Gout is a monoarthritis disease caused by acute joint inflammation. This means that gout usually strikes each part of the body, one at a time.
Dr Hisham Kunhimon
Consultant Orthopaedic Surgeon
MBBS (UM), MS Ortho (UKM),
CMIA (NIOSH)
Tropicana Medical Centre
The sudden attack of the disease causes very painful joint pain, along with a swollen joint that is red and painful.
What is the cause of gout?
Gout occurs due to the crystallisation of uric acid, which forms a needle-like shape around the joint affected. Uric acid is a form of waste from purine metabolism, one of the basic structures of DNA and nucleic acid in cells. Cell destruction and food digestion that is high in purine will cause the uric acid content in the blood to increase. The kidney is an organ that disposes of uric acid through the process of urination. When the kidney cannot dispose of the uric acid at a rate equal to, or higher than which it is produced, the uric acid content in the blood will increase. This is called hyperuricemia. This condition causes the crystallisation of the uric acid around a certain joint. This crystallisation causes acute inflammation of the joint, resulting in gout.
What are the symptoms of this disease?
Gout causes acute and severe joint pain, where the pain occurs suddenly, but usually takes place after the consumption of high purine foods. Podagra is the term for gout involving the big toe, which is the most common form of joint inflammation in terms of gout. Another common occurring location of gout is the ankle and the knee. The said joint will swell and turn a reddish colour, and is often accompanied by severe pain. Acute symptoms of this condition may make it difficult to differentiate gout from other conditions such as joint infection, especially when the joint involved is large.
Can it be fatal?
No, gout is not fatal, but high uric acid content can cause the formation of corals. If left untreated, this may lead to more serious conditions, like kidney damage.
Does gout only occur in the elderly?
No, men between the ages of 40 and 50 most often develop gout. Women develop gout less often unless they have hit menopause. Children and youth seldom suffer from gout.
Who is at risk for this disease?
- Males
- Those who are genetically predisposed; individuals are more likely to develop gout if they have a family member who has had gout.
- Individuals who have a high intake of purine high food like seafood, sardines, anchovies, legumes, asparagus, cabbage, and red meat.
- Those who are obese, diabetic and have high blood pressure.
- Individuals who regularly consume diuretic medications.
Must gout patients completely avoid the consumption of seafood?
Gout patients do not need to eliminate these foods from their diet, but it is strongly advised for them to reduce their intake of high purine foods like seafood. They are recommended to reduce their consumption of these foods to around 100-150mg per day.
What treatments are there for gout patients?
Acute gout attacks require the joint involved to have rest. Painkillers can help to relieve the pain. Medicine like colchicine can also help treat acute gout attacks. Plentiful consumption of water will help the uric acid to be disposed from the body through urination. Massaging the affected joint and the surrounding area is not recommended, as it will irritate the area. Using a cortisone injection to the surrounding area may reduce the severity of the gout attack. Patients who experience gout attacks frequently can consume medication such as allopurinol, which helps to reduce uric acid levels in the blood.
What is your advice for gout patients?
Watch your diet, avoid getting obese, and drink plenty
of water.
Is it true that gout is a genetic disease?
Yes. Gout occurs more frequently when a family member has also experienced gout. However, gout can still occur in individuals who are not genetically predisposed for gout. This is due to behavioural factors such as diet and obesity.
Among the sexes, who are more at risk for this disease: males or females?
Males are more at risk and develop this disease more often because their body produces higher quantity of uric acid. The incidence of females developing gout increases after they experience menopause.
