Drink Water - Stop Gout


By Ed Susman

A research project that recruits patients through GoogleAds indicates that one way to lessen the risk of suffering a recurrent attack of gout is to drink more – water.

When individuals surfing the Net clicked on a gout-related advertisement, they were taken to the home page of the researchers who then vetted the participant – after receiving permission to analyze medical records.

Those who were accepted into the study and reported drinking more than eight, 8-ounce glasses of water a day experienced a 48% reduction in gout attacks compared with individuals who tended to drink one glass of water or less a day.

“We think that drinking water might be a simple, safe and effective way of preventing recurrent gout attacks,” said Tuhina Neogi, MD, PhD, assistant professor of medicine at Boston University School of Medicine, in her presentation at the American College of Rheumatology Annual Scientific Meeting here.

“While there are other treatments for gout, people still continue to have gout attacks,” Neogi said. She said some people don’t take their medications; some people can’t tolerate the dosages of the medications and some people are not put on optimal doses of available medications.

Neogi said that dehydration has been thought to be a possible trigger for acute gout attacks. She and her colleagues decided to use the Internet to recruit individuals to determine if water consumption could reduce the risk for recurrent gout attacks.

They enrolled 535 people who had experienced a gout attack within one year of the study. The participants click on a Google Ad which takes them to the researchers’ home page. The participants then give informed consent electronically and answer questionnaires. The researchers then ask for access to medical records to confirm the gout diagnosis. Neogi said that the participants represent every state in the nation.

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. The participants are asked to log into their online account when they are having a gout attack, and the report every three months between when they are free of attacks.

The questionnaires elicited information on a person’s lifestyle, eating habits and other factors that were designed to keep him from knowing the intent of the study in order to preclude participant bias.

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.

In the study, it appeared that participants who drank 2 to 4 glasses of water a day reduced their risk of gout attack by 18%, not a significant difference compared with the lowest consumption level. Drinking 5 to 8 glasses of water a day achieved a 43% reduction in gout attacks, and drinking more than 8 glasses of water a day achieved a 48% reduction in gout episodes, Neogi said. The linear trend reached statistical significance (P=0.02), she said.

“Very simply, increasing water consumption was associated with decreased gout attacks,” she said.

“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,” Neogi said. “Using our 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.”

“We have medications that probably do a better job of managing gout than drinking water,” said Eric Ruderman, MD, associate professor of medicine at Northwestern University Feinberg School of Medicine. “But drinking a lot of water may help control gout attacks for those people who do not go on medication.”