ACR: Drinking Water May Wash Away Gout Attacks

PHILADELPHIA -- Drinking a half-gallon of water a day may keep gout attacks away, researchers said here.

Participants in an online survey who said they drank more than eight 8-ounce glasses of water a day experienced a 48% reduction in gout attacks, compared with individuals who reported drinking one glass of water or less a day, according to Tuhina Neogi, MD, PhD, assistant professor of medicine at Boston University School of Medicine.

"We think that drinking water might be a simple, safe, and effective way of preventing recurrent gout attacks," Neogi told attendees at the American College of Rheumatology's annual meeting here.

"While there are other treatments for gout, people still continue to have gout attacks," she noted.

Some gout sufferers don't take their medications or can't can't tolerate the dosage, and others are not put on optimal doses of available medications, she explained.

Neogi said dehydration has been identified as a possible trigger for acute gout attacks. So she and her colleagues used the Internet to recruit individuals to determine if water consumption reduces the risk of those recurrent episodes.

Using a Google ad to attract candidates, they enrolled 535 people who had experienced a gout attack within the previous year. Some 78% were men.

The participants provided informed consent electronically and answered questionnaires. The researchers then asked for access to medical records to confirm the gout diagnosis. Neogi said that the participants represented every state in the union.

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 were asked to log into their online account when they are having a gout attack, or to report every three months when they are free of attacks.

Researchers studied the relationship between the amount of water consumed -- recorded as zero to one, two to four, five to eight, and more than eight glasses per 24-hour period -- and the risk of recurrent gout attacks.

Among participants, whose average age was 53, water intake during the prior 24 hours was associated with a significant reduction in risk for recurrent gout attacks, even when accounting for other fluid intake.

Overall, it appeared that participants who drank two to four glasses of water a day tended to reduce their risk of gout attack by 18%, which was not significant compared with the lowest water consumption level.

Those who drank five to eight glasses of water a day achieved a 43% reduction in gout attacks, and drinking more than eight 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 were 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," she added.

As intriguing as the findings may have been, "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.

"But drinking a lot of water may help control gout attacks for those people who do not go on medication."

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