Gout

 

What is GOUT ?

  • A form of arthritis cause 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.
  • Most common part affected by gout: big toe. Other possible areas: elbows, hands, knees.
  • Pain comes very quickly, often at night.

Signs and symptoms

  • Classic picture is of 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 a temperature

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

Self Care

  • See a doctor for treatment as soon as symptoms start
  • Medicines to prevent gout should be taken every day even in the absence of any symptoms, otherwise attacks of gout will 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 for a weight loss programme
  • Stay away from alcohol and foods that are high in purines- consult our nutritionist for further informations.


Medicines
Consult our doctors or pharmacist for suitable medicines for you when lifestyle modification failed, family history of gout, presence of stone, have kidney problem or uric acid level unexpectedly high.

  • Medicines to relieve pain: NSAIDS, colchicines.
  • Medicines to prevent gout attacks: (e.g. Allopurinol)
    • May be started after a few attacks. Usually start with a low dose then increase gradually.
    • Do not start taking medicines to prevent gout 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. A doctor might advise you to keep taking these medicines during these times.

Dietary Management
Avoid (High purine content)

  • Not more than one item once a week
    • Herring, meat extracts, meat gravies, sardines, fish roe, alcohol, anchovies, meat soup, salmon, brain, liver, kidneys, heart, sweetbread, meats, poultry, lobster, crab.
Be careful (Moderate purine content)
  • Not more than one item 4 x a week
    • Asparagus, cauliflower, beans, lentils, mushrooms, oysters, peas, spinach, wholegrain cereals and bread.

Acceptable (Low or no purine content)
  • As often as desired
    • Beverages-tea, coffee, cocoa, chocolate
    • Fruits
    • Vegetables ( except those under BE CAREFUL)
    • Bread and cereals (except wholegrain)
    • Eggs
    • Milk and milk products
    • Nuts- all kinds, peanut butter.

Supplements

  • Fish oil - shown to have anti-inflammation properties that reduce inflammation of arthritis.
  • Celery – shown to have anti-inflammatory properties that reduce swelling and pain around the joints.
  • Ural – urine alkaliniser to neutralize the uric acid and help to flush out excess uric acid
  • Surbex Zinc – High potency B –complex with folic acid, zinc, Vit E and Vit C.
    • Vit B (esp B5) assists in uric acid excretion
    • Vit C and Zinc can boost the immune system, expedite body’s repair and renewal of damaged tissues.
    • Vit E reduce inflammation and pain
* Always ask a pharmacist when choosing a supplement for your condition.