Gout

Gout

Gout, the most common kind of inflammatory arthritis, is a condition characterised by attacks of swelling and severe pain in the joints. Almost half of all gout cases are in the big toe joint. It is estimated to affect one to two per cent of the western population [37] and is thought to be becoming more prevalent. [38]

Symptoms

Gout has many symptoms that can vary between people, but the defining symptom is an abrupt bout of severe pain in a joint or multiple joints. Usually, this is seen in the metatarsal-phalangeal joint in the big toe. The inflamed joint may also feel hot and too tender to touch. There may also be swelling, itchy and flaky skin, and an intense red colour on the skin around the inflamed area.

Causes

Gout is caused by the crystallisation of uric acid forming in the joints. When there is too much uric acid in the blood stream (hyperuricemia), usually as a result of inefficient kidney functioning or genetics, the uric acid forms crystals around the joints, causing inflammation. [39]

Other risk factors for gout include:

  • Medicines that increase uric acid levels
  • Meat and fish
  • High fructose drinks [40]
  • Metabolic syndrome [42]
  • Alcohol [41]

Treatment

Once you have been diagnosed with gout, you will be given the appropriate medicines to treat the initial pain. However, these won’t cure your gout, or stop your bouts of inflammation from returning. The most effective treatment is to lower uric acid levels, through lifestyle changes.

Losing weight has been shown to decrease uric acid levels, subsequently treating gout. Weight loss is achieved when the body is burning more fuel than it is consuming. This can be achieved with the help of exercise. Try exercises that are low impact, such as walking, swimming or cycling, as these are easier on the joints.




It is also important to decrease the amount of purines ingested from foods and drink, as these are broken down into uric acid. Foods and drinks high in purines include:

  • Meat extracts: Bovril, marmite and gravy
  • Seafood: mussels, crabs, caviar, shrimps
  • Fatty fish: herring, salmon, mackerel, whitebait trout and anchovies
  • Game meat: pheasant, venison, rabbit
  • Offal: liver, heart, kidneys

Foods that have moderate amounts of purines include:

  • Meat: beef, lamb, pork
  • Poultry: chicken, duck, turkey

Foods that are low in purines include:

  • Dairy
  • Eggs
  • White bread and cereal
  • Pasta and noodles
  • Fruit and vegetables

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