Gout is a kind of inflammatory arthritis that can be very bothersome, especially when it flares up frequently.

WHAT CAUSES IT?

 

Gout is caused by an impaired metabolism of a substance called ‘purines’, that results in small mineral crystals being deposited in the soft tissue in and around your joints, causing pain and swelling.

 

It is far more common in men, and usually only occurs in women once they have gone through menopause.

 

LIFESTYLE FACTORS

 

Gout is a condition that depends very heavily on your lifestyle. There are a lot of foods that can cause it to flare up, and a high intake of these foods will increase the likelihood of you having gout flares.

 

Foods that cause gout flares

 

• All kinds of alcohol - beer, wine, spirits

• Red meat - like lamb or beef

• Other meats - like pork and turkey.

• Organ meats - like liver, kidney, heart, tongue

• Organ soups - like ‘Bak Kut Teh’, meat broth, ‘Chicken Essence’

• Fish

• Some kinds of nuts and beans - like Fava beans and peanuts. This means Mooncakes are also not ok!

• Sugar, high-fructose foods (like the sugar in high-fructose corn syrup)

• Some fruits - like strawberries and durians

 

In moderation, or with care

 

• Since most chocolate you can buy in your supermarket is high in sugar and artificial sweetener, it can trigger gout flares as well. Try dark chocolate that have a ‘no sugar added’ label.

• Chicken is moderately high in purines so it does trigger gout flares if taken excessively.

• Shellfish like prawns, crabs, crayfish, lobster, scallops, oysters are moderately high in purines, so you can probably enjoy a small helping from time to time.

• Refined carbohydrates are not high in purines, yet can still lead to weight gain and increase your uric acid levels. Try to pick wholegrains for your carbohydrate source.

• Having said that, oatmeal is moderately high in purines as well, so you can’t eat it excessively.

• Some vegetables - like Asparagus, spinach, peas, mushrooms - are moderately high in purines, so enjoy them in moderation.

 

Foods that are ok

 

• Most vegetables

• Fruits other than strawberries and durian

• Rice, pasta, noodles

• Low-fat milk

• Low-fat yoghurt - but avoid those high in sugar! Just look at the nutritional value label before eating the cup of yoghurt.

• Coffee, tea

 

WATER

 

A good water intake is very important if you have gout! It helps you to maintain your excretion of gout, and reduces the chance of you getting a kidney stone. Drink 1.5 to 2L of water a day, unless you have a medical condition that limits your fluid intake (like kidney or heart issues).

 

HOW DO I KNOW IF

I HAVE GOUT?

 

You can do a simple blood test to check your ‘Uric Acid’ levels. A high level, together with joint pain, swelling and redness, indicates that you have gout.

 

It is possible to have high uric acid levels but not have gout, and it is also possible to have a gout attack with normal uric acid levels. Your doctor will correlate the blood test findings with your symptoms, and let you know if your joint pain, swelling and redness looks like a gout flare.

 

TREATMENT

 

The best way to manage gout is to minimise the frequency of your gout flares. Look at the diet part above to get an idea of the foods you need to avoid, and religiously avoid these trigger foods.

 

You can take medication like ‘Colchicine’, an anti-inflammatory painkiller like ‘Diclofenac’, ‘Celebrex’ or ‘Arcoxia’, or a steroid like ‘Prednisolone’ to settle your inflammation and symptoms down, but the problem is that if your gout is not well controlled, over time you can have crystal deposits on your tendons and in your joints.

 

Once the crystal deposits build up and cause arthritis, you’re kind of stuck with it and may have chronic intermittent pain and swelling that gets worse as you age. Definitely not something you want.

 

When you do have a flare, see your doctor to get checked and get some medications. Your doctor will make sure it really does look like a gout flare, and prescribe you some of the above medications. Of the 3 kinds of medications I mentioned above, you should still try and minimise your use of the anti-inflammatory painkillers and the steroid medication, since they can have negative effects on your health if you use them too frequently.

 

Get the doctor to issue you a medical certificate for a few days, so you can rest. Stay off your feet, and minimise the physical activity you do so that the inflammation in the affected area can settle down.

 

If you have frequent gout flares, usually more than 3 a year, your doctor may offer to start you on a medication to help prevent gout flares. This is called ‘Allopurinol’. You’ll need to do some blood tests before you start this medication, and you’ll also need to look out for side effects from this medication, some of which include severe skin rashes, liver inflammation (in which case you’ll have upper right abdominal pain and jaundice), and stomach upset (like nausea, general stomach cramps and diarrhoea). You’ll also need to do blood tests every 2 to 3 months to monitor your blood counts, and kidney and liver function whilst on this medication. Your doctor will also check your uric acid levels regularly and titrate your medication dose until your uric acid levels are within the normal range.

 

WRAP IT UP!

 

Gout is a real pain to deal with, so the best way to manage it is to minimise the amount of flares you get. Maintain a healthy lifestyle and healthy bodyweight, avoid trigger foods, and you’ll manage alright.