Gout

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Overview

Gout is a form of arthritis caused by high level of uric acid in the body, which can then deposit around joints and form needle-like crystals leading to acute painful gout attacks. Pain comes very quickly, often at night.

Most common part of the body affected by gout:

  • Big toe.

Other possible areas:

  • Elbows
  • Hands
  • Knees

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Signs and Symptoms

  • A classic picture of gout is excruciating, sudden, unexpected and burning pain.
  • The affected joints become swollen, warm, red and painful.
  • An extremely tender joint, painful and sensitive to touch- sometimes even the weight of the bed sheet can cause severe pain.
  • May have fever or chills developing.

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Contributing Factors

  • Family history.
  • Drinking too much alcohol.
  • High intake of rich foods.
  • Long term consumption of low dose aspirin and diuretic.
  • Certain health problems (e.g. kidney problem).
  • Congenital or presence since birth.

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Avoid

Not more than one item once a week:

  • Herring
  • Meat extracts
  • Meat gravies
  • Sardines
  • Fish roe
  • Alcohol
  • Anchovies
  • Meat soup

 

Not more than one item 4 x a week:

  • Asparagus
  • Cauliflower
  • Beans
  • Lentils
  • Mushrooms
  • Oysters
  • Peas
  • Spinach
  • Whole-grain cereals
  • Bread

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Acceptable

As often as desired:

  • Beverages – tea, coffee, cocoa, chocolate
  • Fruits
  • Vegetables (except those under *Avoid)
  • Bread and cereals (except wholegrain)
  • Eggs
  • Milk and milk products
  • Nuts –  all kinds, peanut butter

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Medicines

Consult our doctors or pharmacist for suitable medicines for you if you:

  • Have tried lifestyle modification and failed
  • Have family history of gout
  • Have kidney problem or the presence of kidney stone(s)
  • Have unexpectedly high uric acid level

 

Medicines to relieve pain

  • NSAIDS

 

Medicines to prevent gout attacks: (e.g. Allopurinol)

  • May be started after a few attacks. Usually started with a low dose then increase gradually.
  • Do not start taking gout prevention medicines during or after an attack, otherwise the attack may be prolonged.
  • These medicines do not relieve an attack that has already started and will prevent attacks only while you take them regularly. Taking these medicines on-and-off may put you at risk of an attack.
  • Gout attacks may continue to occur during the first 3-6 months of taking the medicines. Despite this, you may be advised by your doctor to continue taking these medicines during this initial period. This could be attributed to the rapid uric acid lowering effect of the medicine which reduces the uric acid level to below the saturation point therefore causes existing crystals in joint cartilage to partially dissolve and become smaller.

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Self-care

  • See a doctor for treatment as soon as symptoms start.
  • If you are on long-term medication to prevent gout, you should take your medication every day even in the absence of gout symptoms, otherwise attacks of gout may recur.
  • Drink lots of water.
  • Avoid vigorous exercise, but keep your joints mobile with regular moderate exercise.
  • Maintain your ideal weight. Consult our doctors/pharmacist at BP Diagnostic Centre/Lovy Pharmacy for a weight management programme
    Stay away from alcohol and foods that are high in purines. Consult our nutritionist at BP Diagnostic Centre/Lovy Pharmacy for further information.

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Supplements

  • Fish oil – shown to have anti-inflammation properties
  • URAL – Urine Alkalinizer to neutralise the uric acid and also helps to flush out excess uric acid

 

*Consult a pharmacist at Lovy Pharmacy when choosing a supplement for your condition.

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