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Gout |
There is nothing much more painful than an acute attack of gout, which commonly presents in the big toe, but can involve other joints such as the ankle, knee or elbow. It occurs when too much uric acid builds up in the body, which can lead to uric acid crystal deposits in the joints and sometimes stones in the kidneys. Classically one wakes up in the night with a red hot painful toe which makes walking very difficult.
It is commonly brought on by a big night out with an overindulgence in alcohol and the eating of certain food that contain purines. Examples of these foods are shellfish like prawns, sardines, anchovies, and organ meats, some vegetables such as cauliflower, asparagus and spinach. Sometimes it will come on spontaneously without an obvious cause.
The people most likely to get gout are overweight men who enjoy a drink or two (or more) and eat rich foods. Some medications make it more likely that a person will get gout.
Treatment is initially aimed at relieving pain with anti-inflammatory medication or a medication called colchicine. Those people who get recurring gout or have high uric acid levels in the blood may need to take a tablet every day called allopurinol which lowers the uric acid level and this helps prevent gout.
Other ways for sufferers to prevent gout attacks are to avoid overconsumption of food high in purines, to moderate their alcohol intake, to drink plenty of water and try to gradually lose a bit of weight. GPs are seeing a lot of gout these days largely due to the obesity epidemic. A concern is that it is often associated with a cluster of risk factors (the metabolic syndrome) that can result in cardiovascular disease.
Dr Andrew Binns
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