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Mai 2005 May


HEALTH MATTERS

GOUT

About 1 in a hundred people in the UK has gout, the most famous sufferer being Henry V111. Because of him many people think that you only get gout if you live too well. This is true for some but not all who develop gout. The condition can develop if you are very overweight; drink a lot of alcohol; have high blood pressure; eat food rich in ‘purins’ (see list further on) or take certain medicines such as diuretics (water tablets) or low dose aspirin. The cause of the problem is Uric acid which forms crystals in the affected joint. Uric acid is a waste product formed by the body’s natural breakdown of chemicals called purines (these are found in all cells of the body)

During an attack the crystals cause the joint to become hot, swollen and very painful. The skin may be red and shiny and start to peel, you may feel unwell. Gout usually affects the joint at the base of the big toe. 4 out of 10 sufferers will get gout elsewhere, such as the knee, instep, wrist ankle or finger.

Foods rich in Purines: red meat, liver and kidneys, game, shellfish and seafood especially mussels, herrings, sardines and fish roe, peas beans and lentils, yeast and yeast extract (e.g. marmite) oatmeal, spinach, asparagus, cauliflower, mushrooms and beer and spirits.

So what can you do to avoid gout attacks. Loosing weight may help lower your level of uric acid. If you drink a lot of beer and spirits cut down, this will also lower your risk of high blood pressure. (wine does not seem to increase the risk of gout). As you can see from the list it is difficult to cut out all foods rich in purins, it may be worth reducing the intake of red meat and shell fish as people who eat these foods in high quantities seem to be more likely to get gout.

Treatment: most attacks will clear in a couple of weeks, keep the joint raised and use a cardboard box to keep bed clothes off the joint, take pain killers and put a cold pack on the joint for 30 minutes 4 times a day (protect skin with a cloth) It is very important to see the doctor as the joint pain may be due to infection, it is not always easy to diagnose gout. Your GP will then discuss the best form of treatment for your gout. If you have repeated attacks the doctor may prescribe medicines which lower the uric acid level in the blood to try and prevent the joint being damaged.

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