Once known as 'the disease of kings', gout cases in the UK are on the rise, with the number suffering from this painful condition soaring by two thirds between 1997 and 2012.
Obesity, high blood pressure, and a diet rich in seafood, red meats and alcohol are all contributing to this rise in Brits being diagnosed with gout. If you think you may already have the condition, or are keen to reduce your chances of developing gout, here's what you need to know.
What is gout?
A type of arthritis, gout is a result of sodium urate crystals forming inside joints. It is caused by a build-up of uric acid - a waste product excreted by the kidneys - in the blood. As the uric acid builds up, it can cause tiny crystals to form in and around the joints, and when these tiny crystals build up themselves, they can expand into the soft lining of the joint, or pack together into larger lumps called 'tophi' that can damage the joint and bone. Small white lumps just under the skin are evidence that tophi are present. It often takes several years for the symptoms to become apparent, and men are three times more likely to develop the condition than women.
Sufferers are usually alerted to a problem with a sudden and severe pain in one or more joints. In 70 per cent of cases, the first joint affected is the big toe, though it can also occur in the midfoot, ankles, knees, fingers, wrists and elbows. Swelling around the affected joint may also occur, with red, shiny skin a sign that gout has taken hold. In the first instance, the symptoms commonly last for between three and ten days, before the pain begins to subside. Peeling, itchy, flaky skin around the affected area commonly occurs at this point.
More than half of sufferers go on to experience a second attack within 12 months, and as the condition progresses, symptoms can occur regularly, though it differs greatly from person to person.
Gout is extremely painful, and your immediate reaction will undoubtedly be to relieve that pain. Keeping the affected limb elevated and rested will help, and an ice pack on the joint for around 20 minutes can help to relieve the symptoms. Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed by your doctor to help reduce the swelling as well as the pain, and you should use these as early as possible when an attack occurs.
Colchicine, derived from the crocus, may be prescribed if you are unable to take NSAIDs, while corticosteroids can help in severe cases. In the long term though, your doctor may prescribe a course of urate-lowering therapy (ULT) to help lower uric acid levels and dissolve existing crystals.
You can help yourself to reduce your chances of either developing gout at all, or of experiencing further attacks, with a range of simple lifestyle changes.
Because uric acid is used to break down compounds known as purines, a diet rich in the latter can lead to the build-up that causes gout. Therefore, cutting back on those foods that are high in purines can help to prevent attacks of gout.
Red meats, particularly kidney, liver, veal and venison, are known to contain high levels of purines, as do some seafoods, including herring, mackerel, sardines, mussels and scallops. Some vegetables, notably asparagus, kidney beans, lentils and spinach, are also rich in purines, as are some foods that contain yeast extract, like Marmite and Quorn. If you regularly chow down on the above in large quantities, then you're increasing your chances of developing the condition.
Similarly, beer and stout are purine rich, as are spirits such as vodka and whiskey, so cut back if you're worried that you are at risk. And lastly, maintaining a healthy body weight will help to reduce your chances. When you are overweight, the levels of uric acid often rise, so weight loss and a healthy, balanced diet, teamed with regular exercise, will significantly reduce your risk of gout.
If you are worried that you are at risk of developing this excruciating condition, or have already experienced an attack, don't hesitate to visit your GP.
Do you suffer with gout? What have you done to alleviate your symptoms or reduce the chances of another attack? Leave your comments below...