MEDICAL INSIDER
DR. CORA LIM
FOR AUGUST 20, 2023

GOUT
(Part 2)

We started last week with our discussion of Gout and we
tackled the following topics: What is Gout; How Urate is
Produced; What Causes Gout; What Are Symptoms of an
Attack of Gout; and What May a Doctor Suggest if a Person
Has a Gout Attack.
Today let us discuss the initial treatments for acute attacks of
Gout. These are some of the suggestions:Non-steroidal anti-
inflammatory drugs (NSAIDs), or Colchicine tablets, or
Steroids (injected into the joint or muscle, or as tablets),
Applying ice packs and resting the joints.
There are also longer-term treatments that aim to lower urate
levels and reduce the risk of further attacks. These include the
following: Allopurinol or febuxostat (which will reduce the
amount of urate your body makes) and Uricosuric drugs (which
will increase the amount of urate your kidneys get rid of).
Studies suggest that If you’ve had an attack before, you should
be on the lookout for early signs of another attack. You have to
take your prescribed treatment as soon as possible. The earlier
you start treating an acute attack the better.
Here are some Self-Help Measures: Lose weight if you’re
overweight; Have a balanced diet and avoid eating excessive
amounts of purine-rich foods (for example offal, oily fish, yeast);
Avoid drinking too much alcohol; Avoid dehydration by drinking
plenty of water; Avoid sugary fizzy drinks and fruit juices that
can be high in sugar; Include fruit, vegetables and other foods
rich in vitamin C in your diet; Control blood pressure, diabetes

and raised cholesterol; Exercise regularly; Avoid stress and
have enough rest.
What should be one’s outlook regarding Gout attacks?
Further studies say that gout attacks can vary from person to
person. However, in time, attacks tend to happen more often
and new joints are affected. A continued build-up of urate
crystals and formation of hard tophi can damage your cartilage
and bone, leading to long-term (chronic) arthritis.
Nevertheless, with appropriate help from a rheumatologist and
some changes to your diet and lifestyle, this type of damage
can usually be prevented.
Let us all remember that NOT EVERYONE with a raised uric
acid level needs treatment to lower it. There is a need for you to
discuss the matter with your rheumatologist for details. (To be
continued)