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Gout is a type of arthritis that causes sudden and severe joint pain. Many of us can suffer to varying degrees from this painful and uncomfortable irregular complaint.
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Gout is a form of arthritis, which is where a joint (or joints) become inflamed. The affected joint becomes hot, red and swollen.
Generally, it only affects one joint at a time (usually your big toe) but it can impact other joints such as your feet, hands, wrists, elbows or knees too. It may flare up suddenly, often lasting for several days or even weeks, before going back into remission. It’s an extremely painful and uncomfortable condition and you may experience recurring attacks, known as chronic gout.
It can be eased or prevented using medication. But avoiding foods which are high in purines (so sugary drinks like sodas, seafood such as scallops, meats including liver and alcohol), exercising regularly and losing weight can also help.
Men are more susceptible to suffering from gout than women, and it’s more common amongst older people. Other issues which can contribute towards the onset of gout can include obesity and diet. Ethnicity can also be a contributing cause, with a higher prevalence of gout amongst ethnic minorities, particularly black people.
Other factors which can increase the likelihood of gout are:
Although not especially common, it’s estimated that gout affects between 1 and 2% of the UK population. Men over 30 are most likely to be the main sufferers, as well as women who have gone through the menopause. Worldwide, it’s believed as many as 6% of the population is affected at one time or another.
Global epidemiology of gout: prevalence, incidence, treatment patterns and risk factors. Nature reviews. Rheumatology, 16 (7), 380–390.
Racial and gender disparities among patients with gout. Current rheumatology reports, 15(2), 307.
Gout symptoms and treatments.
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Gout is triggered by the build-up of uric acid in the blood. If too much uric acid is produced or the kidneys cannot filter it out, it begins to accumulate and form tiny sharp crystals in and around the joints, causing them to become inflamed (swollen and red) and painful.
Certain foods which contain purines, including red meat, seafood, alcoholic drinks and sweetened drinks (which have fructose in them) can trigger higher levels of uric acid too.
Any joint can be affected by gout, although it’s often the ends of the limbs which are prone to it, such as toes, ankles, knees and fingers. When an attack of gout occurs, it’s typically sudden and severe. The affected joint can suddenly feel hot and very tender, with swelling in and around the area and red, shiny skin over the affected joint. It’s accompanied or followed by severe, long lasting pain.
Symptoms normally develop very quickly over a few hours and can last from a few days up to two weeks. Afterwards the pain will usually subside and the joint should return to normal.
Almost everyone who experiences gout will at some point suffer from further attacks, usually within a year. These subsequent attacks or chronic gout can in turn lead to other problems, in which the joint can become damaged. In addition, urinary (kidney) stones are found in 14% of gout sufferers. Other, more severe complications associated with gout are chronic kidney disease, myocardial infarction (heart attack) and other heart problems.
CKS is only available in the UK. [Accessed 26 Oct. 2021].
Treatments can be given to both lessen symptoms and also to help healing while attacks are ongoing. To reduce pain and swelling, gout can be treated with non-steroidal anti-inflammatory drugs (NSAID) such as ibuprofen. Colchicine can also be given during attacks, which helps ease pain by reducing swelling and lessens further build-up of the uric crystals in the affected joints.
If pain or swelling persists, or NSAIDs and colchicine are unsuitable, a short course of steroid tablets or injections may also be considered.
If you’ve got chronic gout or high levels of uric acid in your blood, medication can also be prescribed which can help prevent further attacks. These medications, which are known as urate-lowering therapy (ULT) will help lower the uric acid levels in the blood and can prevent further attacks.
What will work for one person may not be as effective for another. This will be dependent on the severity and regularity of symptoms, along with other health factors such as weight, diet and age.
Often further attacks of gout can be reduced or prevented through simple lifestyle changes. These can include:
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