Gout – it’s a red hot subject!
When we think of gout, many of us will think of portly politicians or King Henry VIII, hobbling round after indulging in too much port. It’s the stuff of comic lampoons – but for its many sufferers, gout is no laughing matter. What is especially hard is that assumption that it’s their own fault for eating too much rich food. In fact, most gout sufferers are innocent victims!
Gout – what is it?
Gout is caused by a build-up of a chemical called uric acid. All of us make this chemical in our bodies, and most of us get rid of it without any problems in our urine. But if levels of uric acid build up, it can collect in your joints as tiny, gritty crystals which cause inflammation, redness and intense pain.
Who gets it?
Gout often runs in families. As you get into your forties and fifties your risk of getting gout increases, and you’re more likely to suffer if you’re a man than a woman.
What are the symptoms?
Gout tends to come on in attacks that come on over a few hours and last for several days. The most common joint to be affected is the base of your big toe, although gout can affect any joint. 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.
How is it diagnosed?
Your doctor may be able to make the diagnosis just by examining you. However, he may want to send of a blood test to check the level of uric acid in your blood.
How is it treated?
For acute attacks of gout, anti-inflammatory tablets (see the box) help enormously with the pain. If you get repeated attacks, your doctor may recommend a regular tablet called allopurinol to lower the level of uric acid in your blood. However, you can’t start it while you have an attack as it can make your symptoms worse in the short term.
How do I prevent it?
Some foods, such as herrings, sardines, yeast extract and heart can raise the level of uric acid in your system. So can too much alcohol or some sugary soft drinks (not ‘diet’ drinks). Avoiding these foods, and losing weight if you’re overweight, may help.
Easing painful joints
We all suffer from strains and sprains of our joints from time to time. Simple painkillers can help, although many people swear by anti-inflammatory tablets. You can buy some non steroidal anti-inflammatory tablets, or NSAIDs, from your pharmacist without a prescription. They include ibuprofen (I usually prescribe doses of 200-400mg three times a day) and diclofenac (I prescribe 50mg two of three times a day). Don’t forget that these medicines can irritate the lining of your stomach quite severely, so don’t take them without your doctor’s advice if you’ve had indigestion or a stomach ulcer, and always take them with food.
For strains, sprains and gout, RICE can be invaluable – and not the kind you eat! RICE stands for
- Rest – this gives the inflammation a chance to settle
- Ice – an ice pack or a pack of frozen peas (wrapped in a towel to avoid ice burns on your skin) applied for up to 20 minutes at a time
- Compression – pressure on the joint may make the pain of gout even worse, but a tubigrip can ease the pain of a sprain
- Elevation – putting your joint above the level of your heart (by lying back along the sofa with your arm or leg up on one arm) helps reduce inflammation and pain.
With thanks to 'My Weekly' magazine where this article was originally published.