What is gout?
Gout happens when there are high levels of uric acid in your blood, a condition called hyperuricaemia. Uric acid is a waste product your body makes when it breaks down purines, which are found in your own cells and in some foods.
Most of the time your kidneys clear it out, but when it builds up, the acid can form tiny, needle-sharp crystals of a salt called urate in and around a joint. Those crystals set off the sudden swelling, heat and intense pain of a gout attack, and the same build-up can lead to kidney stones in some people.
What causes gout?
High uric acid levels are the root cause, but several factors push levels up or trigger a joint flare.
Common risk factors include:
- A diet high in purine-rich foods like red meat, offal and some seafood
- Regular alcohol, particularly beer and spirits
- Sugary drinks and foods high in fructose
- Carrying extra weight
- Some medicines, including certain diuretics (“water tablets”)
- Kidney problems that reduce how much uric acid you clear
- Conditions such as high blood pressure and diabetes
- A family history of gout
Men are three times more likely to get gout than women, and the risk of gout climbs with age. Women’s risk rises after the menopause.
Gout Symptoms
The symptoms of gout tend to come on fast, often overnight. The big toe is the usual first target, though it can hit the ankles, knees, wrists, fingers or elbows.
During an attack, you might notice:
- Sudden, severe joint pain, often at its worst in the first 12 to 24 hours
- Swelling and pain that leave the joint hot and tender
- Skin that looks red, shiny or slightly purple
- Pain that lingers as a dull ache for days or weeks after the sharpest pain fades
Some people have one attack of gout and never another. Others get repeat flares, and without treatment, the gaps between them can get shorter.
Diagnosis of Gout
A GP can diagnose gout based on your symptoms and a blood test that checks your uric acid levels.
How to Treat Gout
Treatment for gout works on two fronts: calming a flare when it hits and keeping uric acid low so flares stop.
Prescription Treatments
For acute attacks of gout, prescription options bring gout pain and inflammation down quickly:
- Naproxen: one of the anti-inflammatory medicines known as NSAIDs, easing the pain and swelling of a flare. It works best when started as early in an attack as possible.
- Colchicine: used to settle a flare, particularly when anti-inflammatories aren’t suitable. It’s taken over a short period at the first sign of symptoms.
- Corticosteroids: a short course of steroid tablets, such as prednisolone, can calm a severe attack when other options don’t fit.
As a long-term treatment to prevent future attacks, urate-lowering medicine is taken every day:
- Allopurinol: the most widely used urate-lowering medicine. It gradually reduces uric acid and, over months, dissolves the crystals already sitting in your joints.
- Febuxostat: an alternative when allopurinol isn’t suitable, working in a similar way to bring uric acid down.
We have a range of these medications available for purchase from our online pharmacy after a short consultation with one of our licensed pharmacists, who can prescribe the right option for you. Once approved, we’ll have your prescription sent directly to your door.
Over-the-counter Treatments
For mild symptoms, some pain relief is available without a prescription:
- Ibuprofen: an over-the-counter anti-inflammatory that can ease mild pain and swelling during a flare.
- Paracetamol: helps with the pain, though it won’t reduce inflammation, so it’s often used alongside an anti-inflammatory.
These can take the edge off a mild attack, but they won’t lower the uric acid levels that cause gout, so they’re not a long-term fix.
Preventing Gout & Managing it Day to Day
Medication does the heavy lifting, but a few everyday changes help prevent gout and can cut how often flares happen:
- Drink plenty of water to help your kidneys clear uric acid
- Reduce consumption of beer, spirits and sugary drinks
- Follow a low-purine diet, going easy on red meat, offal and shellfish
- Reach and keep a healthy weight, losing it slowly rather than crash dieting
- Stay active with low-impact exercise that’s kind to your joints
- Keep taking any urate-lowering medicine even when you feel well
Some people also find the DASH plan (dietary approaches to stop hypertension) useful, since the same eating pattern is linked to lower uric acid.
During an attack, resting the joint, keeping it cool and raising it can take the edge off while your treatment works.
