George Practice

3 Trefoil Square, Gloucester Ln, George Central, 6529

Opening Hours

Mon - Thu: 8am - 5pm
Friday: 8am - 3pm
Sat - Sun: CLOSED
24 Dec - 2 Jan: CLOSED


Fax : 044 874 6299


Feel free to contact us


Without warning and, for some reason, in the middle of the night, gout strikes — an intense pain in a joint, most often the big toe, but sometimes other joints, including knees, ankles, elbows, thumbs, or fingers.

Ask any person who has had an attack of gout and they will confirm that it is excruciatingly painful.

What is gout really?

Gout is actually a form of arthritis. It is the body’s reaction to irritating crystal deposits in the joints. It happens in people who have too much uric acid in the blood. Uric acid can form sharp needle-like crystals that build up in the joints and cause pain

The most common factor that increases your chance of gout and gout attacks is excess consumption of alcohol, especially beer. It used to be known as “the disease of kings” since it was mainly seen in wealthy men who drank and ate too much.

Is there a test for gout?

Yes. To test you for gout, your doctor can take a sample of fluid from the joint that is in pain. If he or she finds typical gout crystals in the fluid, then you have gout. Even without checking the fluid from a joint, the doctor might still strongly suspect gout if:

  • You have had pain and swelling in one joint, especially the joint at the base of the big toe
  • Your symptoms completely go away between flares, at least when you first start having them
  • Your blood tests show high levels of uric acid

How is gout treated?

There are a few medicines that can reduce the pain and swelling caused by gout. When you find one that works for you, make sure to keep it on hand all the time. That way you can take it as soon you feel a flare starting. Gout medicines work best if you take them as soon as symptoms start.

The medicines used to treat gout flares include:

  • NSAIDs– This is a large group of medicines that includes ibuprofen and indomethacinNSAIDs might not be safe for people with kidney or liver disease, or for people who have bleeding problems.
  • Colchicine– This medicine helps with gout but it can also cause diarrhea, nausea, vomiting, and stomach pain.
  • Steroids– Steroids can reduce swelling and pain. These steroids are not the kind that athletes take to build up muscle


What can I do to prevent gout

Uric acid is formed when proteins in the food we eat, called purines, are broken down. Therefore, there has been a great deal of interest in the dietary management of gout by avoiding purine-rich foods. However, a diet very low in purines is extremely difficult to follow, because purines are a natural part of many healthy foods. Even when a diet very low in purines is followed strictly, the uric acid level in the bloodstream is only slightly lowered.

The following dietary principles are important in the management of gout:

  • Gout is associated with obesity, and significant weight loss can dramatically improve the management of gout. A calorie-reduced diet is helpful for weight loss.
  • A diet low in saturated fat, with increased protein and replacement of refined carbohydrates (for example, sugar, white bread, potatoes) with complex carbohydrates (such as vegetables and whole grains) reduces the serum uric acid.
  • Decreased consumption of seafood and red meat.
  • The consumption of low-fat dairy products decreases the risk of gout.
  • Drinking beer and liquor increases the risk of gout. However, drinking wine does not appear to increase the risk of gout.
  • In one study, consumption of fresh cherries was associated with a 35% decreased risk of gout. Some people believe that black cherry juice or dried cherries have the same effect, but this has not been proven.
  • Drinking beverages sweetened with sugar or high fructose corn syrup increases the risk of gout.

With repetitive episodes of gout, there are options to take medication daily to prevent attacks.



Urinary Incontinence Overview

Urinary incontinence — the loss of bladder control — is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that’s so sudden and strong you don’t get to a toilet in time.

Up to 50 percent of women experience urinary leakage during their lifetime, and 10 to 20 percent suffer from bothersome leakage. It is important to understand that leakage is not a normal part of aging and that treatments are available to reduce or eliminate the problem

Urinary incontinence isn’t a disease, it’s a symptom. It can be caused by everyday habits, underlying medical conditions or physical problems. A thorough evaluation by your doctor can help determine what’s behind your incontinence.

Incontinence can be divided up in 4 main groups:

The two most common types of urine leakage in women are stress incontinence and urgency incontinence

Stress incontinence — Stress incontinence occurs when the muscles and tissues around the urethra (where urine exits) do not stay closed properly when there is increased pressure (“stress”) in the abdomen, leading to urine leakage As an example, coughing, sneezing, laughing, or running can cause stress incontinence. Stress incontinence is a common reason for incontinence in women, especially those who are obese or have given birth by vaginal delivery.

Urgency incontinence — In people with urgency incontinence (also called overactive bladder), there is a sudden, uncontrollable urge to urinate. You may leak urine on the way to the toilet. Common triggers of urgency incontinence include unlocking the door when returning home, going out in the cold, turning on the faucet, or washing your hands.

Many people with urgency incontinence also have to go to the bathroom more frequently than most people during the day and/or night. “Normal” frequency is considered to be eight times per day and once at night, but this depends on how much you drink and may increase if you drink fluid in a day.

Mixed incontinence — Women with symptoms of both stress and urgency incontinence are said to have mixed incontinence.

Overflow incontinence — Overflow incontinence occurs when the bladder does not empty completely, causing leakage when the bladder becomes overly full. It may result in symptoms of either stress or urgency incontinence or both.

There are a number of causes of persistent urinary incontinence. They include:

  • Changes with age. Aging of the bladder muscle can decrease the bladder’s capacity to store urine. Also, involuntary bladder contractions become more frequent as you get older.
  • Pregnancy and childbirth
  • After menopause women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of these tissues can aggravate incontinence.
  • In women, the bladder and uterus are supported by many of the same muscles and ligaments. Any surgery that involves a woman’s reproductive system, including removal of the uterus, may damage the supporting pelvic floor muscles, which can lead to incontinence.
  • Enlarged prostate. Especially in older men, incontinence often stems from enlargement of the prostate gland, a condition known as benign prostatic hyperplasia.
  • Prostate cancer. In men, stress incontinence or urge incontinence can be associated with untreated prostate cancer. But more often, incontinence is a side effect of treatments for prostate cancer.
  • A tumor anywhere along your urinary tract can block the normal flow of urine, leading to overflow incontinence. Urinary stones — hard, stone-like masses that form in the bladder — sometimes cause urine leakage.
  • Neurological disorders. Multiple sclerosis, Parkinson’s disease, a stroke, a brain tumor or a spinal injury can interfere with nerve signals involved in bladder control, causing urinary incontinence.

Although leaking urine can be difficult to talk about, it is often treatable with weight management for women who are obese, pelvic floor muscle exercises, and/or medications. Talking about it with your health care provider is the first step in getting help for this problem that is affecting your life.

Important questions to discuss include:

  • When do you leak? (When you get a sudden urge, with coughing/sneezing, or does it occur without warning?)
  • When did your leakage begin? Has it worsened or improved over time?
  • Have you tried any treatments to reduce leakage?
  • Are there any medications that you are taking that might be worsening the problem (diuretic medicine for high blood pressure or high doses of pain medications)?
  • Have you seen blood in your urine or had fevers with bladder pain or other pelvic symptoms such as bulge or pressure? These symptoms should not be ignored and you should be evaluated by a clinician.

Bladder diary — A bladder diary is a record of how much urine you make and how frequently you go generally during a 24-hour period. You should write down how much fluid you drink and how much urine you make and record any leakage and the activities that caused leakage. This diary may provide useful information about the cause(s) and potential treatment of your leakage.

Tests — Simple tests may be done during an office visit to determine the type of leakage you are experiencing.

A urine test (urinalysis and sometimes a urine culture to test for bacteria) is usually done to look for signs of infection or blood in the urine. Blood tests may be ordered to measure the kidney function.

A test to see how well you empty your bladder when urinating may be done. This can involve inserting a small catheter in the bladder or a simple ultrasound.


If you’re embarrassed about a bladder control problem, you may try to cope on your own by wearing absorbent pads, carrying extra clothes or even avoiding going out.

But effective treatments are available for urinary incontinence. It’s important to ask your doctor about treatment. You’ll be on your way to regaining an active and confident life.


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  • Mon - Thu8:00 - 17:00
  • Fri8:00 - 15:00
  • Sat - SunClosed
  • HolidaysClosed
  • 24 Dec - 2 JanClosed

Welcome! We are two dedicated doctors offering a full-service family practice situated in the centre of George on the beautiful Garden Route. We are eager to optimize the health of patients in and around George, as well as the surrounding area. Our doctors collaborate in order to meet the health needs of the whole family, from baby-care to care of the elderly, in a friendly relaxed atmosphere. We regard our role as being family doctors, concerned with care and support to each member of the family. Being familiar with the personal and family history of each patient, ensures that we will be able to give high quality care and service.

Drs. van der Spuy © 2019 All Rights Reserved