DR. CORA LIM
MEDICAL INSIDER
Rheumatology Made Simple
(Part 3)
We are still in the discussion of the topic “Rheumatology
Made Simple”.
We continue with the topic by presenting the following:
The Spectrum of Gout, Generalities about Gouty
Arthritis, Acute Gouty Arthritis, Gout and Diet, and
Suggested Treatment of Gout Flare-up.
What does the spectrum of gout include? This
spectrum includes: Hyperuricemia Acute gouty arthritis,
Tophaceous deposition of urate crystals, Urolithiasis,
Interstitial deposition of urate crystals in renal
parenchyma, and Uric acid nephropathy.
What are the generalities in the study of Gouty
Arthritis? These generalities are: extremely painful
episodes of arthritis; intermittent course; usually
monoarticular involving the big toe, ankle, knee; may later
be oligo- or polyarticular; tendency to abuse NSAIDS (and
steroids); and may be precipitated by stress e.g surgery,
blood transfusion
What is Acute Gouty Arthritis? Acute gouty arthritis
have the following facts: it is precipitated by local trauma
unaccustomed exercise & alcohol consumption with the
following manifestations – excruciating pain over hours
frequently nocturnal; swelling, redness & tenderness;
monoarticular & lower extremities; may affect knees, wrist,
elbow & rarely SI & hips.
How is Gout Treated? The following are suggestions for
the treatment of gout: 1) Treat acute attack : cold
application, NSAIDs, colchicine, (arthrocentesis);
2) Lifestyle modification; 3) Treat concomitant conditions;
4) Remove precipitating factors e.g. drugs; 5) Maintain
normouricemia; and 6) Prophylaxis to prevent acute
attacks
What about the Diet to be followed by People who
have Gout? When one has gout, he is advised to eat
more fruits, vegetables and whole grains, which provide
complex carbohydrates. He is also told to avoid foods and
beverages with high-fructose corn syrup, and limit
consumption of naturally sweet fruit juices. Moreover,
doctors will him to stay well-hydrated by drinking water.
So, what are the top foods and drinks that trigger
gout” These foods and drinks are sugary drinks and
sweets like: high fructose corn syrup; alcohol; organ
meats; game meats; certain seafood, including herring,
scallops, mussels, codfish, tuna, trout and haddock; red
meats, including beef, lamb pork and bacon; and turkey.
Should I keep myself seated when I have gout?
Studies have it that when one has gout, the condition
could be the reason for sudden and intense pain. This can
even cause the swelling of the affected joint. And because
of this, it may be difficult for the person who has gout
attack to walk or to bear weight on the foot. But, even with
this condition, when one has a gout flare up, it is safe to
walk and walking may even help reduce pain.
(To be continued).