Gout

Written by Dr Claudia Pastides, 11th March 2019

Gout is a very common condition in which a specific waste product in the body builds up and forms crystals in the joints and other tissues. It can be triggered by eating a lot of meat or seafood or drinking a lot of alcohol. It usually causes severe pain, swelling, and redness that can last for days to weeks.

It most commonly affects the base of the big toe, but can also affect other joints such as the ankle, knee, wrist and elbow, as well as connective tissues and the urinary tract.

Causes

Gout is caused by a problem in the metabolism of purines. This leads to raised uric acid levels in the bloodstream and the deposition of urate crystals, which cause inflammation and pain.

Risk factors

Your are more likely to get gout if you:

  • Are male
  • Are of older age (it is rare if you are under 20)
  • Consume a diet rich in meat and seafood
  • Consume excessive amounts of alcohol
  • Are overweight
  • Take medications that increase the risk of gout (i.e. ACE inhibitors , beta blockers, diuretics)
  • Have high blood pressure
  • Have diabetes
  • Have a family history of gout
  • Have had recent surgery

Typical Symptoms

  • Intense pain of the big toe/knee (or other joints)
  • Inflammation
  • Redness
  • Limited ability to move the joint

Common Treatment

  • Medications to prevent episodes of gout
  • Medications that reduce pain caused by gout
  • Anti-inflammatory medications

When to speak to a doctor

If you’re worried or unsure whether you have gout or if you are having a flare-up, gout can often be initially managed via a digital consultation. If the GP decides you need a face to face appointment, they will discuss what steps to take next.

It is important to speak to a doctor if you are:

  • Feeling unwell, with or without a fever, as this can be a sign of septic arthritis as opposed to gout. Septic arthritis is infection of the joint and this is very serious, requiring urgent treatment.
  • Getting repeated episodes of gout symptoms
  • Finding nodules under the skin and over joints
  • Having abdominal pain that could indicate kidney stones

Prevention

Gout can be managed and prevented by:

  • Drinking plenty of fluids
  • Avoiding drinking alcohol
  • Limiting meat and seafood consumption
  • Maintaining a healthy body weight
  • Eating low fat dairy products


More information

NHS - https://www.nhs.uk/conditions/gout/

Arthritis foundation - https://www.arthritis.org/about-arthritis/types/gout/