Gout, also known as gouty arthritis, is condition that results from crystals of uric acid depositing in the joints, which results in joint inflammation. The signs and symptoms are similar to arthritis. It is interesting to note that the joint of the big toe is often the first to be affected. Other joints such the wrists, fingers, elbows, ankles and knees could be affected as well.

Gout has the unique distinction of being one of the most frequently recorded medical illnesses throughout history. It is often related to an inherited abnormality in the body's ability to process uric acid. Uric acid is a breakdown product of purines that are part of many foods we eat. An abnormality in handling uric acid can cause attacks of painful arthritis (gout attack) and also other medical conditions such as kidney stones, and blockage of the kidney filtering tubules with uric acid crystals, leading to kidney failure.

Causes of Gout

The main cause of gout is the high levels of uric acid in the blood and the inability of the kidney to process and remove uric acid from our blood stream. Listed below are some of the risk factors.

  • Lifestyle
    12% of the causes of gout could be linked to dietary causes. A diet high in meat, seafood, fructose-sweetened drinks and alcohol could lead to an increase in risk of developing gout.
  • Genetics
    Gout could be passed on from one generation to another.
  • Medical conditions
    Gout is often diagnosed together with a couple of other medical conditions. Some of them include hypertension, obesity and insulin resistance. Gout could also complicate other medical conditions such as lead poisoning.
  • Medication
    Certain medication could be linked to the increased frequency of gout attacks.
Stages of Gout
  • Asymptomatic phase
    This describes the phase before the first gout attack. There are no signs and symptoms observed. However, the uric acid level in the blood is constantly on the rise and the formation of crystals in joints are occurring.
  • Acute gout
    This is also known as “gout attack”. This usually happens when there is a trigger, such as the consumption of alcohol, which leads to a huge spike in the uric acid levels in the blood stream. This triggers in an attack and the inflammation experienced in the joints could last for over 8-12 hours. The symptoms will begin to ease after 1-2 days and it usually takes about a week for the pain in the joints to completely disappear.
  • Interval gout
    This describes the phase in between the “gout attacks”. There could be low-level inflammation in the joints.
  • Chronic gout
    Chronic gout develops in people if there is not treatment or adjustment to the lifestyle of a person. Unusually high levels of uric acid in the blood over a long period of time could result in more frequent gout attacks and the pain takes longer to go away. Hard lumps of uric acid could build up around the joints and result in the damage of the cartilage which could leave a person permanently paralysed and immobile.
Diagnosis of Gout
  • Blood tests
    Blood tests allow the gout specialist to analyse the levels of uric acid in the blood. An abnormally high level of uric acid could signal the possibility of gout.
  • Joint aspiration
    Joint aspiration is a medical technique whereby the fluid that lubricates the joints will be drawn out using a needle and analysed. The levels of uric acid and the presence of crystals of uric acid is analysed.
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Leong Keng Hong Arthritis and Medical Clinic
6 Napier Road #04-18
Gleneagles Medical Centre
Singapore 258499

Tel: (65) 6472 4337
Fax: (65) 6472 0691
Email: info@leongkenghong.com
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