Managing gout at Christmas

Gout is a type of arthritis, and is an inflammatory condition which can cause bouts of swelling, which generally are sudden and can be very painful. Gout affects an estimated two out of every hundred people in the UK, with men suffering more from the condition than women.

As our lifestyle becomes more indulgent – and especially so at Christmas – gout attacks become more common, and cases of gout are on the rise. Dr Taher Mahmud of the London Osteoporosis Clinic advises what you can do to reduce your risk of developing gout, and how lifestyle measures can help minimise the risk of an attack.

What is gout?

Gout is a type of inflammatory arthritis  which occurs in those with high levels of uric acid in the blood. Uric acid forms crystals in joints, more frequently in areas such as the feet and toes. As a result, swelling and pain develop in the joint, which is known as a bout, or attack, of gout.

A gout attack usually develops quickly, over the course of only a few hours, then going on to last several days. After some time has passed, the inflammation and pain go down, and the joint returns to normal.

What are the symptoms of gout?

Common symptoms of gout, often felt in the toes, ankles, knees, fingers, and elbows, include:

• Heat and tenderness felt in the joint, with the joint often becoming unbearable to touch
• Mobility being affected by intense, severe pain
• Red, shiny skin on or around the skin of the joint affected
• Swelling in the affected area, or around it
• Itchy skin, or skin which peels and flakes as the swelling reduces

An attack of gout can come on at any time, but bouts do occur more frequently at night, and they develop quickly. After your first attack, it is likely that you will experience another, but this can happen after months or years have passed. It is important that gout is treated, as if left alone, it can develop and attacks will become more frequent.

What is the treatment for gout?

Treatment for gout focuses on relieving symptoms when they occur, and trying to prevent further attacks from happening. Symptoms during an attack can be reduced through anti-inflammatory drugs, and certain types of medication.

To prevent attacks of gout, and to reduce the likelihood of the condition developing, however, the best approach is a change in lifestyle to help reduce levels of uric acid, and prevent crystal deposits from developing.

What can you do to help prevent gout?

Rest well and get enough sleep

Even in those who do not suffer from gout, aiming for 8 hours sleep every night should be the ideal. Getting the right amount of sleep can help your immune system, which in turn helps prevent against infection and inflammation. Getting enough sleep can help to manage levels of stress and improve your memory, too.

Exercise frequently

Staying active should be a healthy habit which everyone strives towards, but getting enough exercise can also help prevent against attacks of gout. Being overweight or obese can also be a risk factor for gout, so being at a healthy weight can help prevent the onset.

Try to reduce stress levels

Stress can trigger a gout attack, and make symptoms worse when they do occur. Seek out ways to help reduce stress, or help to manage what you have on your plate - even managing in small ways, such as writing lists of what you have to do on a specific day, or setting 30 minutes aside in your day devoted to just you, can help to minimise stress.

What should patients avoid to help prevent gout attacks?

Limit your alcohol consumption

Alcohol (in all forms) is thought to increase uric acid production, so moderation with alcohol is key in preventing gout attacks. It can be difficult at times like Christmas to avoid drinking, but having a large glass of water after each drink may help you to moderate the amount you drink, and keep track of exactly what you are drinking so you are aware of your consumption.

Try to stick to a low-purine diet

Purine compounds, found in many different foods (and alcohol) increase the build-up of uric acid crystals in the body.

Eat more:

• Fruit and vegetables
• Dairy products (low-fat)
• Cherries – these have been linked to decreased levels of uric acid
• Vitamin C – an increased level of vitamin C may help to decrease the risk of a gout attack
• You should also drink plenty of water and stay hydrated, as fluid helps to flush uric acid out and hinder the development of crystals

Eat less:

• Particular types of seafood and shellfish, including shrimp, scallops, and mussels
• Certain types of fish, like haddock, codfish, anchovies, trout, and sardines
• Red meat (meat in general contains levels of purine, but white meat is generally considered to be a better choice)
• Organ meats, like liver, and kidneys

If you do suffer from gout, remember not to suffer in silence and make sure you get the right treatment. If it's left untreated, gout can lead to further problems and attacks can become much more frequent. Talk to your healthcare provider for advice and support. 

Concerned about having gout? Arrange a consultation with Dr Mahmud to address any questions you have, and treatment you may require, via his Top Doctors profile.