Why gout can happen to anyone
Is Britain the gout capital of Europe? A recent study certainly suggests it might be. The number of people suffering from this painful joint condition has gone up in the UK by one third in just the last 15 years.
Tradition may have it that gout is the preserve of portly gentlemen with a taste for red wine, but in fact anyone can get it. Gout is a form of arthritis or inflammation of the joints. It's caused by an excess of a chemical called uric acid in your blood system - large amounts form tiny crystals that get laid down in your joints, usually in the joint at the base of your big toe.
In about one in five people who get gout, the condition runs in their family. However, having other medical conditions like diabetes, high blood pressure, kidney problems or raised lipid levels can also increase your risk.
Gout tends to come on in attacks that come on very quickly - over a few hours - and last for several days. Your joint will get more and more painful and swollen, and the skin around it often gets hot and red. Walking, or having shoes (or even bedclothes) touching it can be hard to bear. Although the big toe is most often affected, it can cause the same symptoms in other joints.
Do I need to see a doctor?
It's important to get a hot, red, painful joint checked out if you haven't had gout before. Rarely, other conditions like infection in a joint, which can cause serious complications, can look like gout. With this sort of infection (called a septic arthritis) you're likely to feel feverish and unwell as well, and won't be able to move the joint at all. Your doctor should be able to make a diagnosis of gout just from examining you. He or she is probably want to take a blood test to check your levels of uric acid, but that won't delay your treatment.
How is gout treated?
An acute attack of gout is extremely painful, but anti-inflammatory tablets such as naproxen or indometacin are very effective. You'll need to take it regularly for a few days and if you've had attacks in the past, it may be worth keeping a supply at home for emergencies. If you can't take anti-inflammatory tablets, a medicine called colchicine may be offered.
To prevent attacks in the future, your doctor may discuss taking regular allopurinol tablets in the long term. He or she is unlikely to suggest this after just one or two attacks, since sometimes lifestyle measures are enough to cut the frequency of attacks dramatically.
Top tips to avoid gout
- Foods to avoid - liver, kidneys, seafood, Marmite® (or other yeast extract spreads) and high-protein foods may all increase your risk of gout
- Fluids good and fluids bad - drinking enough water protects against gout but alcohol and sugary drinks have the opposite effect
- Diet sensibly - losing weight can cut your uric acid levels, reducing the risk of further attacks. But crash or fad diets (such as Atkins-type diets) can bring on gout
- Check your meds - some medicines, including blood pressure-lowering tablets, can bring on gout. Check with your pharmacist
- Foods to feast on - fruit, veg and low-fat dairy products.
Check your blood pressure!
People who have gout are more likely to have high blood pressure, so get yours checked once a year
Self-help options - can we cherry pick?
Lots of my patients would prefer to avoid regular prescribed medicine if they can, so I'm often asked about alternative treatments. One study of vitamin C (in much higher doses than those found in citrus fruits) suggested taking it regularly could reduce your risk of getting gout. Sadly, other studies haven't shown the same positive finding.
Regular intake of cherries or cherry juice, on the other hand, seems to be pretty consistently linked with a lower risk of gout, possibly as much as a third less. With summer now in full bloom, give them a try!
With thanks to 'My Weekly' magazine where this article was originally published.