Monday 19 September 2022 10:29 PM Suddenly gout is on the rise - so why do so few patients get the treatment they ... trends now

As an active young man in his 20s, Harry Tyndall was both shocked and scared to wake up one morning with an intense shooting pain in his right foot.

‘It was the worst pain ever — I thought I’d broken it. I couldn’t even walk, yet I had done nothing to injure it,’ recalls Harry, who was then just 27.

A trip to A&E followed, where Harry was diagnosed with gout, a form of arthritis that causes sudden, severe joint pain and is often associated with elderly men paying the price for over-indulging in rich food and port.

‘I thought gout was all about too much good living and older people — not men in their 20s,’ admits Harry, who lives in South-East London and works for a plumbing materials delivery firm.

New figures suggest the so-called ‘disease of kings’ is on the rise, with hospital admissions for gout surging. It is thought this increase is largely a result of lack of exercise and poor diet during successive lockdowns.

The number of cases has risen by 20 per cent in three years, with 234,000 patients admitted to hospital with gout in 2021-22, according to figures released last month by the NHS.

About 1.5 million people in the UK are affected by this agonising condition, according to the charity Arthritis UK.

Yet experts say that while lifestyle can trigger flare-ups, genetics play a more significant role in who develops gout in the first place. Harry’s father also had gout, for instance.

And it is feared that outdated perceptions of gout as both self-inflicted and transient are preventing thousands of people from receiving medication to prevent attacks.

‘There’s a lack of awareness that it is inherently a genetic disease,’ says Dr Alastair Dickson, a GP and trustee of the UK Gout Society, who believes it is still seen as a Victorian condition, caused by excess drink and food.

As such, it is ‘misunderstood by many health professionals and the public’, he says, adding that, for this reason, fewer than half of Britons with gout receive the appropriate treatment.

The significance of this was underlined by research published last month in the Journal of the American Medical Association, which found that those with gout were more likely to suffer a heart attack or stroke in the four months following a flare-up than people without gout.

Scientists from Nottingham and Keele Universities, who monitored 62,000 UK gout patients, said this is because the inflammation caused by the condition doesn’t only affect the joints but other parts of the body, including the arteries around the heart.

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

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

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

But those who are genetically susceptible can go on to develop full-blown gout if an environmental trigger — such as a virus — causes the immune system to identify the crystals as foreign bodies, launching an inflammatory response.

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

Attacks are usually treated with the anti-inflammatory drug colchicine, or painkillers including ibuprofen.

The preventative medications allopurinol and febuxostat (which reduce uric acid levels) are recommended by the National

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