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Gout

Gout

Everything you need to know about living well with gout

Introduction

Introduction

Here, we explore symptoms of gout, treatments for gout, what causes gout and how to change your diet for gout prevention. We also provide lots of other sources of information and help for gout.

If you think you have any symptoms you read here, consult your GP. This guide is not to be taken as an alternative to seeking professional, medical advice.

What is gout?

Gout is a type of arthritis and causes acute attacks of pain in the joints. Gout is caused by too much uric acid in the body. Some people have frequent attacks, whereas other people have gout only once. It is important to seek treatment for gout to reduce the risk of having another attack. During an attack, a person can have difficulty with mobility and movement for several days or even longer.

Around 1 in 40 people in the UK have a diagnosis of gout, and research suggests it is becoming more common, which may be due to dietary and lifestyle changes. It is more common for men to develop gout, and it is more common in older age.

For more information on gout, visit the NHS website.

What causes gout?

As our bodies break down the substances that come from the foods we eat, there are waste products released. Many foods contain purines, which are converted into uric acid or urate in the body. Urate is not needed by the body so it is carried by the blood and flushed out through the kidneys. Gout symptoms are caused by high levels of urate in the blood stream, which causes crystals to form under the skin or within joints. It is these crystals that cause gout pain and joint inflammation. This process of urate build up may take years.

You may be wondering what triggers gout to occur in some people and not others.

There are many possible gout triggers such as:

• Genetics

• Being overweight

• Drinking excessive amounts of alcohol

• Eating high purine foods e.g. seafood, red meat, offal

• High cholesterol

• Diabetes

• High blood pressure

• Chronic Kidney Disease

• Medications e.g. diuretics (water tablets)

For detailed information about what causes gout, visit the Arthritis Research UK website.

Did you know
Gout is really common in the UK, and experienced by men more often than women.

Symptoms of gout

Gout attacks can come on very suddenly and the first time you experience gout can be quite concerning. Gout symptoms may last a few days, gradually reducing in severity and often leaving no after effects or symptoms. However, symptoms may reoccur if the level of urate in your body is still high, so it is important to visit your GP if you think you have gout symptoms.

Everyone experiences gout differently, depending on how severe their symptoms are, their general health and wellbeing and how well they respond to gout treatments. If you think you have any of the symptoms listed here, it is important to visit your GP to see if the root cause of your symptoms is gout. If you have sudden onset of leg pain and fever as well, you should consider getting emergency help.

Symptoms of gout

During the initial gout attack, you are likely to have symptoms such as:

• Extreme pain around a joint

• Swollen joint

• Joint may feel hot

• Skin may look shiny or may shed

Usually, only one particular area or joint is affected in a single attack, and it’s normally upper and lower limb joints that are affected e.g. toes, fingers, wrist, elbows, knees, ankles and feet.

Sometimes, more than one joint is affected at once, and this is a different type of gout called polyarticular gout.

For some people, gout causes urate crystals to form under the skin which look like pimples called tophi.

For more information about gout symptoms, visit the NHS inform website.

Diagnosis of gout

If you think you may have gout symptoms, visit your GP, who may be able to diagnose the condition straight away based on your symptoms. They may also carry out a blood test, to see how much urate is in your blood and confirm if it is likely to be gout. To find out more about gout diagnosis, visit the NHS website.

Did you know
Gout is a type of arthritis which is caused by a build-up of urate in the body.
Treatment for gout

Treatment for gout

Treatment for gout usually involves taking medications to reduce pain and joint inflammation and provide relief during the initial attack. It is important to seek a diagnosis from your GP when you have the first episode of gout. This will ensure you follow the right treatment plan (rather than trying to treat it yourself at home). Your GP is likely to provide you with lifestyle advice such as how to eat a low purine gout diet and reduce the amount of alcohol you consume in order to prevent further attacks.

During the initial gout attack, you should:

• Apply an ice pack to the joint for short 20 minute periods

• Keep the joint raised and protected from knocks

• Take over the counter non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or one previously prescribed for your gout

• Ensure you drink lots of fluids to avoid dehydration

Medication treatments for gout may include:

• Non-steroidal anti-inflammatory drugs (NSAIDs)

• Colchicine

• Steroids

• Urate-lowering therapy

For detailed information on gout treatments, visit the Arthritis Research UK website.

You are also likely to be advised how to change your lifestyle to prevent further gout symptoms, and lots of people who follow this advice do not have any more gout attacks.

You will likely be advised to:

• Stop smoking

• Reduce alcohol consumption

• Eat a healthier, balanced diet, with lower purine foods

• Take regular exercise

Did you know
Gout causes intense pain for short periods of time, but can be treated successfully with medication and lifestyle changes.

Living with gout

There are ways to live well with gout, and everyone will have a different experience of the condition. Some people will have gout symptoms once, and some will have more frequent attacks, which will inevitably affect their daily life and wellbeing to some degree. Read on to find out more about living with gout.

Living with gout

Impact on daily living

Gout can cause a great deal of pain during an attack, but it may only last for a few days and medications can help reduce the pain and discomfort of gout symptoms. However, some people may worry when another attack is about to occur and the pain can be severe enough to require a few days off work or a rest from normal routine.

Some people report that there is a lack of understanding about gout, and it is wrongly seen as a condition experienced by those that drink or eat to excess. This may make it difficult to tell people about the condition, such as friends and employers. However, gout is a genuine medical condition and nothing to be ashamed of.

Some people find it useful to read other people’s experiences of living with gout, to understand the challenges and hear how others live positively with their condition. Read Danny’s story about gout here.

Gout can cause temporary or even permanent disability in some cases, the latter occurring when joints are badly damaged due to frequent gout episodes which can lead to joints being fused together. Many people though, are able to take medication and make lifestyle changes where necessary, to reduce the risk of gout occurring again or too often.

Some people are unable to walk for a few days if gout occurs in their foot, which can have an impact on their ability to undertake daily activities. If you are experiencing gout, you may wish to consider having an assessment from an Occupational Therapist (OT), who can help recommend ways to adapt your daily tasks in order to make them easier when gout symptoms are causing challenges. You may be eligible for an OT assessment via your local social services department, or you may wish to consider paying for a private OT assessment.

Products for gout

If gout is causing challenges in your daily life, and making everyday tasks or mobility difficult, you may wish to explore what gout products are available to help. There are many daily living aids that can help. Here is a selection of daily living aids that may provide temporary or more long term help or relief for those living with gout, depending on the activities they are finding difficult.

 

Elevating the legs
Elevating the legs
Keeping bedding away from your legs
Keeping bedding away from your legs

Healthcare Pro provides a range of products and gout aids for daily living that may provide gout help. If you need further advice, our team of in-house Occupational Therapists are on hand to recommend products to suit your needs. Contact them on 0345 121 8111 or email [email protected]

Diet for gout

Gout is not solely caused by diet, but making changes to your diet can help prevent gout. This is because gout is caused by a high level of uric acid in the body, which is a by-product of purine.

Purine is found in foods such as:

• Red meat e.g. beef and lamb

• Shellfish and oily fish

• Offal e.g. animal liver, heart or kidneys

Therefore, a healthy diet for gout should look to reduce the amount of (or completely remove) these foods, to try and lower the level of uric acid in the body. This should be an ongoing and permanent change, to help prevent gout occurring in the future.

You may also wish to reduce your consumption of:

• Fizzy drinks

• Fruit juices

• Yeast extracts (found in Marmite)

These may increase the level of urate in the body.

Alcohol, in particular beers, spirits and fortified wines, also cause uric acid in the blood to rise, so it is advisable to reduce your consumption of these drinks to help prevent gout.

Staying hydrated is also really important so that the kidneys work effectively to flush out urate from the body.

You may wish to read the Gout Society’s booklet All About Gout and Diet.

Some people choose to take supplements for gout, such as omega-3, Montmorency cherry capsules and Quercetin. There is little evidence to prove that taking gout supplements reduces the frequency of gout, lowers uric acid or relieves gout symptoms. However, if you are interested in taking gout supplements, speak to your GP in the first instance for advice.

Exercise for gout

Maintaining a healthy body weight and taking regular exercise can help reduce the level of uric acid in your body, or help the body to process uric acid more easily.

Gout exercises should include stretches to keep joints moving, aerobic exercise to get the heart pumping, and muscle strengthening exercises.

If you feel you need help to improve your fitness or develop a gout exercise programme, a physiotherapist may be able to help you.

Gout and employment

Many people with gout are able to work, but may need time off during an attack. Some people are able to do different duties at work when their gout symptoms flare up. Many people find that speaking to their employer about their condition can help manage workload and sick days. Your employer has a duty to make reasonable adjustments to your job or tasks, to support you whilst you have a healthcare condition.

Did you know
Eating foods with high purine levels can lead to gout.

Support

We hope this guide has provided a comprehensive gout explanation. If you are concerned you may have gout, you should visit your GP in the first instance. Gout is increasingly common in the UK and as such there is lots of gout support available.

Below, we list lots of organisations you can go to for information, advice and to meet other people with gout or arthritis. If you have any concerns about your health, you should seek advice from your GP.

Support

Communities

Arthritis Forum – an online forum for people affected by all types of arthritis, including gout

GoutPal Gout Help – a member’s forum for people with gout to share their experiences, tips, advice and stories

Resources

Arthritis Action – a charity providing practical arthritis help for members, such as therapy programmes and education, as well as online information about practical aspects of living with arthritis

Arthritis Care – a charity providing lots of information about living with arthritis, as well as an online community, helpline, local arthritis support groups and face to face services

Arthritis Research UK – lots of arthritis information, including specific information about gout, an online forum and arthritis helpline

NHS – source of official medical information in the UK, including information on gout and related arthritic conditions

UK Gout Society – UK charity dedicated to supporting people with gout, providing information about the condition, living well with it and an online ‘check your risk’ assessment quiz

Did you know
Consuming a lot of alcohol can be a risk factor for gout.

Glossary

Although we always try to explain things as simply and as clearly as possible, sometimes it’s necessary to use the correct medical terminology. Medical terms are often known for being tricky to pronounce and if you’re not an expert in the subject, they can also be a little difficult to understand. Below, we’ve put together a list of terms used on this page along with a brief explanation of what they mean to help make your understanding of gout as straightforward as possible.

A gout medication that reduces inflammation during an attack

Part of the human skeleton, where bones fit together

A dietary supplement taken from fruit which is suggested as being an anti-oxidant and capable of reducing the amount of uric acid in the blood

Drugs that reduce inflammation e.g. ibuprofen and naproxen

A fatty acid, available as a dietary supplement which is sometimes taken by people with arthritis

A less common type of gout where multiple joints become inflamed

A chemical found in food and drink which is converted to uric acid in the body

A supplement made from plants that is supposed to have anti-inflammatory effects

A drug administered by injection into the joint of someone with acute gout

The salt form of uric acid, created in the body from purines, which is a waste product usually flushed through the kidneys but which can build up in the body and form crystals in the joints and skin

A course of medication designed to reduce the level of urates in the blood, and reduce the risk of gout attacks e.g. allopurinol or febuxostat

A waste product created when the body breaks down purines from food

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