What is Gout?

Gout is a disease caused by a build-up of uric acid crystals. Gout progresses through several clinical phases namely

 •Acute gout (self limiting, few days to 2-3 weeks)

 •Intercritical gout  (asymptomatic periods)

 •Chronic gout (long-term, permanent chalky deposits)

 A number of pathophysiological events involving elevated urate concentrations and crystal formations are required for the development of gout.

Gout affects up to 8.3 million people, or 4% of the population worldwide. It is more prevalent in men than in women, with increasing age, and in some ethnic groups.

Normal Uric Acid Levels

•Male and post-menopausal women: < 0.42mmol/L or 7.0mg/dL

•Pre-menopausal women: < 0.36mmol/L or 6.0mg/dL

Risk Factors

•High purine food intake (red meat, seafood, beans)

•Genetic factor

•Alcohol consumption

•Chronic kidney disease

Sign & Symptoms

•Sudden, severe pain & swelling at joints, especially big toes

•Redness, warmth, and tenderness of joints

•Severe pain & disability

•Severity of flare usually reached within 12-24 hours

Complications

•Kidney stones

•Joint damage & deformity

•Tophi formation

Food according to Purine Content

Lifestyle Modifications

•Restrict consumption of high purine food.

•Reduce alcohol consumption & smoking.

•Adequate fluid intake (2-3L daily).

•Consume low-fat dairy products/skim milk.

•Daily exercise (walking, cycling, swimming)

References

1. Management of gout (second edition) - moh.gov.my [Internet]. [cited 2022Jan5]. Available from: https://www3.moh.gov.my/moh/resources/Main%20Banner/2021/Okt/Draft_CPG_Management_of_Gout_(Second_Edition)_for_Reviewers.pdf

2. MacFarlane LA, Kim SC. Gout: A review of nonmodifiable and modifiable risk factors [Internet]. Rheumatic diseases clinics of North America. U.S. National Library of Medicine; 2014 [cited 2022Jan5]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251556/

3. Guidance for consumption of purine containing food ... [Internet]. [cited 2022Jan5]. Available from: https://www.researchgate.net/figure/Guidance-for-consumption-of-purine-containing-food_tbl1_10580725