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This is an arthritic condition which is related to an excess of uric acid in the blood. It causes joints to become red, swollen and painful. Uric acid crystals are deposited in the joints, tendons, kidneys and other tissues where they cause damage and inflammation. The joint of the big toe is the most common area on the body for gout to occur.

This disease mostly affects adult men. It is characterised by high levels of uric acid which is the end product of metabolism of compounds known as purines. Uric acid is a by-product of certain foods so gout is closely related to diet. There is usually some kidney disfunction in people with gout and there is a higher risk if kidney stones. Gout can also be associated with psoriasis, thyroid and parathyroid disease, cardiovascular disease, obesity and high blood pressure.

There are several possible causes of gout. Foods high in purines increase uric acid levels. High intake of protein, saturated fats, refined carbohydrates, coffee and meat and a low intake of fruit and vegetables may also cause gout. Drugs such as aspirin, penicillin, diuretics and insulin may reduce the ability to excrete uric acid from the body. Alcohol increases uric acid production and reduces its excretion. Alcohol may also impair kidney function. Obesity, hereditary factors, insufficient exercise, kidney disease and lead toxicity can also lead to gout.

The disease is characterised by intense pain usually in the big toe. Other joints such as ankles, mid-foot, knee, wrists and fingers can be affected. Gout is exacerbated in cold weather as blood supply to the feet is reduced and the crystals of uric acid can form.

Gout can be diagnosed by a simple blood test. Medication may be necessary for long periods of time and the prescription medicine usually acts to reduce uric acid levels in the blood. There is a variety of creams and gels available over the counter. These anti-inflammatory products can be applied several times a day and may reduce the pain and inflammation.

Care should be taken with diet. Liver, kidney, heart, brains, pate, sardines, herrings, anchovies, mackerel, shell fish, fish roe, yeast, beer and asparagus should be avoided. Plenty of water should be consumed and fructose intake should be minimised. Celery and carrot juices may help remove excess uric acid from the body. Folic acid and vitamin C supplementation may also help to reduce the uric acid levels.

Please ask for advice from the Staff at the Pharmacy who will be happy to discuss over the counter preparations which may help to relieve the pain associated with gout with you.

Further information and support are available from the Arthritis Foundation of Ireland, 1 Clanwilliam Square, Grand Canal Quay, Dublin 2. Telephone: 01-6618188.

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Kevin McCormack B.Sc. Pharm. MPSI