Look out for gout

Many of us think of gout as something that affects middle-aged men - and that's not wrong. It is predominantly an older man's condition - but not exclusively... By Karen Evennett

For every 17 men with gout, there will be three women, and your lifestyle doesn't even have to be unhealthy to put you at risk. The painful condition was at one time associated with the Victorian age, but there has been an increase in cases in the UK in the last 30 years. Gout now affects 600,000 people in the UK. Some experts blame the rise on increasingly unhealthy lifestyles, but research is ongoing. Here's what you need to know...

 

What is gout?

Gout is a metabolic disorder that causes acute, intermittent and painful attacks of arthritis in the joints of the foot, knee, ankle, hand and wrist - but most often the big toe. Seven out of ten cases start with the big toe, and attacks usually occur in the early hours of the morning. It can come on so rapidly that your first awareness of the condition may be when you wake up in such agony that even the touch of your bed clothes is intolerable.

 

Your toe is likely to be shiny, red and inflamed - and you may also have a mild fever, loss of appetite and a general feeling of tiredness.

 

Are you at risk?

The culprit is a build-up of uric acid in the blood and tissues, causing uric acid crystals to enter the joint. This can be because you've inherited a problem with your kidneys that prevents sufficient urate from passing through your urine, and causing it to build up in the blood instead. But it can also be caused by:

 

• Chronic stress

• Unusual physical exercise (anything over-exertive that you wouldn't normally do, such as trying to run a marathon without training first).

• Being overweight

• Some medicines - such as diuretics and antibiotics, as these can interfere with the normal excretion of uric acid.

• Drinking too much alcohol (especially beer and fortified wine).

• Drinking too many sugary soft drinks (the fructose in them increases levels of uric acid in the bloodstream). A 12-year study of 46,000 men aged 40 and over found a link between drinking too many sugary drinks and gout.

• What you eat Purine-rich foods such as red meat, offal and game are classic culprits - but healthy foods such as mussels, herrings, sardines, oatmeal, mushrooms, asparagus, spinach and lentils are also high in purines, which increase the levels of uric acid in your body, so you should go easy on these, too. Coffee, surprisingly, seems to have a protective effect if you drink four or more cups a day.

• Trying to lose weight quickly (especially if you binge, then fast) is a problem, too, as it causes the kidneys to retain uric acid.

 

How is it diagnosed?

Symptoms are severe and sudden, so you'll know something's up. Your GP can confirm the diagnosis by drawing fluid from the affected joint for analysis.

 

Get the right treatment

During an attack, the best way to relieve pain is with anti-inflammatory drugs, such as ibuprofen. Once the attack has passed, you should take steps to reduce the risk of a subsequent one. Start by losing weight if you need to - but sensibly. Cut right back on alcohol (especially beer, port and rich red wines). And limit the amount of purine-rich foods you eat.

 

Many people never have another attack of gout but, if your uric acid levels remain high, you could have a second attack within the next couple of years, and this may be followed by more frequent and prolonged attacks. If this happens, your doctor can prescribe drugs to lower the uric acid levels in your blood.

 

For more information, visit www.ukgoutsociety.org, or write to UK Gout Society, PO Box 527, London WC1V 7YP.

 

---

 

If you found that useful, try these... 

 

Are you thinking that you need to lose weight? We've got over 50 diets and tips

 

Stress less with our imaginative instant stress-busters 

 

Bag a pair of the best new-season boots 

 

Subscribe - 3 Issues for £3