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Gout

Key points

  • Gout is a type of arthritis, which causes inflammation of your joints.
  • Gout can affect any of your joints but is most common in the big toe.
  • What you eat and drink can have an impact on gout.
  • You may be prescribed medicines to help to ease pain and swelling from 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 the symptoms of gout and how often you get it, try not to eat 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 and seafood.

Explanation

Gout is caused by a build-up of uric acid, a waste product formed from purines. These are found in every cell in your body and in certain foods. Your diet plays an important role in causing gout. If you make some changes, it may reduce your risk of gout coming back.

Foods that are very high in purines include:

  • meat, such as liver and kidneys
  • game, such as pheasant and rabbit
  • seafood, such as mussels and scallops
  • oily fish, such as sardines and anchovies
  • food and drinks that contain yeast, such as Marmite
  • mushrooms
  • oatmeal

There is no need to cut out all of these foods completely because they still contain other essential nutrients and protein. Rather, reduce how much of them you eat as it may help with gout. Instead, you could eat more of sources of protein that are low in purines, such as dairy products and certain vegetables.

What you drink can also affect your symptoms of gout. For example, some sugary drinks can raise the amount of uric acid in your blood and make gout worse. Cutting down on how much alcohol you drink, especially beer, stout and port wine, can improve your symptoms too. If you drink excessive amounts of alcohol, it can trigger symptoms of gout, even if you’re already taking medicines to prevent it.

If you eat a low-purine, healthy, balanced diet, it will help you to manage your gout symptoms. However, depending on your condition, you may also need to take medicines 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

Pseudogout is caused by a build-up of different crystals to the ones that cause 'real' gout. Pseudogout is also known as 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. These can collect in and around your joints in particular. 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 joint.

Pseudogout is most common in people over 60, and men and women are affected equally. Pseudogout can affect any joint, but often it will be your knee, wrist or hip. Pseudogout tends to start with severe pain, stiffness and swelling, and then settles on its own and usually gets better within 10 days. 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 chronic condition. A chronic illness is one that lasts a long time, sometimes for the rest of the affected person’s life.

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

If you think you may have gout or pseudogout, see 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 rare and this medicine is suitable for long-term use. However, as with any medicine, look out for anything unusual and speak to a pharmacist if you're worried.

Explanation

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

Your GP or rheumatologist (a doctor who specialises in conditions that affect the joints) will prescribe you a low dose of allopurinol to start with. This will help to identify any side-effects of the medicine, such as a rash, before they become serious. He or she will then build your dose up gradually.

You may get symptoms of gout during the first few months after you first start taking allopurinol. You may be prescribed medicines to try to prevent this. These may include a non-steroidal anti-inflammatory drug (NSAID), or a medicine called colchicine to take alongside allopurinol. Start these medicines as soon as possible and continue taking them for at least three months. It's also important to keep taking allopurinol even during acute attacks of gout.


Reviewed by Rachael Mayfield-Blake, Bupa Health Information Team, March 2014.

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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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