If you think gout only afflicts people who eat rich food and drink too much port, you're in for a surprise. The often very painful condition is actually a form of inflammatory arthritis, which affects around one in 100 people in the UK, rising to five in 100 for men aged 65 and over. Men are more prone to gout than women, as they tend to have higher levels of uric acid in their blood.
So what are the symptoms?
Severe pain is certainly the most noticeable symptom, often accompanied with a feeling of heat and tenderness in the affected area. Swelling is also common and the area can appear red and shiny. Peeling, itchy, flaky skin around the affected area is also quite frequently experienced.
Symptoms come on rapidly over just a few hours - and take three to 10 days to subside again. Almost all sufferers will experience another attack. The British Medical Association estimates that 60% of sufferers will have a second attack within a year, more than 75% within two years, and over 80% within three years.
What to do?
Your first priority is to relieve the severe pain, by resting and elevating the affected area - and possibly holding an ice pack to it for 20 minutes.
Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to help reduce the swelling - and you these should be taken as quickly as possible when an attack begins.
You should see your GP in the first instance of a suspected case of gout, since the symptoms can be very similar to other serious conditions such as an infected joint.
What causes it?
Gout occurs when there is a build-up of uric acid in the blood, either because a patient is producing too much of it or their kidneys are not filtering it out of the bloodstream effectively.
This build-up of uric acid causes tiny sharp crystals to form in and around joints - which then causes inflammation and pain.
Obesity, high blood pressure, kidney problems and diabetes are all linked to the condition - and you're also more likely to suffer if a relative has it too. Eating lots of red meat, offal and seafood is a risk factor, as is drinking red wine and beer.
Can it be prevented?
One route to prevention involves taking medication to lower the patient's uric acid level, this is known as urate-lowering therapy (ULT) and the drug allopurinol is often prescribed.
Lifestyle changes can be just as important - and might involve losing weight, getting regular exercise, changing diet or cutting down on alcohol. If you can't give up the booze, stick to white wine and lager, and give up red wine, stouts and spirits. You should also avoid eating a lot of kidney, liver, veal and venison and cut back on herring, mackerel, sardines, mussels and scallops.
And you may be surprised to learn that some vegetables are high in purines too - notably asparagus, kidney beans, lentils and spinach. Quorn and yeast spreads such as Marmite should be avoided by sufferers too.
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