We already knew gout – a condition associated with Victorian Britain was on the rise in the UK. Figures released by the NHS today revealed the dietary habits of certain regions of England could hold the key as to why gout is becoming more prevalent.
People in Greater Manchester were found to be 1.3 times more likely to be admitted to hospital with gout than the English average.
A diet high in processed foods and beer may be to blame for this - recent research by the British Medical Journal has found that a diet low in salt and red meat, but high in fruit and vegetables may reduce the risk of developing the condition.
How to prevent gout attacks
- Keep a healthy weight. Doctors know that carrying too much weight heighten your chances of developing gout. Losing weight can reduce the number of attacks
- Ensure you're drinking plenty of water and non-alcoholic drinks. The amount of water you should drink will vary from person to person – your urine should be a pale, straw-colour
- Work out your trigger foods by keeping a diary
- Get a referral to a consultant rheumatologist to discuss further treatment
Gout has a genetic basis
Dr Stephanie Kaye-Barrett, Consultant Rheumatologist says that although diet can help sufferers of gout, it’s important to understand that gout isn’t simply caused by over-excess. “People assume gout is an amusing, old fashioned ailment caused by drinking too much port,” she comments. “But the condition is often inherited, and can be very serious. It occurs when a normally harmless chemical called urate builds up in the system and forms tiny crystals in joints, causing inflammation and severe pain.”
Avoiding foods with high levels of purine (the chemical involved in the production of uric acid) such as red meat, seafood and beer should be part of the treatment plan but it may not alleviate symptoms completely.
The best drug for gout
“The most important thing you can do is see your doctor and ask for a referral to rheumatologist,” advises Dr Kaye-Barrett. “Patients should seek treatment as there are really effective drugs for the condition such as allopurinol, as this allows the sufferers to rid the body of the troublesome gout crystals which are effectively dissolved and passed out through the urine.
Dr Kaye-Barrett notes that none of the other drugs such as anti-inflammatories (Ibuprofen, Naproxen, diclofenac), colchicine will do this. “There is a clear link between gout and cardiovascular disease if the gout is left untreated for a long time, so it's important to get help. The breakdown and excretion of the crystals is so important to reduce risks of joint and kidney damage and increased risk of heart disease and strokes.”
However, sometimes when you start allopurinol it may trigger an attack of gout, as the crystals begin to dissolve. Dr Kaye Barrett says: “It is important to persist with the allopurinol (usually at 300mg or more per day) even though gout attacks may occur on the treatment. We use the anti inflammatory drugs and colchicine to control pain and inflammation during the breakthrough attacks, while the crystals are being mobilised and excreted from the body. “
If an alternative to allopurinol is required, fenofibrate or febuxostat may be prescribed. “The first line is still allopurinol, a most effective drug if introduced carefully.” Comments Dr Kaye-Barrett. “Specialist referral to a rheumatologist is ultimately the best way to achieve the best control of your gout.