Getting to grips with gout

Gout is a painful type of joint inflammation that affects approximately 5% - 10% of New Zealanders.

It most commonly develops in the ball of the big toe. Joints in the feet, ankles, heels, knees, wrists, hands and elbows can also be affected. Gout develops quickly, often within 12 - 24 hours, with symptoms that include:

• Severe pain, tenderness and swelling in the affected joint
• The skin over the joint may feel hot and tight and may look shiny and red
• Some people may also experience nausea, a loss of appetite and a slight fever

With the right treatment, and by looking after yourself, gout attacks can be prevented and you can get back to doing the things you enjoy.

The causes of gout – not quite what you may have heard

Many people think you get gout from drinking too much beer, juice and sugary drinks, or from eating too much meat and shellfish. It’s not as straightforward as that. In fact, gout is caused by having too much of a chemical called uric acid in your blood.

Your body naturally makes uric acid from substances called purines. Purines are in your body’s tissues and in some foods like red meat, offal, oily fish and legumes. Beer, fruit juice and sugary drinks can raise uric acid levels.

It’s normal and healthy to have some uric acid in your body. Excess uric acid is filtered by the kidneys and flushes out of the body in urine.

However, some people either produce too much uric acid or their kidneys cannot remove it sufficiently, so uric acid levels begin to accumulate. Uric acid salts turn into crystals in the joints, which are very sharp and cause pain. The crystals cause lumps, called tophi (pronounced toe-fy). If tophi get too big, they can make it hard to wear shoes, use utensils, write or walk easily.

Who should look out for gout?

If you or someone in your family experiences any of the symptoms above, see the doctor. They can do a blood test, give you a diagnosis and prescribe medicine if required.

Gout most commonly affects adult men (particularly after age 40), and people of Maori and Pacific Island decent (due to a range of genetic and lifestyle factors). Women are less likely to get gout – if they do, it’s more likely to occur after menopause. If gout isn’t treated, attacks can become more frequent and severe and can lead to joint damage and disability.

How to keep uric acid levels down and prevent gout attacks

High uric acid levels can be a result of your genes, weight, kidney problems and increasing age. What you eat and drink, and medicines you take, can also be a factor.

What you can do to bring down uric acid levels:

• Be active – walk, swim, go to the gym, play a sport
• Keep to a healthy body weight
• Eat a healthy diet including lots of vegetables and fruit
• Eat only small amounts of red meat or seafood – stick to chicken and white fish
• Drink plenty of water throughout each day
• Don’t drink too much alcohol – especially beer
• Don’t drink too many fizzy drinks, energy drinks or too much fruit juice 
• Spread your meals evenly through the day and try not to overeat or under-eat
• If you’re taking gout medication, be sure to take it every day, even during an acute gout attack

If you are concerned about gout, come in and have a chat with your local Unichem Pharmacist. They can help you identify if you may have gout and refer you to a doctor if needed. Your Pharmacist may also be able to provide you with suitable pain relief to help you manage the pain of gout until you can see your doctor.

Cathy – Advisory Pharmacist