Mention gout and you will probably be accused of living too high on the hog. Only those who have experienced the excruciating pain will offer sympathy. It has been called the disease of kings, and Henry VIII may well have chopped off a few heads in a gouty rage, but these days you will find increasing numbers from all walks of life suffering from this most agonising of afflictions.

The gout story begins with proteins. Some come from the food we eat but most come from our own body cells as they naturally die and replenish. As a result of breaking down proteins, there is a waste product called uric acid (bird droppings are full of it). This acid is not completely soluble. Imagine dissolving sugar crystals in a jug of water – when you stop stirring, they sink to the bottom.

Uric acid crystals are carried by the bloodstream into the kidneys. Their job is to separate out any unwanted substances into the urine and recycle the water and salts back to the bloodstream. If you get gout, something is going wrong. You have more uric acid than your kidneys can cope with, not enough is getting flushed out. The little crystals still circulating in the bloodstream eventually 'sink to the bottom', most commonly settling around joints in your feet, but thumbs and knees can also be afflicted.

You can help your kidneys do their job by drinking plenty of water. Like the jug of sugar, the more liquid you put in, the lower the concentration of the crystals. Any activity which dehydrates you could cause a gout attack: an evening of alcohol, exercise on a hot day, a holiday in the sun.

Sometimes dehydration, and gout, is caused by taking diuretics ('water tablets') which are often prescribed as part of high blood pressure treatment. These cause the kidneys to put less water and salt back into the bloodstream and more of it out into the urine. The reason for this treatment is to lessen the load on the heart by reducing the weight of blood it has to pump around. Water is heavy stuff. It is still important to give your kidneys plenty of liquid to work with, even though a smaller quantity is being recycled, to keep down the concentration of uric acid.

Only humans and higher primates are affected by gout which makes laboratory testing very difficult, something to bear in mind when reading about 'miracle' remedies. Gout advice tends to focus on diet, with purines in lead role as the 'gout baddies'. Purines, like proteins, are a natural part of the genes of all plants and animals, including ourselves. Remember, that only about 30% of the proteins we process come from food, the rest is from our own cells.

Red meat, game meat, offal, oily fish and seafood have high purine content and have been shown to increase uric acid, whereas fruit and vegetables have not. Low-fat dairy products with high purine content have even been found to be beneficial. Avoiding certain foods is certainly worth a try and may do the trick for someone whose kidneys are only slightly out of kilter.

Gout is on the increase and biochemists are developing greater understanding of its causes. Meanwhile, if you're tired of insensitive reactions to your suffering, try calling it by its posh name, which is crystal-induced arthritis, to get the sympathy you truly deserve.

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