Health

Gout is on the rise – so why are so few patients getting the treatment they need?


An active young man in his 20s, Harry Tyndall was both shocked and terrified when he woke up one morning with a severe pain in his right foot.

‘It was the worst pain ever – I think I broke it. I couldn’t even walk, but I didn’t do anything to hurt him,” recalls Harry, then 27.

Then a trip to A&E, where Harry is diagnosed with gout, a form of arthritis that causes sudden, severe joint pain and often involves elderly men paying the price for being too greedy. love the rich food and port.

Harry, who lives in South East London and works for a company that distributes plumbing materials, admits: ‘I think gout is caused by too many well-lived people and older people – not men of old age. 20 years old’.

New figures show the so-called ‘disease of kings’ is on the rise, with the number of people being hospitalized for gout. It is thought that this increase is largely the result of a lack of exercise and poor diet during successive weight loss episodes.

Cases have increased by 20% in three years, with 234,000 patients hospitalized for gout between 2021-22, according to figures released by the NHS last month.

New figures show the so-called 'disease of kings' is on the rise, with the number of people being hospitalized for gout.  It is thought that this increase is largely the result of a lack of exercise and poor diet during successive lockdowns. [File photo]

New figures show the so-called 'disease of kings' is on the rise, with the number of people being hospitalized for gout.  It is thought that this increase is largely the result of a lack of exercise and poor diet during successive lockdowns. [File photo]

New figures show the so-called ‘disease of kings’ is on the rise, with the number of people being hospitalized for gout. It is thought that this increase is largely the result of a lack of exercise and poor diet during successive lockdowns. [File photo]

Around 1.5 million people in the UK are affected by this painful condition, according to the charity Ar Arthritis UK.

However, experts say that while lifestyle can trigger flare-ups, genetics plays a more important role for people who develop gout in the first place. For example, Harry’s father also suffers from gout.

And it is feared that outdated perceptions about gout that are both self-inflicted and transient are preventing thousands of people from receiving medication to prevent attacks.

Dr Alastair Dickson, GP and trustee of the Gout Foundation UK, said: “There is a lack of awareness that it is inherently a genetic disease, caused by drink and food. eat excess.

This is therefore misunderstood by ‘many medical professionals and the public’, he added, adding that, for this reason, less than half of Britons with gout receive appropriate treatment.

The importance of this was underscored by a study published last month in the Journal of the American Medical Association, which found that people with gout were four months more likely to have a heart attack or stroke. after flare-ups than people without gout.

Scientists from the Universities of Nottingham and Keele, who followed 62,000 gout patients in the UK, say this is because inflammation causes not only the joints but also other parts of the body, including including the arteries around the heart.

Around 1.5 million people in the UK are affected by this painful condition, according to the charity Ar Arthritis UK.  However, experts say that while lifestyle can trigger flare-ups, genetics plays a more important role in who develops gout in the first place. [File photo]

Around 1.5 million people in the UK are affected by this painful condition, according to the charity Ar Arthritis UK.  However, experts say that while lifestyle can trigger flare-ups, genetics plays a more important role in who develops gout in the first place. [File photo]

Around 1.5 million people in the UK are affected by this painful condition, according to the charity Ar Arthritis UK. However, experts say that while lifestyle can trigger flare-ups, genetics plays a more important role in who develops gout in the first place. [File photo]

Gout – the most common form of arthritis in the UK – is caused by a build-up in the blood and tissues of uric acid, which is released by the breakdown of compounds called purines.

These substances occur naturally in the body but are also found in certain foods, including tuna, beer, bacon, and liver.

Gout occurs when the kidneys cannot remove this uric acid properly. Uric acid crystals then form inside the joints and under the skin, leading to severe pain. Uric acid crystals in the kidneys can also lead to kidney stones and severely reduce kidney function. Dr. Dickson said millions of people have excess uric acid in their blood but don’t get gout because they don’t have a genetic susceptibility.

But genetically susceptible people can go on to develop gout if an environmental trigger – such as a virus – causes the immune system to identify the crystals as foreign, triggering a response. inflammatory response.

Once primed, the immune system continues to attack the body, which is why long-term urate-lowering treatment is needed.

Attacks are usually treated with the anti-inflammatory drug colchicine or pain relievers including ibuprofen.

The preventive drugs allopurinol and febuxostat (which lowers uric acid levels) are recommended by the National Institutes of Health and Care Excellence (NICE) for ‘many or bothersome’ flare-ups. NICE also recommends that these drugs, which cost just 28p/tablet, should be discussed with all gout patients, as most would suffer future attacks without them.

However, a report in the journal Lancet Regional Health – Europe in May found that only a small number of patients in the UK received the preventive medicine within 12 months of diagnosis.

Strong

According to the journal Reproductive Science, men who regularly indulge in sweet treats can harm their fertility.

A study of 300 men found that sperm concentration was 15% lower in those who ate the most foods with added sugar – including cakes and ice cream – compared with those who ate the least.

It is thought that high sugar content can damage DNA, affecting sperm motility and quality.

One of the report’s authors, Dr Mark Russell, NIHR research fellow at King’s College London, told Good Health: ‘Without preventive treatment, flare-ups tend to become more frequent in over time and can develop into chronic arthritis that never goes into complete remission.

‘Long-term treatment with urate-lowering drugs such as allopurinol prevents attacks and joint damage in people with gout and improves quality of life.’

Dr. Dickson is concerned that many healthcare professionals don’t appreciate it, not just an episode that can be resolved by switching to a low-purine diet, gout for many patients is a Long-term chronic condition that needs to be managed carefully.

Luckily for Harry Tyndall, his doctor promptly prescribed allopurinol after an A&E visit in 2016.

It is thought that, despite Harry’s family history of predisposition to gout and despite being active, his poor diet at the time (he ate a lot of red meat and weighed 16 years old). ) caused an all-out attack.

Allopurinol helped put his symptoms into remission, but it came too late to prevent him from developing kidney stones.

He collapsed a few days later with severe abdominal pain and was given medication to dissolve the stone.

Now 34, he has adjusted his diet: he no longer eats red meat and has lost weight.

“As long as I continue to take allopurinol and be careful with my diet, there’s no reason to fear another flare-up,” said Harry. “But it makes me angry when people see gout as a ‘old man’ condition, or something that greedy people have.

‘Gout can affect anyone and we need to be more aware of it.’

ukgoutsociety.org

Under the microscope

England’s most capped male footballer, Peter Shilton, 73, takes our fitness quiz

Can you run up the stairs?

Not now, because I had my left hip replacement in July. Before my hips started to hurt, I ran for 20 minutes every day. When I recover, I will start over.

Get your year a day?

Right. I usually eat more meat but my wife [Steph Hayward, 54, a jazz singer whom he married in 2016] I have changed my diet quite a lot, so I eat more fruits and vegetables now. I like carrots, Brussels sprouts, fresh cabbage and green beans.

Ever been on a diet?

Never. I’m only about 7lb heavier than when I was playing. I’m 6ft 1in and I’m almost 17 now. I have quite a bit of muscle in my body.

Any evils?

Gambling. I don’t know if watching my dad win big on horses when I was a kid triggered something, but I’ve always enjoyed it and it has earned me a high score. The real escalation came when online betting arrived, making it possible for me to sit at the computer and gamble for hours on end. Things only started to change when I met Steph in 2012. It wasn’t easy to stop.

Any family illness?

My father died of a heart attack, aged 93, in 2015. My mother suffered from Alzheimer’s disease and died two years later. I received my big hand from her.

Worst injury?

I opened my eyes wide once at Wembley when I collided with Des Walker against Brazil in March 1990. It went to my bones and was the most painful experience of my life. My hip needing to be replaced was the biggest thing for me physically.

Take any medicine?

I take a multivitamin every day to strengthen my bones and muscles.

Ever had plastic surgery?

No way. Obviously, I’ve got a younger wife so I have to maintain my fitness, but I want to go and work out.

Coping well with pain?

I was fine, but a few months before my hip surgery, I was in terrible pain. I wouldn’t wish that in anyone.

Ever been depressed?

At the peak of my gambling addiction, I became depressed. Playing ball masked the impact of gambling, but when I stopped, I felt much worse. Sometimes I gamble on the internet all day and don’t finish until 3am. I slowly realized that I could lose Steph if I didn’t stop.

What keeps you awake at night?

In general, I am a good sleeper. People ask me if I ever lose sleep over Maradona’s ‘hand of God’ goal at the 1986 Mexico World Cup, but I didn’t. If he hadn’t cheated, I would have got the ball.

Is it haunted?

I really hate snakes.

Peter is supporting GamCare’s 25th anniversary (gamcare.org.uk).

Source: | This article originally belonged to Dailymail.co.uk




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