READERS QUESTIONS

I have received a number of questions from readers and three of those I have decided to cover in this edition. As always, this column is meant for general advice only, therefore if you have any concerns you should see a healthcare professional in person.

What causes Gout?

Gout used to be known as “podagra” – from the Greek for “seizure of the foot”.   

The first  attack of gout is often both sudden and severe and nearly always involves the first metatarsophalangeal joint of the big toe.

Subsequent attacks may involve other joints such as the ankle, knee, elbow or wrist. 

Gout is caused by the depositing of sodium urate crystals in joints and tendons. It occurs in those whose blood uric acid level is exceptionally high because of over-production or defective secretion by the kidneys.

The joints most commonly affected are the metatarsophalangeal joint of the big toe (the joint most people associate with gout), the ankle, knee, wrist and elbow.

The excess of urates can also damage the kidneys, in which stones may form.

Gout can arise from drinking too much alcohol (port drinking has been traditionally associated with the condition), and from excessive consumption of foods which are rich in purines which after digestion will produce uric acid, such foods include offal, venison, goose, duck, fish roe, lobster and herrings. However,  elderly people who hardly drink at all are also susceptible to the condition.

The joint is usually swollen and the skin over it is red, shiny, taut and hot.

For those suffering gout of the big toe, the pain can be so intense that the person cannot bear the toe to be touched, and even the weight of the bedclothes can be unbearable. After a few days the attack subsides leaving the joint apparently normal. However, after several attacks the joint may become deformed and its movement limited.   

Impetigo

Impetigo can arise in healthy skin or may occur in skin that has been damaged by another condition such as eczema, cold sores, insect bites or scabies. It is an infection of the skin which is highly contagious. The

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bacteria which cause the infection (staphylococcus or streptococcus) are found in the nose and are thought to be transmitted to the skin by sneezing or the breath where they set up infection in the damaged skin. 

It can spread rapidly to other members of a household or school either by direct contact or by contact with towels and/or flannels used by the affected person.           

Signs and symptoms

Impetigo usually begins on the face, scalp hands or knees, with the appearance of small red spots which turn into blisters. The blisters quickly break and ooze a sticky yellowish liquid, after which they dry and form irregularly shaped brownish yellow crusts. If  a large area is infected the person may feel unwell and have a slightly raised temperature and swollen lymph glands.      

What causes cramp?

Cramp is a prolonged painful contraction of a muscle. Many people get night leg cramps, resulting in severe pain and a knotted feeling in the muscle.

Cramp is often caused by fatigue, stress or incorrect posture; although sometimes it can be caused by an imbalance in body salts.   

Stretching the muscle can be helpful as can drinking plenty of fluid.