Gout: Not just for old men

Posted on: 19 June 2017 by Michael Edwards

Once known as "the rich disease", case numbers are increasing, a limping Michael Edwards investigates

gout pain

"Excruciating pain, in my foot, woke me in the early hours and my husband got me to A & E," reported a svelte friend in her mid-forties, who spends too many hours in Lycra - seemingly an unlikely gout victim. According to her doctor, the attack was probably triggered by the dehydration of a four-hour bike ride.

The timing, in the early hours, is typical of gout's stealth. When the duvet becomes too painful for your foot you know you are in trouble. Though gout, a build-up of Uric Acid crystals, can also occur in the ankle, knees, wrist or fingers.

The number of gout cases is increasing. The Annals of the Rheumatics Diseases Journal, reported in 2014, that 1 in 40 Brits are likely to suffer. While around 4% of Americans are hit by attacks too.

Discard images of ruddy-faced men, with Henry Vlll contours, overindulging on red meat and port. Inevitably some cases are self-inflicted, doctors report increasing numbers of men in their twenties arriving in their surgery after a stag weekend. But one in every five sufferers is female. I realised how egalitarian gout is becoming when I met a lean thirty-something Personal Trainer hobbling into her gym.

Although the British Medical Journal recently carried a paper linking soft drinks high in fructose to gout there is no simple answer as to what causes gout. Sufferers tend to point the finger at alcohol, game, red meat and seafood. Yet for one of my relatives, cauliflower, allegedly, is her nemesis.

Essentially most foods contain purine which is processed into Uric Acid. Ageing kidneys are likely to be less efficient at flushing through this waste product. Many doctors would suggest that those of a sensible weight and whose exercise regime speeds up their metabolism are less likely to suffer from an attack. Drinking plenty of water also helps to flush excess Uric Acid through the system.

What is beyond doubt is the agony of gout. "Like walking over white-hot needles," said one sufferer (inadequately) trying to find words to describe the excruciating pain. Lady Montagu, the 18th Century writer, wished gout, rather than death on her worst enemies.

Doctors prescribe strong anti-inflammatory tablets, dispensed alongside warnings that they may upset your stomach, with advice to elevate your foot and ice it, if that is where gout has struck.

Once gout has hit it is likely to return.  Some sufferers, feeling a tingling in their foot, can anticipate an attack and pre-empt it with glass after glass of water and off-the-shelf Ibuprofen. Others prefer to lower their purine levels by permanently taking tablets, but inevitably many of these tablets have side effects.

Personally, I'm attempting lifestyle management and disciplining my diet: avoiding alcohol and only occasionally consuming small portions of red meat. But the approach has had limited success, it was a mild attack, not sufficiently painful or debilitating to necessitate bed rest or a walking stick, which prompted me to share my pain with you.

Gout seems to be a "First World Problem", another symptom of "affluenza". Maybe a dose of austerity would help.

You can learn more at NHSChoices/gout

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