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Gout

 

This section contains answers to frequently asked questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

I've been diagnosed with gout. Are there any foods I shouldn’t eat?

Answer

To reduce your gout symptoms and how often you get it, you can help yourself by not eating foods that contain very high levels of purines. Purines are substances that are broken down into uric acid and can make gout worse. Foods that contain high levels of purines include certain meats, seafood and pulses.

Explanation

Gout is caused by a build up of uric acid, a waste product formed from purines (which are found in every cell in your body and certain foods). Your diet plays an important role in causing gout and making changes can reduce your risk of it coming back.

If you have gout, certain foods that are very high in purines can make it worse. These foods include:

  • meats, such as red meat and offal (eg liver and kidneys)
  • game (eg pheasant and rabbit)
  • seafood (shellfish including mussels and shrimp)
  • oily fish, such as sardines and herring
  • yeast-containing food and drink, such as Marmite and beer
  • mushrooms and foods made from mushrooms (eg Quorn)
  • certain vegetables (eg cauliflower, asparagus and spinach)
  • beans and pulses (eg lentils)

There is no need to cut out all of these foods completely because they still contain other essential nutrients (for example, protein and iron in red meat), but reducing how much of them you eat can help with gout. Instead, you could eat more sources of protein that are low in purines, such as milk, cheese and eggs.

You may find that other foods make your gout worse. These can include strawberries, oranges and tomatoes. If these foods affect you, it's probably best not to eat them. If you have gout, cutting down on how much alcohol, especially beer, you drink can improve your symptoms. Drinking excessive amounts of alcohol can trigger symptoms of gout, even if you’re already taking medicines to prevent it.

Reducing how much food and drink you have that contain high levels of fructose, such as sugar-sweetened soft drinks, fruit juice and sweet fruits like raisins, can help to prevent gout. This is because fructose can raise the level of uric acid in your blood, which makes gout worse.

Maintaining a low purine, healthy, balanced diet will help you to manage your gout symptoms. However, depending on your condition, you may need to take medicines prescribed by your doctor to help treat your symptoms and prevent gout from coming back again.

I've been diagnosed with pseudogout. What's the difference between that and 'real' gout?

Answer

You're diagnosed with pseudogout when the pain and swelling in your joint is caused by a build up of different crystals to the ones that cause 'real' gout. Pseudogout may also be called calcium pyrophosphate crystal arthritis.

Explanation

You can develop gout if you have too much uric acid in your body. Uric acid is a chemical that everybody has in their blood. If the level of uric acid in your body is too high, it can form tiny crystals that collect in your tissues, particularly in and around your joints. This is what may cause your swelling and pain.

When you have pseudogout, the crystals that form aren't uric acid crystals, as they are with 'real' gout. They are made of a calcium salt called calcium pyrophosphate. These crystals can often be seen on an X-ray of your affected joints.

Pseudogout is most common in people over 65, with men and women affected in equal numbers. Any joint can be affected, but often it will be your knee or wrist. Pseudogout usually starts with severe pain, stiffness and swelling, and settles on its own, getting better within two weeks. Sometimes, if you have another illness, it can set off pseudogout, but often there is no apparent reason for it starting.

Like gout, pseudogout can return, or become a long-term (chronic) condition. A chronic illness is one that lasts a long time, sometimes for the rest of the affected person’s life.

Although you can be treated for pseudogout with similar medicines to those used for gout, if you have chronic pseudogout, there are fewer treatment options to prevent it or reduce the frequency of it happening. Some patients may need to take NSAIDs or steroids over a long period of time because there is no treatment to lower the levels of the crystals that cause pseudogout.

If you think you may have gout or pseudogout, contact your GP for advice.

I have had gout a few times and I am now taking allopurinol. Can I expect any serious side-effects?

Answer

In general, serious side-effects from allopurinol are very rare and this medicine is suitable for long term use. However, as with any medicine, look out for anything unusual and see your GP if you're worried.

Explanation

Allopurinol is a medicine that prevents gout by stopping the formation of uric acid.

You may get symptoms of gout during the first few months after you first start taking allopurinol. Your GP or rheumatologist (a doctor who specialises in conditions that affect the joints) may prescribe you a non-steroidal anti-inflammatory drug (NSAID), or a medicine called colchicine to take alongside allopurinol to try to prevent this.

People have occasionally developed a rash after taking allopurinol. If you have a rash, you should contact your GP or your rheumatologist as soon as possible.



Produced by Louise Abbott, Bupa Health Information Team, May 2012.

For our main content on this topic, see Information.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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