Ask Dr Mel: Gout and blood clots

Average rating:

Every week we bring you expert advice from Woman's Weekly's health expert Dr Melanie Wynne-Jones, a GP from Stockport with 26 years' experience. This week she answers questions on gout and blood clots.

Q. My big toe is swollen and very painful. I'm not overweight and am careful with alcohol - surely it can't be gout?

A. Gout is caused by crystals of uric acid inside joints. It produces sudden hot, red swelling, and eye-watering pain, usually at the base of the big toe and is one of the most painful forms of arthritis. See your GP during an attack; she can see whether it's gout, and prescribe treatment (usually NSAIDs, such as ibuprofen, or colchicines which interferes with uric acid).

Our uric acid levels can increase if we drink a lot of alcohol, eat certain foods (such as meat) or take medicines, for example, diuretics (water pills), but gout is often due to a genetic disorder which affects how we metabolise uric acid. So you'll also need a blood test, and if this shows high uric acid levels, taking allopurinol to lower them may reduce attacks.

If pain and swelling are less dramatic, or are present most of the time, gout is less likely, and you might have some other form of arthritis, or even a bunion. Try taking an NSAID (tell your pharmacist if you have asthma, indigestion or take other medicines), but see your GP if things don't settle.

Q. I have multiple sclerosis (MS), so I'm not very active and have to sit down a lot. Could this increase my risk of blood clots?

A. Being immobile can increase our risk of developing blood clots in the deep veins of the calf and leg (DVT - deep-vein thrombosis), but many other factors affect this, too.

Some people have blood disorders that make their blood clot more easily, and we're all more likely to develop blood clots after surgery or accidents, because our bodies naturally try to protect us from bleeding.

Air travel and other activities that leave us wedged in our seats for several hours and restrict blood flow have also been linked to DVT. However, American emergency-department researchers report that travellers are at less risk of DVT than people with medical conditions that cause paralysis, restrict limb movement or confine them to bed. So it's important to try to keep moving, in whatever way you can, and this can also help to relieve pain and stiffness.

It's perfectly possible to do stretches and simple exercises in a chair, or even in bed; your GP can refer you to a physiotherapist or occupational therapist who can show you the safest and most effective ways to do this.

There's more expert health advice in this week's Woman's Weekly, on sale every Wednesday, only 82p!
Subscribe today to Woman's Weekly and get 20% off!

Advice given here is for general information only and is correct on date of publication. Please seek help from your own GP if you have a medical problem.