FOR MANY English football fans it’s a cruel blessing that the team has been knocked out of Euro 2004. For if England had got through to the next round, a significant number of otherwise healthy young men could have ended the tournament hobbling about, unable to squeeze their feet into socks, let alone shoes.

As was the case for Paul Webber, a 28-year-old sales manager from Cambridge. The problem, he says, started with “a little tingling” during the England-France game. He had been at a barbecue where he had consumed “about ten pints” throughout the day, and the “tingling” was the first sign of an attack of gout.

Gout is a cripplingly painful condition traditionally associated with portly old buffers, their bulging stomachs a testament to a life of excess. But increasingly it is found among men like Paul — young, slim and fit, who enjoy a drink or two at the weekend. Gout is probably the most excruciatingly painful condition known to men — who are between five and nine times more likely to develop it than women. And as a new study indicates, beer-bingeing may be largely to blame.

Gout is a form of arthritis. It usually affects the base of the big toe, although it can attack other joints. These bouts usually last a couple of days, and there may be months, even years, between attacks. But left untreated, severe gout can eat away at the joint (the condition is frequently misdiagnosed as osteo- or rheumatoid arthritis).

It is caused by high levels in the blood of uric acid, a waste product that is usually excreted in the urine; the excess uric acid forms crystals around the joints. Treatment may involve a combination of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, to reduce pain and inflammation, lifestyle changes, and medication to reduce uric acid levels.

About a quarter of gout cases are associated with genetic factors, says Professor Roger Sturrock, consultant rheumatologist at Glasgow Royal Infirmary. However, eating and drinking to excess also increases uric acid levels — binge-drinking is particularly problematic as the excess alcohol interferes with the removal of uric acid (alcohol also dehydrates).

And it is beer, not spirits or wine, that is most damaging, as a major 12-year study involving nearly 50,000 professional men has recently indicated. The study, published in April in The Lancet and the New England Journal of Medicine, found that men who drink two or more beers a day are two and a half times more at risk of gout than those who do not drink beer; a couple of spirit drinks increased the risk by 1.6 times; while drinking a moderate amount of wine did not increase the risk at all.

“If you start off with a higher level of uric acid in the blood and binge-drink eight to ten pints of beer in one sitting, then it may precipitate an attack of gout,” says Sturrock.

Dr Michael Snaith, a consultant rheumatologist who works at two community hospitals in Derbyshire and a trustee of the UK Gout Society, concurs. “It seems likely that some young men with a pro-gouty set of genes have increased their risk of getting attacks of gout as a result of alcohol binges and that the drinking habit will stick, leaving them vulnerable to future chronic gouty arthritis.”

Young women who indulge in a similar lifestyle and watch their intake of carbohydrates may be at risk too. The study found that the more meat — particularly beef, pork and lamb — the men ate, the higher their risk of gout, a finding that comes as little surprise to Professor Sturrock. “An Atkins diet may precipitate an attack of gout, and I’ve seen that in one individual, so it’s possible.”

Snaith says: “There’s no evidence that boozing young birds are falling down with gout as well as falling out of taxis, but research to seek such evidence is bound to be slow in coming.” But, he adds, “it’s reasonable extrapolation to say that there will be a continuing frequency of gout in people who drink heavily, and particularly intermittently heavily.”

UK Gout Society: www.ukgoutsociety.org