Find out more about this type of arthritis & the lifestyle changes you can make to help prevent gout attacks
What is gout?
Gout is a type of arthritis that is estimated to effect between one to two in every 100 people in the UK. Gout causes a sudden attack of severe joint pain which for some, can be debilitating and difficult to manage.
If you have gout or suspect you may have gout, there are treatments available that can help make the condition more manageable by relieving symptoms to help prevent further attacks. Consult your GP for advice and support regarding treatment.
What causes gout?
Gout develops when there are high levels of uric acid (waste product) in the body. Uric acid is the product your body uses to break down chemicals known as purines (substances found naturally in your body). They’re also found in certain foods, such as:
• Seafood (in particular shellfish and oily fish)
• Red meat (such as beef, pork and lamb)
• Offal (such as liver, heart and kidneys)
• Alcoholic beverages
Uric acid usually passes through your kidneys into urine. However, when your body produces too much of this substance or your kidneys filter out too little uric acid, it builds up. This causes small crystals to form in or around the affected joint leading to inflammation, tenderness, swelling and severe pain.
What are the signs & symptoms of gout?
The most common symptom that people experience with gout is a sudden attack of severe pain which can be recurring. This usually develops in one or more joints at the same time. Typically, the big toe is commonly affected. However, it can also affect your feet, ankles, knees, elbows, hands, fingers or wrists.
Other symptoms of gout can include:
• Swelling both in and around the affected joint
• Flaky, itchy, peeling skin as the swelling starts to reduce
• Limited range of mobility due to the intensity of joint pain
• A hot sensation of the joint that also feels very tender and difficult to touch
• Red skin over the affected joint that looks shiny in appearance
Most people will notice a pattern in the symptoms of their gout attacks. Although attacks can be unpredictable, making it difficult to pinpoint when they will happen and how often, there are some signs you can look out for, including attacks that:
• Tend to occur at night (although they can happen at any time)
• Develop at a fast pace over a few hours
• Last between three and 10 days
• Keep returning more frequently — It’s possible that you may experience gout attacks every few months or years
If you notice any of the above patterns and are concerned, consult with your GP or pharmacy team.
How is gout diagnosed?
The moment you start experiencing symptoms of gout, you should make an appointment with your GP. During your appointment, you’ll likely be asked questions regarding your symptoms and medical history. The affected area will then be examined.
If your GP feels it’s appropriate, they’ll request further tests to either confirm a diagnosis or rule out any other underlying health conditions. These tests can include:
• Joint fluid test – takes a sample of fluid from the affected joint to help detect whether there are crystals in the joints
• Blood test – measures the amount of uric acid in your blood
• X-ray – used to help rule out similar conditions (gout is usually undetectable using this method)
• Ultrasound scan – helps detect crystals in the joints
What can increase your risk of gout?
Although high levels of uric acid in the blood is a common factor that contributes to the risk of developing gout, it’s difficult to pinpoint why those with the same high levels of uric acid in their blood don’t develop gout too.
It’s thought that several other factors may also contribute to the development of gout, including:
• Family history — around one in five people with gout have a close family member with the condition
• Some underlying medical conditions including, diabetes, high blood pressure, psoriasis, obesity, kidney disease, osteoarthritis and high levels of cholesterol and fat in blood
• Certain medications can increase uric acid levels. If you have gout and are taking medication, speak to your GP
• Diets that contain a high level of purines (before you make significant changes to your diet, consult with your GP or dietician)
• Alcohol and sugary drinks may increase uric acid levels
How do you treat gout?
If gout is left untreated, it’s likely that it will start to affect more joints over time. Therefore, it’s important to seek treatment as soon as possible. Typically, gout is treated with:
• Non-steroidal anti-inflammatory (NSAID), like ibuprofen – commonly used for pain relief
• Colchicine – a medicine that helps reduce some of the pain and swelling associated with a gout attack. It’s often used under circumstances where NSAID has not been effective, or you cannot take NSAID
• Corticosteroids – can be used to treat severe cases of gout, when other treatments have not been effective
Your GP should discuss any side effects of the above treatments with you and determine your suitability for each treatment option.
To help treat gout, you should try to:
• Take medicine as soon as your GP prescribes it. Don’t worry if it doesn’t work straight away, it can take up to two days before you start noticing an improvement in symptoms
• Rest and raise the affected limb
• Drink plenty of water unless your GP has instructed otherwise. Need help incorporating more water into your daily routine? Read out practical tips to help you drink more water
• Refrain from putting pressure on the affected joint
• Keep the affected joint cool. You can apply a cold compress for around 20 minutes at a time. Avoid using a cold compress for longer than 20 minutes as this can damage the skin
Lifestyle tips for preventing gout
There are some steps you can take which may help prevent future gout attacks:
Tip 1: Eat a healthy, balanced diet
Maintaining a healthy, balanced diet may help you prevent the risk of gout attacks. Aim to eat foods that are low in purines. These include, low-fat and non-diary fat products (yoghurt), fresh fruits and vegetables, nuts and grains, to name a few.
Try to avoid eating lots of fatty foods and sugary snacks. These foods have higher purine levels which can increase your risk of a gout attack. If you need help with your diet, talk to your GP. They may be able to refer you to a dietician.
Alternatively, you can find plenty of free tools and advice to support effective weight management, including tips on how to maintain a healthy diet, through online resources like the NHS Better Health website and our very own Weight Management Health Hub.
Tip 2: Minimise your alcohol intake
Alcohol can increase uric acid levels in the body, which can contribute to your risk of gout attacks. If you drink alcohol, try to avoid drinking more than 14 units a week.
Tip 3: Engage in regular exercise
Regular exercise contributes to a healthy lifestyle. Moderate intensity exercise, like walking or water aerobics, can prove effective in helping you manage your body weight and uric acid levels. Lowering your uric acid levels can help prevent your risk of a gout attack.
When it comes to exercise, you should refrain from intense physical activity, like running or cycling fast, as it can put a lot of pressure on your joints, worsening inflammation.
Speak to your GP before starting a new exercise regime if you're taking any medication or if you haven't exercised for some time.
Tip 4: Drink plenty of fluids
If your GP tells you to drink more or less fluid, follow their guidance. Drinking plenty of fluids can prevent your risk of dehydration and may help prevent gout attacks.
Looking for more advice regarding gout? Whether it’s help choosing a suitable treatment option or questions about your symptoms, you can visit your local Boots pharmacy and talk to one of our in-store pharmacists. Alternatively, you can make an appointment with your GP to talk about Gout.
