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What is Gout?
Gout is one of the most common types of arthritis.
It is a disease in which there is a build-up of uric acid in the
body.
A relatively small amount comes from the food we eat. It is normally
dissolved in the blood-stream and passed out through the kidneys.
If the body cannot get rid of enough, the build-up of uric acid
will be deposited in joints.
The first attack of gout usually involves the big toe or "bunion"
joint.
Attacks can occur quickly, often overnight.
The affected joint rapidly becomes painful.
Untreated, each attack lasts about a week.
After the first attack it is usually months or years before the
next one occurs. Without the right management attacks become more
frequent, last longer and may involve other joints.
Repeated attacks may accelerate joint damage.
Attacks often occur for no obvious reason but can be triggered
by:
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Drinking alcohol
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Over-eating
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Minor injury to a joint
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Drinking insufficient fluid
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Attempted crash diets
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Fasting eg: before surgery
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Who gets Gout?
Almost all people with gout have too much uric acid in their blood,
a condition called hyperuricaemia.
Hyperuricaemia and gout can be hereditary.
About 90% of people with gout are men.
The first attack usually occurs between 40 and 50 years of age but
can occur at any age. Women with gout usually develop it after menopause.
Management
NSAIDS (non-steroidal anti-inflammatory drugs) are commonly used
to control both the
pain and swelling.
Colchicine used to treat inflammation.
Corticosteroids, usually injected directly into the inflamed joint,
are sometimes used and can control an acute episode.
Control of weight is important. Being overweight interferes with
the body's ability to get
rid of uric acid.
Exercise is important to keep the joints mobile.
Gout can sometimes be associated with hyper-tension and other vascular
disorders (eg. Coronary artery disease) so the blood pressure of
people with gout should be checked regularly.
Proper diagnosis and management should mean that gout can be totally
controlled.
Gout Diet
There are many myths and misconceptions about the relationship
between diet and gout. Here are some of the facts:
If you are overweight, you would benefit from developing a weight
loss program under your doctor's supervision. Being overweight interferes
with the body's ability to get rid of uric acid. However, fasting
or trying to diet too severely can temporarily make gout worse by
raising the level of uric acid in the blood General nutritional
principles are important.
It is important to eliminate or restrict foods high in purines,
particularly if a specific food precipitates an attack. These include
offal such as brains, kidney, liver and sweetbreads, sardines and
anchovies, leguminous vegetables, roe, yeast, broths and gravies.
(See table of Purine Content of Common Foods below.) Usually people
who have gout can eat what they like, in moderation, but details
of the diet should be discussed with your doctor.
Drinking tea and coffee is usually OK; so is alcohol in moderation.
More than one glass of wine or one can of beer a day can raise uric
acid levels.
A daily intake of at least 2 litres of fluid is important, particularly
when you have kidney stones.
PURINE CONTENT OF COMMON FOODS
Foods high in purines:
Liver, kidney, sweetbreads, sardines, meat extracts, leguminous
vegetables, brains, anchovies, broth, roe, yeast , consommé.
Foods moderate in purines:
Meat and fish, shellfish, asparagus, mushrooms, dried peas, spinach.
Foods low / negligible in purines:
Bread, butter, cereals, cheese, coffee, eggs, fats, fruit, milk,
nuts, noodles, oils, olives, puddings, salt, rice, vinegar, chocolate.
The information presented is adapted from several sources available
from the Arthritis Foundation of South Australia.
The information presented is not intended to replace the medical
advice of your doctor or health care provider. Arthritis SA recommends
that you consult your doctor about specific medical conditions.
Other information and resources available
from Arthritis SA
Full fact sheet on Gout and Gout Diet
Email: advisors@arthritissa.org.au
(please include your postal address in email)
Telephone Advisory Service
9.30am - 3.30pm, Mon - Fri
8379 5711 or country free call on 1800 011 041
Library
Book, Getting Rid of Gout by Bryan Emmerson available
from the Arthritis
SA library - members only.
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