Gout

Symptoms

Signs and symptoms of gout are generally acute – they come on suddenly without warning. A significant proportion of patients experience them at night. The following are the general symptoms:

• • Severe pain in the joints. The person may experience pain in his ankles, hands, wrists, knees or feet. More commonly the big toe is affected. Many people describe the affected areas as warm/hot.

• • Redness and inflammation. The sufferer will most likely have tender, red and swollen joint(s) in the areas that experienced the most pain.

• • Red/purplish skin. The affected area may become red or purplish, making the person think he has an infection.

• • Fever. Some people have an elevated temperature.

• • Less flexibility. The affected joint may be difficult to use, the person has limited movement.

• • Nodules. The gout may first appear as tophi (nodules- a small aggregation of cells) in the elbows, hands, or ears.

Causes

A number of risk factors are related to the development of gout:

• • Genetics may play a role in determining a person’s risk, since up to 18% of people with gout have a family history of the disease.

• • Being overweight increases the risk of gout because there is more tissue available for turnover or breakdown, which leads to excess uric acid production.

• • Eating too many foods rich in purines can cause or aggravate gout in some people.

• • Exposure to lead in the environment can cause gout.

Gout risk factors

The following types of medicines can lead to gout because they reduce the body’s ability to remove uric acid: :

• • Diuretics (taken to eliminate excess fluid from the body)

• • Salicylates (or anti-inflammatory medication made from salicylic acid, such as aspirin)

• • Nicotinic acid

• • Immunosuppressants

• • Certain medication used to treat Parkinson’s disease.

Treatment

There is no permanent cure for gout, but much can be done to manage the pain of an acute attack, lessen the duration of an attack, and prevent future attacks.

Pain and other symptoms of an acute gout attack can be managed with high doses of non-steroidal anti-inflammatory medication (NSAIMs). Corticosteroid medicines may be injected directly into the affected joint. People usually notice an improvement within a few hours and completely recover within a few days. Treatment is most effective if it begins as soon as possible when an attack occurs.

If NSAIMS do not control symptoms, the doctor may prescribe colchicine. It can be given by intravenous injection or by mouth. When taken by mouth diarrhoea is a common side effect. Colchicine is most effective when given within 12 hours after an acute gout attack begins.

Alternative and complementary gout treatments focus on helping your body prevent and eliminate the build up of uric acid. These include: :

• • Doing everything you can to support the healthy function of your blood cleaners – the liver and kidneys. The better they are working, the better they can clean your blood of uric acid and toxins.

• • Drinking lots of fluids, especially water. Try to drink six glasses a day.

• • Reducing the amount of meat in your diet because meat is rich in uric acid forming components. Consider a vegetarian lifestyle.

• • Eating plenty of raw fruit, vegetables, grains, seeds, and nuts. Cherries and strawberries appear to be most beneficial.

• • Avoiding purine rich foods like anchovies, asparagus, crab, fish roe (caviar), herring, kidney, liver, meat gravies and broths, mushrooms, mussels, peas, beans, and sardines.

• • Exercising regularly.

• • Drinking black cherry juice.

 

Our Employee Wellbeing Programme (EAP) is available 24 hours a day if you want to know more about gout.