What is Gout?

What causes gout?

Gout is caused by having too much uric acid in the blood, a condition known as hyperuricemia. This usually stems from diet and lifestyle choices.

In Singapore, many diets are high in protein, which can lead to increased uric acid levels as the body breaks down purine-rich foods. Foods like organ meats, venison, sausages, bacon, seafood, and shellfish have a lot of purines and can heighten the risk of a gout attack.

Drinking alcohol can also raise uric acid levels because it dehydrates the body and slows down the kidneys’ ability to get rid of uric acid. Instead, uric acid crystals build up in the joints.

Risk factors for gout include:

Some research also suggests that abnormal thyroid hormone levels might contribute to gout due to their impact on kidney function.

What is a gout attack?

Acute gout attacks come on suddenly and cause intense pain in the affected joint. These attacks can be triggered by sudden changes in uric acid levels due to things like drinking too much alcohol, stress, fasting, rapid weight loss, or starting medications that lower uric acid.

The pain usually gets worst within 8-12 hours and can be so severe it makes moving the affected joint almost impossible. While the big toe is the most common area for gout attacks, it can also affect other joints like the midfoot, ankles, knees, wrists, fingers, and elbows.

Sometimes, the pain is so bad that even light contact, like a bed sheet touching the toe, can cause significant discomfort. In some cases, the pain might not completely go away, especially if uric acid levels stay high.

Gout gets worse over time if it’s not properly treated. If gout attacks are left to heal on their own, uric acid crystals build up in the joints, leading to more frequent and severe attacks in the future. Over time, this can cause serious damage to the bones and joints, particularly in the feet, which bear a lot of weight. This damage can turn into painful arthritis.

If gout has already caused joint damage, just taking medication won’t fix the pain or the joint problems. It can also lead to pain in other parts of the foot, ankle, or even the knee due to the damage.

Managing gout in Singapore involves several steps. First, it’s important to tackle the pain and inflammation. This means staying hydrated, resting, and applying an ice pack to the affected area until you can see a foot specialist or podiatrist.

To confirm whether gout is causing your pain, your podiatrist will review your medical history and conduct a thorough examination. This might include imaging tests like ultrasounds or X-rays to get a clear picture of what’s going on.

In addition to these immediate measures, you should continue taking oral medications to manage gout’s underlying causes and prevent future attacks, complications like gouty arthritis, kidney stones, and the buildup of tophi (deposits of uric acid crystals in soft tissues). However, these medications won’t fix any joint or bone damage already caused by gout.

A podiatrist will use various non-invasive treatments to ease the immediate pain and inflammation of gout attacks. Once the acute symptoms are managed, they can help with ongoing joint pain and deformities by adjusting the biomechanics of your foot and lower limbs. This might involve custom orthotics to stabilize your joints and advanced therapies to improve joint function and reduce long-term damage.