Not that long ago, gout was associated with elderly well-to-do men who ate too much rich food and drank too much port. Today, however, the numbers of cases are soaring, with one in 40 people thought to be affected in the UK.
One study suggests the number of people affected by gout has increased by 64 per cent since 1997 (i).
By Lamberts Informa
Gout affects one or more of your joints, causing pain, redness and swelling (inflammation). The affected joint becomes very tender, and you may not be able to bear even touching it. Then as the inflammation starts to ease, you may notice the skin over the affected joint becomes itchy and flaky.
The most common joint that’s affected is that of the big toe (70 per cent of people with gout experience their first attack in the big toe joint). As well as the big toe, it tends to affect joints at the ends of your arms and legs, such as the fingers, wrists, elbows, ankles, joints in the middle of the feet and knees. It rarely affects other joints near the centre of the body, such as the spine, shoulders and hips.
If you’re really unlucky, you could have gout in more than one joint at the same time (this is known as polyarticular gout). Indeed, the pain of gout can be so severe; it’s often compared to the pain of childbirth.
Nutritional advisers often recommend them for gout because of their antioxidants
Gout usually comes in an attack that can develop fairly quickly, during just a few hours. After an attack starts, it can last for anything from three to 10 days.
You may have just one attack of gout in your lifetime, or you could have an attack every few weeks, months or years.
Certain things are thought to trigger a gout attack, including stress, illnesses that cause fever and injury (just a minor bump to a joint could bring an attack on).
Dehydration can also be a gout trigger, as can having surgery, which – like some illnesses – can raise your temperature.
Gout is caused by a build-up of a substance called uric acid in your body. Uric acid is a waste product made in the body and excreted by the kidneys that breaks down substances or chemicals known as purines, which are found naturally in the body and in some foods. Usually it’s harmless, but if your body makes too much uric acid – or you don’t excrete enough of it – levels can build up and become too high. This can create tiny crystals that collect in and around a joint, causing inflammation and pain in the soft lining of the joint (the synovium).
There are several things that could affect your risk of developing gout, including the following:
If you have gout, there are certain lifestyle changes you can make to reduce your levels of uric acid – which may help to prevent attacks or make them less severe – including changes to your diet.
Purines: Foods that contain high levels of chemicals called purines may contribute to raised uric acid levels, so avoiding them may help reduce your risk of a gout attack. These foods include:
According to the Gout Society, some foods that contain a moderate amount of purines should also be eaten in moderation, including poultry, mushrooms, mycoprotein, whole grains, dried peas, beans and legumes and certain vegetables such as asparagus, cauliflower and spinach.
Soft sugary drinks: Experts believe that drinking just two sugar-sweetened soft drinks a day may increase your risk of developing gout, and that fruit juice may also make your risk higher. However, it’s important to drink lots of water, which may prevent uric acid forming into crystals. The NHS recommends you should aim to drink at least 1.2 litres of water a day – that’s six to eight glasses.
If you struggle to drink that much water, remember that non-alcoholic and non-caffeinated drinks can replace some of it, including skimmed milk and herbal teas.
According to the Arthritis Research UK, there is also some evidence that drinking coffee may help your kidneys to excrete more uric acid. The charity also claims that a glass of skimmed milk every day may help to prevent acute attacks. Vitamin C
Foods that contain high levels of vitamin C, including many fruits and vegetables, may also help, as vitamin C is thought to encourage the kidneys to excrete uric acid. Try red, yellow and green peppers, guavas, dark green leafy vegetables such as kale, kiwi fruit, broccoli, berries and citrus fruit.
Meanwhile, losing weight if you need to be also a good idea, as having a lower body weight means you produce less uric acid. But avoid high-protein diets, as these tend to contain very high levels of purines. Drastic weight-loss diets are also a bad idea because they can increase your production of uric acid.
Moderate exercise an help you to lose weight and maintain a healthy weight, and it’s also good for your joints as it keeps them moving. Swimming, for instance, is ideal because it keeps your joints moving but doesn’t put any pressure on them, since the water supports your weight.
Conventional treatments for gout are designed to do two things: prevent attacks and relieve the symptoms of an attack.Drug treatments that reduce uric acid levels are often prescribed to people when they are first diagnosed with gout to reduce the frequency of attacks and also the risk of their joints being damaged. These treatments are known as urate-lowering therapy (ULT), and include the medicines allopurinol and febuxostat. Both of these medicines – and other ULT drugs – have common side effects that you should be aware of, so it’s a good idea to discuss these with your GP or refer to the patient information leaflets in the packet.
If you have an attack, the main medicines used to reduce pain and inflammations are anti-inflammatory painkillers called non-steroidal anti-inflammatory drugs (NSAIDs), plus colchicine and corticosteroids. NSAIDs such as naproxen and diclofenac can also cause side effects, including stomach ulcers, indigestion an gastric bleeding, and you should also be prescribed medicines called proton pump inhibitors (PPIs) to reduce any such risk.
Colchicine and corticosteroids are used if you’ve tried NSAIDs but haven’t found them effective, but again there are side effects you should be aware of including nausea and diarrhea in the case of colchicine and weight gain, bone and skin thinning in the case of corticosteroids. If you’re worried about side effects, talk to your GP.
How to help yourself
In the event of an attack, there are a few things you can do to make yourself feel more comfortable:
Besides conventional treatments, there are a handful of natural nutritional products that may provide beneficial support in people who have gout.
Disclaimer:The information presented is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor’s care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.