That's 1 in 40 people : from our 40,000 patients that's 1000 people. Read on because the management of gout is changing and the condition is now understood to be more important than previously realised. Gout is no longer understood to be a troublesome condition with occasional episodes of pain, but a long term inflammatory arthritis with flares. It is caused by high levels of uric acid in the blood which crystallize; crystals are deposited in body tissues continuously but only cause symptoms periodically. In order to prevent gout causing long term pain and disability ALL patients with gout should be offered long term medication to keep their uric acid levels down. This is contrary to past medical teaching, when preventative medication was offered as an option to patients having 2 or more flare ups a year. That advice is now regarded as inadequate and can lead to poor outcomes of chronic arthritis, disability and poor kidney function.
Every patient with gout needs to know this: your condition is continuous, grinding on between attacks and will lead to problems in the future if you do not manage it properly . Taking some over the counter pain killers when you are in pain is not the answer.
You may be wondering if your aches and pains amount to gout . Nearly three quarters of gout presents itself as a throbbing pain in a big toe but it is also common for it to present as an acutely painful midfoot( bootlace area of the foot), heel,ankle, knee, finger, wrist or elbow. The diagnosis is made by the doctor from the history and examination : blood tests in an acute attack are not helpful as once lots of crystals have formed the blood levels of uric acid may well be normal. A blood test 4-6 weeks after an attack is of much more use. There are a number of medications in use but the aim of all of them is to get your blood uric acid levels to below 300umol/l and keep them there. Gout often comes along with other trouble : kidney problems, high blood pressure, type 2 diabetes and obesity. Your doctor will also advise screening for these conditions if you have developed gout and will carefully consider any regular medication you take which may be making the problem worse..
If you have gout then the following advice is important:
If you would like more information about new thinking on gout then Arthritis Research UK have produced an excellent booklet available on line. Or make an appointment to see us and work with us to manage your health well for now and the future.