSAIDS. Problem with this type of surgery. With everyone concerned about ulcers and bleeding, this could be a problem when trying to remedy the problem. How does a doctor alter for this?? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2008 Report Share Posted December 10, 2008 Hi , Would you mind sharing your handout on gout? Mine is very old. Thanks. -DaraDara Bergen, MPH, RD, CDNRegistered Dietitian & Nutritionist718-544-0770www.darabergen.com From: Tarra <jedmonds14@...>Subject: Gout Date: Monday, December 8, 2008, 12:05 PM Hello all,I received the following email from a patient, and could use some help in answering his questions. I do have several handouts on gout, as well as lists of foods that are moderate to high in purines. Also, the general recommendation for gout seems to be follow low-fat diet and weight loss. Thanks in advance for any help you can provide! Tarra MS, RDSan Diego, CAFrom patient: I recently have had 2 gout episodes (new diagnosis) within the past 2 months. Currently on Allopuronol to lower the uric acid level but the medicine to help me when having a gout attack is from my understanding a very powerful nsaid (Colchicine and Indomethacin) . 1. The diet you prescribe is high in protein. Very bad idea for a person with gout. How do you get around this? Sounds like a bad idea if a high protein diet would most likely cause more gout attacks since that is once potential cause for the gout attack in the first place.2. The 2 drugs used to reduce pain and swelling are powerful NSAIDS. Problem with this type of surgery. With everyone concerned about ulcers and bleeding, this could be a problem when trying to remedy the problem. How does a doctor alter for this?? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2009 Report Share Posted February 10, 2009 I would be interested in the handout also, but never saw an attachment. I can usually open them. Theresa From: [mailto: ] On Behalf Of Musselman Tina Sent: Tuesday, February 10, 2009 11:59 AM Subject: Gout Good afternoon, Last night I went digging through the old files and messages looking for things on gout s/p rygb. Many messages mentioned that a handout was attached, but I could not open it. I would appreciate if anybody would share a gout handout with me. Thanks Tina Musselman RD, CCN Bariatric Program Coordinator (708) 747-4000 ext. 7444 or 679-2717 (708) 679-2418 (fax) tina.musselmanssfhs (DOT) org The information contained in this e-mail and any accompanying documents is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited. If you are not the intended recipient(s), please contact the sender by e-mail and destroy all copies of the original message. Thank you. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2010 Report Share Posted May 21, 2010 The Nutrition Care Manual has a very thorough section on gout, including educational materials. I put some of the information below; however, it has been my understanding that nutrition for gout and nutrition for WLS do not coincide and those at risk for gout will likely have a flare up no matter what we do, unless they decide not to have surgery. If possible, I would discuss with patients w/ a h/o gout beforehand that their gout will likely flare-up as a result of the pre- & post-op diet, especially during times of rapid weight loss. Overview: "Acute attacks typically occur at night or in the early morning and may be accompanied by systemic symptoms, such as fever, chills, and malaise. They may be triggered by a variety of circumstances, such as stressful events, alcohol or drugs, crash dieting or starvation, or the presence of another illness. The attacks are usually self-limited and subside within 3 to 10 days, even without intervention. Subsequent attacks may not occur for months or even years. Over time, however, the attacks can last longer and occur more frequently (Rosenthal, 1998). With repeated episodes, joint damage results in permanent deformities, loss of motion, and chronic pain. With proper early treatment, most people with gout do not progress to an advanced stage." Nutrition Therapy: During an acute attack: Consume 8 to 16 cups of fluid/day, at least half as water. Abstain from consuming alcohol (should be discussed with physician). Limit animal foods (see list below). Eat a moderate amount of protein; recommended sources: Low-fat or nonfat dairy foods, tofu, eggs, and nut butters; limit meat, fish, and poultry to 4 to 6 oz/day. During remission (between flares): Consume 8 to 16 cups of fluids/day, at least half as water. Abstain from consuming alcohol (should be discussed with physician). Follow a well-balanced eating plan following U.S. Dietary Guidelines as a basis: as tolerated, consume animal foods; continue to eat a moderate amount of protein. Maintain a desirable body weight; avoid fasting or high-protein diets for weight loss. Abby Klemme, RD, LD Missouri Bariatric Services Columbia, MO From: foodladyrd <Foodladyrd@...> Sent: Thu, May 20, 2010 10:30:02 AMSubject: Gout Recently we had a patient with an episode of gout during the pre-op liquid diet. He was told by the ER doc this was caused by high protein. I am not familiar with gout, is there anything else in a full liquid diet that could contribute. Also, how can we prevent issues post surgery? He is scheduled for gastric bypass.Thank,Jen Pullman MA, RD, LDNPhiladelphia PA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2010 Report Share Posted May 21, 2010 Thank you for the information. This is very helpful. Jen Pullman Gout Recently we had a patient with an episode of gout during the pre-op liquid diet. He was told by the ER doc this was caused by high protein. I am not familiar with gout, is there anything else in a full liquid diet that could contribute. Also, how can we prevent issues post surgery? He is scheduled for gastric bypass.Thank,Jen Pullman MA, RD, LDNPhiladelphia PA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 25, 2010 Report Share Posted June 25, 2010 Do you have access to the Nutrition Care manual? There are a few good handouts there. Larmour MSRD,CNSC,CDE Northridge Hospital Medical Center 18300 Roscoe Blvd. Northridge,Ca 91328 (818)885-8500 x3893 stephanie.sanders@... From: [mailto: ] On Behalf Of Jarzombek Sent: Friday, June 25, 2010 12:19 PM Subject: GOUT Does anyone have any handouts on GOUT? Thank you, A. Jarzombek Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 29, 2010 Report Share Posted June 29, 2010 Mayo Clinic has good handouts. Also, for more of an intergrative approach check out www.drweilcom where he talks about eating cherries and cherry juice for Gout. Sanam Shahrokhinia MS RD Center for Weight Loss Cedars-Sinai Medical Center From: Jarzombek <jarzombek.julie@...> Sent: Fri, June 25, 2010 12:18:45 PMSubject: GOUT Does anyone have any handouts on GOUT? Thank you, A. Jarzombek Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 29, 2010 Report Share Posted June 29, 2010 You may want to try the RD411 website too to see if there are any handouts there too!Tammy HutchisenFrom: Jarzombek <jarzombek.julie@...>Subject: GOUT Date: Friday, June 25, 2010, 3:18 PM Does anyone have any handouts on GOUT? Thank you, A. Jarzombek Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 30, 2011 Report Share Posted June 30, 2011 can kefir cause gout ?? i put my 92 yr. old mother on kefir to help her with digestion. She has been on it about 1 month and has developed gout in one of her toes. When you have gout...you are supposed to avoid milk products. Should i take her off the kefir??? Rudee Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2011 Report Share Posted July 1, 2011 I would take her off of cow's milk for sure. I would possible try kefir made with goat's milk. From everything I have read on milk intolerance, I just would not take the chance, especially if you can see she is getting worse since you started the kefir. Then too, from my experience, she may need to supplement with magnesium if you even give her goat's milk kefir. Kefir has a rather high amount of calcium and your mom may be low on magnesium (most people, especially elderly are) and consuming a the high calcium milk kefir daily can make her magnesium even lower. This can cause stiffness in body parts too. Alice can kefir cause gout ?? i put my 92 yr. old mother on kefir to help her with digestion. She has been on it about 1 month and has developed gout in one of her toes. When you have gout...you are supposed to avoid milk products. Should i take her off the kefir??? Rudee Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2011 Report Share Posted July 1, 2011 Yes, and if you give her magnesium, give her just magnesium, not the magnesium-potassium mix that is so readily available. I take postassium morning and noon, and I take magnesium at night. Doing that has made a difference. There are a couple of good books on magnesium, what it can do, and how to use it. Joyce On Fri, Jul 1, 2011 at 10:44 AM, Alice Connell <abconn@...> wrote: > ** > > > I would take her off of cow's milk for sure. I would possible try kefir > made with goat's milk. From everything I have read on milk intolerance, I > just would not take the chance, especially if you can see she is getting > worse since you started the kefir. Then too, from my experience, she may > need to supplement with magnesium if you even give her goat's milk kefir. > Kefir has a rather high amount of calcium and your mom may be low on > magnesium (most people, especially elderly are) and consuming a the high > calcium milk kefir daily can make her magnesium even lower. This can cause > stiffness in body parts too. > > Alice > > can kefir cause gout ?? i put my 92 yr. old mother on kefir to help her > with digestion. She has been on it about 1 month and has developed gout in > one of her toes. When you have gout...you are supposed to avoid milk > products. Should i take her off the kefir??? > Rudee > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2011 Report Share Posted December 29, 2011 Try 1 tbsp. of organic cider vinegar per day, such as Bragg brand, and 1 tsp cherry juice per day. Janese Osborne, RD, CDE Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 28, 2012 Report Share Posted March 28, 2012 I have a patient who states that everytime he consumes a “whey†protein shake he has a gout attack. He currently wishesnot to take meds for gout. Anyone else experience this? Have you had luckwith other protein shakes? _,____ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Quote Link to comment Share on other sites More sharing options...
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