Dr Kelsey Jordan on the struggles gout sufferers have over the festive period
PUBLISHED: 13:58 02 January 2014 | UPDATED: 14:00 02 January 2014
Enjoying good food and drink with family and friends is all part of celebrating Christmas, but for gout sufferers, over indulgence can lead to more than heartburn or a hangover. Dr Kelsey Jordan, a consultant rheumatologist, tells us about gout
Gout is a condition that is much lampooned, bringing to mind images of Henry VIII and other similarly well-fed gentlemen. But for sufferers it is no laughing matter, as an attack of gout is excruciatingly painful and can result in permanent joint damage and disability if left untreated. Gout is the most common inflammatory arthritis and the only curable type but sadly is commonly undertreated or not taken seriously.
Symptoms start with pain and swelling in the joint – usually the big toe, but some people get it in their ankles, knees, elbows, fingers and wrists. The joint reddens, gets hot and extremely painful, often unbearable to touch. Sometimes the skin becomes shiny and starts to peel. You may have a temperature and feel very tired. Over time, gouty deposits can occur in the skin called tophi.
According to statistics on NHS.uk, one in 70 adults are thought to be affected. While it is true that the typical gout sufferer is middle-aged and male, this is not always the case and women, especially after the menopause, are prone to it too.
It’s all to do with how the body metabolises uric acid – usually an excess of the substance is eliminated naturally, but in some people it is deposited in needle-like crystals in the joints. Uric acid is produced from a protein called purine, so one of the ways to reduce the risk of an attack of gout is to avoid foods that contain high amounts of purine. This can be easier said than done, particularly at this time of year.
So which festive foods are friendly to gout sufferers?
The Christmas Roast
Turkey, goose and beef all contain moderate amounts of purine, but they are a better choice than venison and other game, as these, although they are leaner, contain more purine. Stuffing made with liver should be avoided, as offal is high in purine.
You can enjoy the roast potatoes and vegetables with impunity as most are low in purine. Cranberry, apple and horseradish sauces are all fine, but go easy on the gravy as this is likely to contain purine, especially if made from scrapings from the meat pan.
Cheese and Pudding
Despite the stereotype of the gouty gentleman gorging on port and stilton, cheese is actually low in purines, so if you have cut back on the meat, then you can appreciate the cheeseboard! Traditional Christmas pudding made with dried fruit is low in purine and fresh fruit and nuts are also fine.
Wine and other drinks
While you don’t need to be completely teetotal, bear in mind that alcohol is not a great friend of gout, as it stimulates the production of uric acid. The worst offender is beer as it contains purine-rich yeasts, so best to have a glass of wine instead. If you opt for soft drinks, make sure these do not contain high fructose corn syrup.
Whether you have gout or not, you should aim to eat a balanced diet, keep alcohol to a minimum and maintain a healthy weight. If you suffer frequent attacks of gout, do consult your GP as it is a condition that can be cured with the correct medication and lifestyle changes. Have a happy and healthy Christmas!”
Dr Kelsey Jordan is a consultant Rheumatologist at Brighton and Sussex University Hospitals Trust and the Montefiore Hospital in Hove. She specialises in the treatment of rheumatic disorders including rheumatoid arthritis and gout and is a trustee of the UK Gout Society - a charitable organisation for gout sufferers. www.ukgoutsociety.org.
For further information please visit www.themontefiorehospital.co.uk or call 01273 828120.
The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.