Flare for pain

Ever wonder why you feel pain in your joints although you do not suffer from any joint disease?  Does it affect your quality of life since you are not able to carry out your duties without feeling discomfort? If you have been racking your brain for an answer, then most likely you could be suffering from a painful arthritic condition known as “gout”. At Central Clinic, we offer screening services to check if you are suffering from the disease. Our doctors will walk you through the procedure. Let us discuss more on this topic.

What is gout?

Gout is a painful and incapacitating disease characterized by abnormally high levels of uric acid (called hyperuricaemia) in the tissues and blood. Uric acid is broken down from substances called purine, which is found in certain foods and drinks. When these acids accumulate and are not excreted from the body, this will result in acute and chronic gouty arthritis and formation of kidney stones. Usually when the big toe becomes painful, swollen and red, it is a common indicator of a gout flare. Recurring flares can damage the joint and lead to chronic arthritis.

Am I at risk?

Typically, gout develops in both males and females over 65 years of age. You are more likely to develop gout if you have high levels of uric acid in your body. Factors that increase risk are:

• Obesity
• High blood pressure, diabetes, high cholesterol (hyperlipidemia), narrowing of arteries (arteriosclerosis)
• Family history
• Excessive alcohol use
• Diets rich in red meats, internal organs, yeast, and oily fish
• Uric acid levels increase at puberty in men and at menopause in women, so men first develop gout after puberty, then do women after menopause.

Gouty flares can be precipitated when there is a sudden change in uric acid levels, which may be caused by:    

• Overindulgence

•  Injury or trauma

• Starvation or dehydration

• Medications that affect blood levels of uric acid

How do I know if I have gout?

The symptoms usually are acute and happen frequently at night, and typically affect a single joint although some people develop a few inflamed joints at the same time. The signs are:

• Intense joint pain. The large joint of your big toe is usually affected, but it can occur in your feet, ankles, knees, hands and wrists. Pain is typically severe during the first 12-24 hours after onset.

• Lingering discomfort. Pain generally improves completely from several days to weeks. Subsequent attacks are likely to last longer and affect more joints.

• Inflammation and redness. The affected joint or joints become swollen, hot, red and tender.

Are there complications I should know of?

• Kidney stones. Individuals with gout are at increased risk of developing kidney stones. Urate crystals may collect in the urinary tract and form a stone. If the stone is large enough, it can block one of the ureters from excreting waste products from the body.

•   Advanced gout. Untreated and recurring gout can result in accumulation of large numbers of urate crystals called tophi that develop over time in joints, bursae, bones, and cartilage or under the skin. Tophi normally are painless, but may cause erosion of the bone and eventually joint damage and deformity.

How can I prevent myself from getting gout?

If you are at risk of developing gout or think you may already show signs of the disease, here are some steps to prevent or delay progression of gout:

• Limit foods rich in purine such as red meats, seafood, beans, oatmeal, spinach, asparagus, mushrooms, yeast, and alcohol. Animal sources of purines carry a significantly higher risk than plant sources of triggering a flare.
 

  
  
  

• Eat more low-fat dairy products as the protein may lower frequency of gout attack. Also, those with gout have a higher risk for heart disease so eating low fat, low cholesterol foods can help reduce such risks.

• Keep hydrated and avoid drinks containing fructose as it is associated with higher uric acid levels.

• Limit alcohol intake, particularly beer as it enhances uric acid production and reduces the clearance of uric acid. A moderate amount of wine, about 300mls per day, is not likely to increase risk of an attack.
  
  

•   Losing weight may decrease uric acid levels in your body. But avoid fasting or rapid weight loss, as this can occasionally precipitate gout attacks.

Diet modification is often recommended along with medications. Making changes in your diet without taking medication, is not likely to make significant difference in your blood urate levels; while following a strict gout diet only lowers blood urate levels marginally.

Should you wish to get yourself screened, do not hesitate to make an appointment at any of our clinics. At Central Clinic, our doctors will assist you with your health screening and discuss which treatment is best for you. You can contact us using the Enquiry and Feedback Form on our website www.centralclinic.com.sg or drop us an email at enquiries@centralclinic.com.sg.