WHEN you think of gout, you probably think of Henry VIII and wine-swilling Tudor courtiers gorging themselves on rich food.
But the agonising disease has made a concerning comeback, soaring by 30 per cent among people in their 20s and 30s, experts say.
GettyWhile gout might be regarded as a disease of times gone by, recent figures show that cases have shot up among young Brits[/caption]
GettyGout is a type of inflammatory arthritis that can cause agonising joint pain and inflamed skin[/caption]
Recent figures show that up to one in 40 Brits may now have gout, a form of arthritis that causes sudden and severe joint pain and hot, swollen skin over the affected area.
This not-so-outdated disease tends to manifest itself as a severely painful, red and hot pain in the big toe.
It can then spread to the rest of our feet and hands until it becomes disabling.
Gout is caused by the accumulation of uric acid in the blood and tissues, which forms crystals. If these crystals get into a joint, they can trigger inflammation.
While flares or attacks can be agonising, gout is the only form of arthritis that is entirely curable with treatment, and cases can be eliminated by regular monitoring.
Treatment for the condition tends to be focused around lifestyle factors like losing weight, eating a healthy diet and cutting down on booze.
GOUT ‘IS NOT TAKEN SERIOUSLY’
Dr Avinash Hari Narayanan, clinical lead at London Medical Laboratory, said: “Unfortunately, gout is a condition that is very much still with us, despite the fact that simple blood tests can help identify people likely to suffer a flare before it ever happens.
“The charity Arthritis Action says one in 40 Brits now have the condition and it can lead to debilitating pain, even for younger people.”
Dr Narayanan cited a study published in the journal BMC Primary Care last November, which claimed that gout is the most common form of inflammatory arthritis.
Despite this, he warned the condition “is not managed well enough or taken seriously”.
The medical expert explained: “The report found the medical management of gout is typically focused on the treatment of flares through lifestyle modification.
“Even though successful treatment using uric acid lowering therapies (ULT) has seen consistent results over 20 years, in the UK only around a third of people with gout are treated with ULT and the report found adherence to treatment is poor.”
These findings were also echoed in research published in The Lancet Rheumatology.
RESEARCH HAS MADE ‘LITTLE ADVANCE’
According to Dr Narayanan, research into gout in the UK has stalled.
“The last major UK study into the condition was held as long ago as 2012,” he stated.
This report, published to the British Medical Journal’s Annals of the Rheumatic Diseases, found that the number of people being diagnosed with gout rose by 29.6 per cent between 1997 and 2012, while prevalence of the condition had surged by 63.9 per cent.
“Concerningly, although most gout patients were still 60 or older, the number of patients aged between 20 and 30 had increased by 30 per cent,” Dr Narayanan said.
“In some ways, there has been little advance since 2012,” he added.
More recent NHS Digital statistics show that 234,000 people were admitted to hospital with gout between 2021 and 2022.
Meanwhile, the 2023 BMC Primary Care report examined 51,784 cases of people with the disease and found 35.9 per cent suffered at least one more flare during the study period.
Men, as well as people who are black, have a higher BMI, suffer from heart failure, chronic kidney disease, cardiovascular disease or take diuretics, were all more likely to get gout flare-ups.
“Urate lowering therapies were used in just 27.7 per cent of cases within 12 months of diagnosis, despite the potentially debilitating impact of recurring flares,” Dr Narayanan said.
“One of the chief problems the BMC report identified is that many patients give up their treatment, because achieving target urate levels can be challenging.”
He said a blood test like the London Medical Laboratory’s General Health Profile finger-prick test can measure urate levels on the blood to help identify people at risk of the condition and to help avoid future gout flares.
HOW IS GOUT TREATED?
Gout can come back every few months or years, flaring up more often if you don’t treat it.
If you have frequent attacks or high levels of uric acid in your blood, you may need to take uric acid-lowering medicine.
You can usually treat attacks of gout with pain killers like ibuprofen.
But if the pain and swelling does not improve you may be given steroids as tablets or an injection.
The NHS advises you rest and raise your limb, keep the joint cool with an ice pack or bag of frozen peas, drink plenty of water and try to keep bedclothes off your sore spot at night.
In the long term, you should try to lose weight if you are overweight – but don’t fall into the trap of crash diets.
The NHS also recommends you eat a healthy diet, following your doctor’s advice on which foods to include or limit.
It’s important to limit the amount of sugary snacks and drinks and fatty foods you consume.
Cutting down on booze can be a good idea, making sure you have a few alcohol-free days a week or not having more than 14 units.
Finally, exercising regularly, staying hydrated and quitting smoking can help you manage gout flare-ups.
Who’s most at risk of getting gout?
GOUT – caused by too much uric acid in the blood – can sometimes run in families and is more common in men as they get older.
Symptoms include:
Sudden severe pain in a joint – usually your big toe, but it can be in other joints in your feet, ankles, hands, wrists, elbows or knees
Hot, swollen, red skin over the affected joint – redness may be harder to see on black or brown skin.
According to the NHS, you’re more likely to get gout if:
You’re overweight
You drink alcohol
You’ve been through the menopause
You take medicines such as diuretics (water tablets), or medicines for high blood pressure (such as ACE inhibitors)
You have high cholesterol, high blood pressure, kidney problems, osteoarthritis or diabetes
You’ve had surgery or an injury
What can trigger a gout attack?
You might get a gout flare if you:
Have an illness that causes a high temperature
Drink too much alcohol or eat a very large, fatty meal
Get dehydrated
Injure a joint
Take certain medicines
You should seek treatment immediately if you think you have a gout flare coming on.
GettyThe Gout, pub. 1835 by James Gillray[/caption]