Gout (podagra or uric acid)

Secondary hyperuricaemia and gout

Is caused by another disease or because of consumption of certain medicines (eg diuretic preparations, which increase the output of urine, and acetylsalicylic acid derivatives including aspirin). In these cases, the problem is that the body produces such large quantities of uric acid that the kidneys cannot keep up.

What are the signs of gout?

Prior to the onset of symptoms of gout, there is usually a latent period of several years in which the concentration of uric acid in the blood has gradually increased. This condition is called asymptomatic hyperuricaemia.

Some 95 per cent of the people with this condition never develop gout.

The first gout attack is often at night. Typically, the afflicted person wakes up in the middle of the night with extreme pain near the joint of the big toe (if the pain is in the knee it is called gonagra). The joint is swollen and may turn a shining purple.

Even the smallest stimuli produce severe pain, for instance a blanket on the toe. The first attack usually subsides after about a week.

About 10 per cent of sufferers will never again experience gout whereas others will experience more frequent and longer lasting attacks if they are not treated.

If it is not treated, repeated cases of gout over several years can produce permanent damage in the joint.

If no preventive treatment is undertaken, over time, sodium urate will collect under the skin. In this case the crystals are seen as small bumps near the joints or on the outer side of the ear called tophi.

Occasionally they rupture or ooze out yellowish chalky materials.

Who is at most risk?

. Gout attacks are brought on by several factors including:

- overconsumption of alcohol, especially beer.
- some foods with a high content of protein and purines, such as liver, kidneys, sardines, and anchovies.
- being overweight.
- haemorrhages in the gastrointestinal canal.
- bodily trauma with extensive tissue destruction.
- major surgery.
- conditions in which there is a high rate of cell turnover, eg leukaemia, lymphoma, psoriasis.

Good advice

- Cut down on alcohol consumption.
- Avoid food that you know can cause attacks.
- Watch your weight.
- The uric acid crystals can be secreted in the urinary system as calculi (stones). Therefore you have to drink plenty of water, preferably 10 to 12 glasses a day, in order to wash out the urinary system and prevent any stones from developing.

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