What is gout?

Gout is one of the most common inflammatory arthritis in the world and affect 2-3% of people in the UK. It is also more common in men than women.

Gout affects mostly the big toe joint, but other areas such as the knees, ankles can also be affected. If gout remains untreated, the flare ups can last for a long time and keep coming back.

What causes gout?

Gout is caused by having too much uric acid in your bloodstream and muscles, which can cause crystals to form in your joints and kidneys, causing a gouty flare up.

Uric acid is the waste product created when the body breaks down purines (a type of protein found in many foods and all of your cells). Increased levels of uric acid in your blood may occur if for example, your kidneys cannot efficiently remove it, or your diet, and lifestyle increases the amount of uric acid that you produce.

The management of gout is often neglected and long term it can result in joint damage and renal stones.

What can I do to manage gout?

If you have an acute attack, you should:

• Rest and elevate the limb.
• Avoid trauma to the affected joint.
• Keep the joint cool and exposed – consider the use of an ice pack or bed cage.

Long term advice

• Weight management.

Being overweight increases the production of uric acid and reduce the amount that can eliminated by your kidney.

• Drink plenty of fluid.

Try to avoid becoming dehydrated by drinking plenty of water throughout the day.

• Try to avoid or reduce the number of soft drinks and diet fizzy drinks.
• Drink alcohol sensibly.
• Take regular exercise.
• Stop smoking.
• Consider taking vitamin C supplements.

What foods should be avoided?

Your diet plays an important role in both causing gout and reducing likelihood of suffering further painful gouty attacks. If you already suffer from gout, eating a diet that is rich in purines can results in a fivefold increase in gout attacks.

It is therefore advisable to reduce the amounts of foods that you eat that are high in purines, these include:

• Offal, such as liver and kidney.
• Game, such as pheasant and rabbit.
• Seafood, such as prawns, mussels, and clams.
• Sugar sweetened soft drinks, such as fizzy drinks and fruit drinks.
• Foods high in refined sugar such as biscuits and cakes.
• Alcohol such as beer, ale, fortified wine, and port.

Individual advice