How changes in diet can solve gout
ORIGINALLY a condition afflicting the likes of kings and noblemen, gout these days is as common as it once was in the royal households.
A painful reminder of the indulgent lifestyles that we invariably lead in the Western world, gout is actually classified as a type of arthritis, and is caused by high levels of uric acid in the blood.
Uric acid is produced from the breakdown of dietary compounds known as purines. Purines are found in many foods that we eat; particularly red meats, seafood and liver. They are also found in high quantities in alcoholic beverages such as beer and spirits.
Uric acid is excreted from the body in the urine and faeces. It is usually harmless, but at high levels, crystals of uric acid form and deposit themselves within the joints. The crystals precipitate an inflammatory reaction in the joint, causing pain and swelling.
Men are four times more likely to experience symptoms of gout than women. Patients who have diets high in purines, or who are unable to effectively excrete uric acid, are also more likely to suffer the effects of gout.
Gout typically targets the big toe, although any joint in the body can be affected. Patients frequently present with a rapid onset of pain, redness and swelling in the base of the big toe. The skin overlying the joint may be shiny and hot to the touch. Symptoms often occur following a weekend of heavy drinking and rich food.
The diagnosis of gout is usually obvious from the clinical history and appearance of the affected joint. However, your doctor may want to measure the levels of uric acid in your body, via a simple blood test. High levels of uric acid in the blood may make the diagnosis of gout more likely.
If the diagnosis is in doubt, fluid from the joint can be aspirated and examined under a microscope, where the presence of uric acid crystals will confirm the diagnosis.
If left untreated, gout attacks will usually resolve within seven to 10 days. However, the pain of gout can be unbearable and will often interfere with normal daily activities. Fortunately, anti-inflammatory medications, such as Diclofenac and Indometacin, can provide immediate relief of symptoms, and allow resolution of the attack within a few days.
As well as prescribing anti-inflammatory medications, I also advise patients to use ice packs to help numb pain and reduce swelling. If an anti-inflammatory drug is not tolerated, a different medication called Colchicine can be given. Colchicine improves symptoms of gout by reducing the amount of uric acid in the blood, although the number of side effects experienced with this drug, often limits its use.
Although acute attacks are easily treated, gout frequently recurs.
Certain medications such as aspirin and bendroflumethiazide (a type of water tablet) can make you more susceptible to gout. You should speak to your doctor if you are taking these drugs and are experiencing symptoms suspicious of gout.
Adapting your diet and lifestyle, to minimise your purine intake, will often be enough to prevent further attacks of gout:
* Cut out red meat and seafood from your diet;
* Avoid eating liver and kidney;
* Limit your alcohol intake, especially beer;
* Increase your water intake;
* Take a vitamin C supplement. Recent studies have suggested that a diet high in vitamin C may be protective against gout.
For cases where dietary adaptation just isn’t enough to prevent further relapses, your doctor can prescribe the drug Allopurinol, which prevents the break down of purines into uric acid and, when taken daily, is effective at preventing recurrent attacks in gout-prone individuals.
So, if you’re suffering the agony of gout, first and foremost, take a good critical look at your eating and drinking habits. A diet fit for a king is invariably the most likely explanation for your symptoms.