Gout

What is gout?

Gout is a condition that affects the joints, causing painful flare-ups that come on suddenly. It’s usually advised that you seek medical attention when affected by an attack of gout.

What are the symptoms of gout?

Gout is a type of arthritis, which means it is characterised by pain and inflammation in the joints e.g. the toes, fingers, wrists, elbows, knees, heels, ankles and feet.

The key symptoms are:

Sudden, severe pain in one of your joints – most commonly the big toe
Swelling and tenderness around the affected joint
Red, inflamed skin on the affected joint that might become itchy and peel away

It’s common for an attack of gout to occur during the night. Usually the pain gets worse, peaking at around 24 hours – after this the attack can last for three to 10 days. If the pain is very severe you might find that you cannot move the joint or even touch it. You might also experience a fever and feel unwell.

In some cases, severe pain in a joint can indicate an infection. If your pain is becoming worse and worse, and you have a high fever, you should seek medical attention as soon as possible.

What causes gout?

Uric acid is a chemical which occurs naturally in the body. If there is too much uric acid in your body it can form into tiny crystals around the joints and cause pain and inflammation. This is gout.

You are more at risk of gout if you have high levels of uric acid in your system. This may be because:

Your kidneys aren’t effectively filtering out uric acid into your urine
You eat foods containing high levels of purines – these are substances which, when broken down by the body, create uric acid
Your body is simply making too much uric acid

It’s thought that gout can run in families. Overall it tends to be more common in men, however it can be a problem for women after they have been through the menopause.

Gout is also more likely to occur in people who:

Drink a lot of alcohol, particularly beer
Don’t drink enough water
Take diuretics, a type of medication that causes your body to make more urine
Are overweight
Have diabetes or high blood pressure
Have psoriasis
Have kidney disease

How is gout treated?

Usually an attack of gout will be treated with anti-inflammatories. Your doctor might write you a prescription for naproxen, or advise that you use over-the-counter medicines such as ibuprofen. If symptoms persist for more than a few days, steroid tablets or a steroid injection (directly into the affected joint) might be the next treatment.

Other tips for managing your symptoms during an attack of gout include:

Resting the affected joint and avoiding vigorous physical activity
Keep the joint raised, cool and uncovered
Using ice packs (wrapped in a towel to protect your skin)

If your doctor is concerned that your gout might return in the future, they may prescribe medicine to lower the amount of uric acid in your blood. You’ll need to take this medicine regularly to prevent attacks of gout.

You can find out more about how gout is treated by having an online consultation with Doctor Care Anywhere.

How can I avoid gout?

One of the best ways to reduce your risk of gout is to cut down on foods that are high in purines. Try to avoid consuming large quantities of the following:

Organ meat such as liver and kidneys
Red meat such as beef and venison
Fish such as mackerel, herring and anchovies
Seafood such as mussels, scallops and oysters
Foods with yeast extracts such as Marmite
Alcohol, and particularly beer, stout and port (it’s best to have at least two alcohol-free days each week)

In general, it’s a good idea to eat a balanced diet with lots of fruit and vegetables, and to maintain a healthy weight. If you’re a smoker you should make an attempt to quit. You should also try to exercise regularly, choosing exercise styles that don’t put a lot of pressure on the joints.

Vitamin C has been shown to reduce uric acid levels, so you can also talk to your doctor about requesting vitamin C supplements. Alternatively you can introduce more citrus fruits into your diet.

Content reviewed by Jemma Shafier, a Doctor Care Anywhere GP