The Department of Rheumatology and Immunology from Singapore General Hospital (SGH), a member of the SingHealth group, shares tips to manage gout attacks, treatments and more.

Gout can lead to deformities and immobility

Without treatment, years of gout attacks can damage the affected joints, leading to deformities, chronic pain, and immobility. A persistently high level of uric acid can cause kidney stones and affect kidney function.

Mr Zalfi, whose first attack occurred in 1997 and the second a year later, has been experiencing an attack almost monthly in the last two years. The father of two has modified his eating habits, and avoids nuts and meat.

Because gout has caused him to walk with a painful limp, he no longer plays tennis and soccer, or jogs. But to keep fit, he swims as often as possible. “My advice to people with gout is to stay positive and exercise. Don’t forget your diet and medication. Most importantly, see your doctor regularly,” Mr Zalfi said.

Patients can never be cured of gout. It is a long-term disease that can be controlled by a combination of medication to control the uric acid level, and anti-inflammation drugs to treat a flare-up. “Lowering the level of uric acid is key to treating gout, and patients must understand this. In the long term, if you do not use the uric acid-lowering medication, the gout will recur,” said Dr Tan.

“We know that putting a patient on uric acid-lowering therapy early helps. By lowering the uric acid in the blood to a certain level, the chance of getting a gout attack is drastically reduced.”

Some medicines reduce the formation of uric acid in the blood while others increase uric acid excretion from the urine system. “All aim to reduce the uric acid,” he added.

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Avoid organ meats and keep diet balanced

Following a low-purine diet can help you limit the body’s uric acid production, according to SGH Department of Dietetics. Purine is a type of protein present in various types of food. When these proteins are broken down, uric acid is the end-product. Gout sufferers should follow a well-balanced diet while restricting their purine intake.

  • Avoid foods rich in purine, such as liver, kidney, brain, heart and other organ meats; small fish such as anchovies, ikan bilis and sardines; mackerel; scallops and meat extracts​

  • Drink plenty of fluids daily, limit alcohol and fat intake

  • Achieve and maintain a healthy body weight

  • Consume asparagus, mushrooms and legumes in moderation

See the next page for the causes, symptoms and risk factors of gout.

See page 3 for the diagnosis and treatment for gout.

See page 4 for diet tips and how to manage gout attacks.

Ref: S13

Also, check out our other gout article:

Gout-Friendly Foods to Eat