Gout is a disease of both metabolism and inflammation caused by prolonged high level of uric acid in the blood, so long that it causes inflammation in the joint(s) and other tissues. It may also cause crystallization of urate in various organs such as kidneys and fibrous tissues. The symptoms may be acute such as joint pain or rather chronic such as the collection of crystals so-called tophus which can damage bone surfaces, or stones in the kidneys.
The preventable risk factors of gout include obesity, certain types of food and beverages which increase uric acid production such as red meat (beef, pork, ham, sausages, bacon), seafood (fish, shrimps, oysters, scallops), offal, high sugar foods and alcoholic beverages.
Dr. Naravadee Kositpesat, our rheumatologist at Bangkok Hospital Hua Hin shares that the risks of having the diseases increase with more occurrence in men than women in general, however the risks become higher for post-menopausal women. The presenting symptom of gout is mostly joint inflammation which usually starts from joints of the lower body. 50% patients start their first gout attack in the joint of the base of big toe. Other joints involved include the ankle or knee joints. The inflammation normally persists for the 24 – 48 hours. This gouty arthritis should be treated immediately, if delayed, it may leave a permanent damage causing joint surface destruction, tophus which can happen anywhere and also kidney stones.
The diagnosis of gouty arthritis includes history taking and physical examination. If the joint inflammation is present, tapping of joint fluid for a visual confirmation using a microscope will provide a definite diagnosis with the presence of urate crystals, even more definite than blood uric acid testing.
The recommendation to avoid having gout in the future is to control the consumption of food and beverages which contribute to uric acid production. As mentioned before, the risky types you should avoid include red meat, seafood, offal, high-sugar food and alcoholic beverages. Regular exercises and weight control to prevent obesity are recommended. Gout also tends to associate with other metabolic diseases such as diabetes, high blood pressure, obesity so controlling these conditions are also as important.
“When the level of blood uric acid exceeds the normal range, we will see the situations into 2 categories, one with the joint pain and the one without. When there is no pain involved regular exercises and diet control is the strategy. If the blood uric acid is high along with joint pain, the consultation is required to provide necessary treatments to the individual. Moreover, patients with gout tends to have associating diseases and require overall approach” Dr. Naravadee concluded.
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