Personal health guide · Easy to read
What gout is, why it happens, what can relieve the pain, which foods to choose, and how to help a 90-year-old feel more comfortable.
1. What Is Gout?
Gout is a type of arthritis that causes sudden, sometimes very strong pain in the joints.
It often affects the big toe, but it can also affect the feet, ankles, knees, fingers, and wrists.
Gout happens when tiny, sharp crystals form inside a joint. These crystals cause swelling and pain.
Common signs
- Sudden, strong joint pain, sometimes during the night.
- Swelling around the joint.
- Skin that feels hot or looks red.
- Pain when walking or touching the area.
A painful gout episode is called a gout attack or flare-up. Without treatment, an attack can last several days or even one to two weeks. Gout can often be controlled with proper medicine and healthy habits.
2. What Causes Gout?
Gout develops when the body has too much of a substance called uric acid.
Uric acid is a waste product. The kidneys normally remove it from the blood, and it leaves the body in urine. When too much uric acid remains, it can form sharp crystals in joints.
Things that can increase the risk
- Kidney problems: The kidneys may not remove enough uric acid.
- Some foods: Large amounts of red meat and certain seafood can raise uric acid.
- Alcohol: Especially beer and hard liquor.
- Dehydration: Not having enough fluid in the body can trigger an attack.
- Some medicines: Certain water pills used for heart or blood pressure problems can raise uric acid.
- Age and family history: Gout becomes more common with age and can run in families.
3. What Medicines Help With Gout Pain?
There are two kinds of gout medicine: those that help during an attack and those that help prevent future attacks.
Medicines used during an attack
Colchicine
- Reduces the swelling and pain caused by gout.
- Works best when taken early in an attack.
- May cause diarrhea or nausea.
- A 90-year-old may need special dosing because of kidney problems or interactions with other medicines.
Corticosteroids, such as prednisone
- Reduce swelling and pain.
- May be given as tablets or an injection into the joint.
- Can affect blood sugar, blood pressure, and other health conditions.
Ibuprofen (Advil) and naproxen (Aleve)
- Can reduce inflammation and pain.
- Can cause kidney problems, stomach bleeding, and heart-related problems.
- At age 90, do not use these for gout unless a doctor says they are safe. They can be especially risky with blood thinners.
Acetaminophen (Tylenol)
- May help with some of the pain.
- Does not treat the inflammation causing a gout attack.
- Ask a doctor or pharmacist for a safe dose, especially if there are liver problems or other medicines involved.
Medicines used to prevent future attacks
Allopurinol
- Lowers uric acid in the body.
- Helps prevent gout attacks and joint damage over time.
- Usually taken regularly over a long period.
- Does not provide immediate pain relief during an attack.
Febuxostat
- Also lowers uric acid.
- Sometimes used when allopurinol is not suitable.
- Needs special consideration if someone has heart disease.
4. What Foods Should Someone With Gout Avoid or Limit?
Some foods and drinks can raise uric acid and make gout attacks more likely.
| Food or drink | What to do |
|---|---|
| Liver, kidneys, and other organ meats | Avoid. |
| Large portions of beef, lamb, and pork | Limit. |
| Sardines, anchovies, mussels, and some shellfish | Limit or avoid. |
| Beer and hard liquor | Best avoided. |
| Sugary soft drinks and sweetened juices | Avoid or greatly reduce. |
| Large amounts of candy and sugary desserts | Limit. |
| Rich meat gravies and large meat portions | Limit. |
Remember: The person does not need to stop eating all meat or seafood. Smaller portions and healthier choices are usually more practical.
5. What Foods Help Manage Gout?
These foods can support health and may help reduce the chance of future attacks. They do not replace medicine when medicine is needed.
| Food | How it may help |
|---|---|
| Water | Helps avoid dehydration. Follow any fluid limits given by a doctor. |
| Low-fat milk and plain yogurt | May help lower uric acid. |
| Cherries | Some evidence suggests they may help reduce attacks, but they are not a treatment. |
| Apples, berries, oranges, and other whole fruits | Provide vitamins and fibre. |
| Vegetables such as carrots, broccoli, and spinach | Support a balanced diet. |
| Oatmeal, brown rice, and whole-grain bread | Good everyday choices. |
| Eggs | Provide protein without high amounts of purines. |
| Beans, lentils, and tofu | Healthy alternatives to some meats. |
| Chicken in moderate portions | A reasonable protein choice. |
A simple example of one day’s meals
- Breakfast: Oatmeal, low-fat milk, and berries.
- Lunch: Vegetable soup, whole-grain toast, and an egg.
- Dinner: A moderate portion of chicken, rice, and cooked vegetables.
- Snacks: Plain yogurt, fruit, or a small handful of nuts.
- Drinks: Water regularly, unless the doctor has restricted fluids.
6. What Can a 90-Year-Old Do to Minimize Gout Pain?
The main goals are to reduce pain, prevent more attacks, protect the kidneys, and avoid falls.
During a gout attack
1. Rest the painful joint
Avoid unnecessary standing and walking until the pain improves. Use a walking aid or get help if needed.
2. Apply a cold pack
Place an ice pack wrapped in a towel on the joint for about 10–20 minutes at a time. Never place ice directly on the skin.
3. Raise the painful foot or leg
For swelling in the foot or ankle, rest it on a pillow while seated or lying down.
4. Keep pressure off the joint
Choose loose, comfortable footwear. Tight socks or heavy blankets may increase the pain.
5. Use doctor-approved treatment early
Gout medicine often works better when started early. Ask a doctor for a plan to follow if another attack happens.
6. Drink enough fluid
Avoid dehydration, but follow any fluid limits if the person has heart failure or kidney problems.
Between gout attacks
7. Have regular medical checkups
Ask about uric acid levels, kidney function, and whether medicine to prevent attacks is needed.
8. Review all medications
Some medicines can worsen gout or interact with treatment. Do not stop water pills, aspirin, blood pressure medicine, or other prescriptions without a doctor’s advice.
9. Eat regular, balanced meals
Choose vegetables, fruit, low-fat dairy, and enough healthy protein.
10. Stay gently active when the flare is over
Short walks and gentle movement can help with strength and stiffness. Do not force a painful joint to move during an attack.
7. When Should a 90-Year-Old Get Medical Help?
A hot, swollen, very painful joint is not always gout. It can sometimes be an infection inside the joint, which needs urgent treatment.
Get urgent medical attention if:
- This is the first time a joint becomes suddenly very painful and swollen.
- There is a fever or shaking chills.
- Swelling or pain gets rapidly worse.
- The person becomes confused, unusually weak, or very unwell.
- The person cannot safely stand or walk because of the pain.
At age 90, it is especially important not to assume every painful joint is gout.
8. The Most Important Things to Remember
- Gout is caused by uric acid crystals that can form in joints.
- Medicines such as colchicine or prednisone can help during attacks, but older people need careful medical guidance.
- Allopurinol can help prevent attacks by lowering uric acid.
- Limit organ meats, large meat portions, some seafood, alcohol, and sugary drinks.
- Choose balanced meals, vegetables, fruit, low-fat dairy, and enough fluid if allowed.
- During an attack, rest the joint, use a wrapped cold pack, and keep pressure off the painful area.
- At age 90, protecting kidney health, checking medicine interactions, getting enough nutrition, and preventing falls are very important.
Final message: Gout does not have to mean constant pain. Appropriate medication, healthy food choices, and regular medical care can help reduce attacks and make daily life more comfortable.