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Gout

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Gout is a common extremely painful joint inflammatory condition; the most common form of arthritis. It generally affects one joint such as the big toe, wrists or the knees. It is brought about by crystals of uric acid building up in the joint, causing an inflammatory reaction. Uric acid is a waste product from the body’s ongoing breakdown of purine proteins, essential building blocks of animal and plant cells; they are present in our own body and also enters the body from food sources. Uric acid itself is then excreted in our urine by our kidneys.  The key symptoms are severe pain, redness and swelling of the affected joint. It can be so severe that the person can not walk on the affected foot if it in the toe or ankle. Attacks can last up to a week.

Whilst incidence is more in men than women, anyone can get affected by gout, and they may only ever get one attack in their lifetime. However some people can get frequent and worsening attacks that are disabling to them. Whilst overindulgence in rich foods and alcohol, which contain a lot of purine protein, can cause an acute gout attack in susceptible people, gout can be hereditary, brought on by certain drugs as well as obesity, high blood pressure or kidney disease. Some people just get it with no known triggers. There is however negative stigma attached to gout that it is a disease of greed and unhealthiness. In my practice I have often found people being very sheepish about an attack of gout as they feel that their lifestyle options are going to be criticized by the Doctor. For this reason I feel little is really known about it in the general public.

If someone gets an acute attack they should rest the joint, put ice on it and should take anti-inflammatory medications if they can, often prescribed by their GP. To prevent future attacks they should have a good look at diet and alcohol intake, but in the unlucky few in whom gout is a recurrent problem there are daily medications that reduce uric acid in the body, preventing future flares.

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