What is gout?

Gout is a kind of arthritis that causes small crystals to turn up inside your joints, around your body. These crystals can then cause sudden swelling and really bad pain.

In the UK, about 1 to 2% of people have gout and it’s becoming more and more common in lots of countries, including:

• The UK

• New Zealand

• China

• The USA

Gout can cause other health problems, especially if you don’t treat it, including:

• Small lumps under the skin called ‘tophi’

• Kidney stones

• Joint damage

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Does it only affect feet and toes?

Gout can affect any joint in the body, but it’s very common to get it in the large joint of your big toe. Other joints that gout can affect include:

• Knee

• Elbow

• Wrist

• Fingers

• Ankle

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What are the symptoms of gout?

The most common symptoms you’re likely to get with gout are:

• Bad pain in one or more of your joints (usually just one joint though)

• Your joint(s) will be hot and feel tender if you touch them. You probably won’t be able to put up with anything touching it, even something as gentle as a bed cover.

• Swelling in and around the joint.

• The skin over the joint might look red and shiny.

• As the swelling goes down you might notice some itchy, flaky, or peeling skin around the joint.

A gout attack can last anywhere from 3 to 10 days, and then the pain should go away, along with any other symptoms. If you’re having these symptoms for the first time you should see a doctor straight away.

You should get medical help straight away if you also get:

• Very bad pain joint that keeps getting worse, and swelling

• A high temperature (38°C or more)

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How do you test for gout?

If you’re getting any symptoms that could be gout-related then you should think about getting tested to find out for sure if it is gout or not. Testing will help you tell whether it is likely to be gout or if it’s another health condition causing your joint problems.

At Superdrug Online Doctor we offer home test kits for a wide range of conditions, including gout. The test kits let you test for a specific condition without having to book an appointment with your GP first, and you take your test sample in the comfort of your own home.

Our gout test kit checks the levels of something called ‘uric acid’ in your blood. This can tell you if it’s likely to be gout causing your symptoms or not. Once you have received your kit, follow these steps:

• Wait 4 weeks after an acute attack of gout to take the test

• Collect a drop of blood from your finger using the lancet (pin-prick device) provided with the kit

• Place a drop of blood in the collection kit

• Use the prepaid envelope to post your sample to our partner lab

You’ll get your results 2 to 3 days after your sample reaches the lab. A Superdrug doctor will also send you advice based on your results.

You can also get a gout blood test through your GP. You’ll need to book a face-to-face appointment with your doctor who will decide if and when you can get tested.

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What causes gout?

Gout shows up when small crystals turn up in the joints of your body, causing the telltale symptoms of gout – pain, swelling, and tenderness. These crystals happen when too much uric acid builds up in your body.

Uric acid is made when your body breaks down another kind of chemical called ‘purines’. The kidneys should normally be able to remove enough of the uric acid out of your body, but if they don’t then it starts to build up, forming small crystals. Your joints are normally slightly colder than the rest of the body, which makes it easier for the crystals to grow there. If the crystals get into the space between the joints then this is what causes gout to flare up.

Having a lot of uric acid in your body is the biggest risk factor for getting gout. But, you can have high levels of uric acid in your blood and not get any symptoms.

There are some factors which make it more likely that you’ll have high uric acid levels and more of a risk of getting gout, e.g.:

• Other health conditions

• Medications you’re taking

• Your diet

• How much alcohol you drink

Other health conditions which make gout more likely, include:

• Diabetes

• Kidney disease

• High blood pressure

• Obesity

• Psoriasis

• Increased levels of fat and cholesterol in the blood

• Osteoarthritis

• Metabolic syndrome

Medications you’re taking can raise your uric acid levels, like:

• Low-dose aspirin

• Diuretics

• Some high blood pressure medications

• Niacin

• Ciclosporin

• Some chemotherapy medications

Your diet can make gout more likely because uric acid is produced from purines and your diet can contain a lot of purines, see the “Does diet affect gout?” section below for more details.

How much alcohol you drink is a big risk factor for gout because it increases uric acid levels in the body. Beer is the worst for this, followed by spirits like vodka, but small amounts of wine are ok.

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Does diet affect gout?

Yes, a diet that’s high in purines can raise your uric acid levels and your risk of getting gout.

Food high in purines include:

• Red meat

• Seafood

• Offal (e.g. liver or kidneys)

• Yeast extracts like Marmite

• Sugary drinks

Foods with a medium amount of purines include:

• Poultry (bird meat like chicken)

• Dried peas, beans, and legumes

• Wholegrains

• Mushrooms and mycoprotein like Quorn

• Cauliflower, spinach, and asparagus

Vitamin C and cherry juice can actually help keep your uric acid levels low, but you should check with a doctor before starting Vitamin C supplements.

Overall, eating a healthy, balanced diet is the best way to help avoid gout attacks.

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What medication is there for treating gout?

There are medications you might be able to take to help you handle gout. There’s 2 main kinds:

• One’s to help with the pain and swelling of a gout attack, including:

  • Colchicine

  • Corticosteroids

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen

• One’s to bring your uric acid levels down and make gout attacks less likely, including:

  • Allopurinol (Zyloprim)

  • Febuxostat (Uloric)

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About Colchicine tablets

You’d normally start Colchicine tablets for gout if you can’t take NSAIDs like ibuprofen, or they are enough to keep you gout symptoms under control. Colchicine works by improving the swelling and pain that comes with gout attacks. The medication is named after the active ingredient in the tablets, ‘Colchicine’.

You should take Colchicine as prescribed by a doctor. The medication works best if you take it as soon as you see the first signs of an attack. The recommended dose is One tablet 2 to 4 times a day, until your symptoms go away.

You should only take a maximum of 12 tablets during 1 gout attack, so if your symptoms still haven’t gone after 12 tablets, you need to stop taking Colchicine and see a doctor.

You should give drinking grapefruit juice a miss while taking your Colchicine tablets because the juice can increase the amount of Colchicine in your blood to a higher level than is safe.

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Can you cure gout?

Even though it’s not possible to cure gout, there are treatments available that can stop gout coming back every few months or years. If you don’t use any treatment for your gout, then it can come back more often.

If you get regular attacks of gout, you might be prescribed allopurinol or febuxostat to drop your blood uric acid levels. These are long-term medications so you’ll need to keep taking them, even if you don’t have symptoms anymore.

You can help to prevent gout attacks by taking your medication as prescribed and making some positive lifestyle changes, including:

• Avoiding foods that have high levels of purine

• Maintaining a healthy weight – obesity is a risk factor for gout

• Drinking plenty of water to help stop the gout crystals from growing

• Getting regular exercise – try a physical activity that doesn’t put lots of strain on your joints, like swimming

• Drinking less alcohol

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Side effects of gout treatment

Common side effects of Colchicine are:

• Nausea (feeling sick)

• Vomiting (throwing up)

• Tummy pains

• Diarrhoea

You should get in touch with a doctor if you get side effects so they can check your dose and see if you need to switch medications.

If you get any of the following symptoms, you should get medical help as soon as possible:

• Fever

• Inflammation (swelling) of your mouth

• Bleeding that won’t stop

• Bruising

• Skin problems

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Sources

Neogi, T. (2011). Gout. The New England Journal of Medicine, Feb; 364: 443-52.

Neogi, T. et al. (2015). Alcohol quantity and type on risk of recurrent gout attacks: an internet-based case-crossover atudy. Am J Med, Apr; 127: 311-318.

NHS Inform. (2019). Gout. [online] Available at: https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions/gout [accessed 19th June 2019].

Roddy, E. and Doherty, M. (2010). Epidemiology of gout. Arthritis Research and Therapy, Dec: 12.

UK Gout Society (2019). All about gout and diet. [online] Available at: http://www.ukgoutsociety.org/docs/goutsociety-allaboutgoutanddiet-0113.pdf [accessed 19th June 2019].

Wockhardt UK Limited (2017). Package leaflet: information for the user. colchicine 500 microgram tablets. EMC. [online] Available at: https://www.medicines.org.uk/emc/files/pil.6415.pdf [accessed 19th June 2019].

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