What is it?
Gout is a type of arthritis (inflammation of the joints) that develops due to high levels of uric acid in the body. The high levels of uric acid can form crystals of uric acid which accumulate around joints, causing them to be painful, tender, swollen and red.
It commonly affects your toes, knees, elbows, wrists and fingers.
In an acute attack, the joint will be tender, swollen and painful over a 6 to 12 hour period, often associated with fever and malaise.
What causes gout?
Gout is most commonly caused by dietary and lifestyle factors. Foods rich in purines produce a lot of uric acid. These dietary sources are very high in purines and contribute towards gout
- Red meat or shellfish (e.g. anchovies, sardines, mussels, prawns)
- Sugary foods and drinks e.g. cakes, biscuits, fizzy drinks
- White bread or sweet bread
- Excessive alcohol use, especially beer and spirits
Other factors which can increase your risk of an attack of gout are being dehydrated and overweight. These all increase the uric acid level in your blood which can lead to an acute attack of gout.
What can I do to prevent a gout attack?
There are many things you can do to prevent an attack of gout. As gout is due to a build-up of uric acid, Long-term control of serum urate is important to suppress gout attacks. The target is a serum urate level of < 0.36 mmol/L. An easy, effective way to prevent an attack of gout is to make simple dietary and lifestyle changes.
- Limit your intake of red meats and shellfish to a serving size and thickness of the palm of your hand
- Limit overindulging in sugary foods and drinks
- Eat plenty of fruit and vegetables (at least 5 portions a day). They contain vitamin C, which may help lower your uric acid levels
- Eat more whole grain foods like whole grain bread
- Keep yourself well hydrated by drinking plenty of water. It also helps to dilute your urine and helps to prevent the formation of kidney stones
- Drink low-fat milk regularly because it can help to lower your uric acid levels and your risk of an attack of gout
Limit your alcohol intake because alcohol increases the uric acid in your blood, in particular beer and spirits. If you drink alcohol, limit it to one to two standard drinks a day, and have at least two alcohol-free days a week. If you have an acute attack of gout, it is best to avoid all alcohol.
Other things you can do are to be more active and lose weight. If you choose to lose weight, do it slowly (1-2kg/month). Rapid weight loss can actually increase your uric acid level and trigger a gout attack.
Your doctor may also start a long-term medication such as allopurinol to lower and maintain your serum urate level to <0.36 mmol/L, to prevent further gout attacks.
What treatment is available for an acute attack of gout?
A non-steroidal anti-inflammatory drug (NSAID) like naproxen or diclofenac (Voltaren) can be very effective to reduce the inflammation and pain with gout in acute flares.
If you are unable to take an NSAID, medications such as colchicine or prednisone are effective in reducing the pain and inflammation with gout.