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Frequently Asked Questions on Gout

by Marica A. Lazo, MD, FPCP, DPRA

Gout is a debilitating form of arthritis that is episodic and commonly affects males in their productive years. In the Philippines, it is said that almost 1.6 million Filipinos have gout (PRA, 2015) and the prevalence has been steadily increasing over the years due to unhealthy diet and lifestyle. The following questions are those that are frequently asked by patients and their caregivers about this painful type of arthritis:

What causes gout?

-        Gout is caused by the buildup of uric acid in the blood, which is termed hyperuricemia. Uric acid crystals may deposit in the joints which thus may lead to painful gout attacks.

Is gout hereditary?

-        Gout may run in families; however, its exact familial incidence is not known. There are several genes that may predispose a patient to hyperuricemia. These genes, coupled with a person’s lifestyle choices, ultimately determine his/her potential to develop gout.

What is uric acid?

-        Uric acid is a compound inside our body that is formed by the breakdown of purines. Purines are found in body tissues, as well as in some food or drinks. High purine substances include beer, organ meats (liver, kidney, sweetbreads), anchovies, sardines, tuna, and foods high in fat such as red meat. If a patient has gout, he/she is advised to minimize his/her consumption of these.

How will I know if I have gout?

-        It should be emphasized that not all people with joint pains have gout. Gout usually occurs in males and postmenopausal females, is characterized by painful swelling of a joint usually in the lower extremities, and is episodic in timing. For those experiencing joint pains and/or swelling, it is important to first consult a specialist and check your uric acid level before taking medications for gout.

My uric acid is normal, do I have gout?

-        Your uric acid may be normal at the time when you are experiencing a gout attack, primarily because the uric acid crystals may be concentrated in your joints and not in your blood. You may still have gout and your doctor may check your uric acid level at a time when your attack has resolved.

Is gout treatable?

-        There are medications which are given to treat the acute attack of gout such as colchicine, non-steroidal anti-inflammatory drugs such as coxibs, and in some cases, corticosteroids. There are also drugs which help control your uric acid level such as xanthine oxidase inhibitors, allopurinol, and febuxostat. Depending on your case, your doctor may prescribe these medications for you after a thorough assessment.

My uric acid is now normal, can I stop my medications?

-        Every gout patient must have regular follow-ups with his/her doctor so as to make sure that the disease is controlled. Stopping your medications even when your uric acid level is normal, especially those which control your uric acid level, may actually precipitate a gout flare.

Can intake of food supplements help my gout?

-        A lot of food supplements have emerged with claims that they can be treatment for arthritis or gout. These claims are unproven and moreover, some supplements have substances in them that are not without side effects. If you are interested in trying them, it is imperative to show them first to a doctor in order to examine if they are safe to take.

Does gout cause kidney problems?

-        One of the complications of untreated gout is kidney disease. Hyperuricemia may also lead to uric acid deposition in the kidneys which may turn into kidney stones. Also, prolonged intake of some pain relievers may lead to kidney damage.

What can we do to avoid having gout?

-        Gout is increasingly being recognized as a lifestyle disease, along with diabetes, hypertension and dyslipidemia. Generally, one should practice proper diet with avoidance of high fat and high purine foods. Regular exercise may also help in your keeping your metabolism adequate in order to avoid not just gout, but the other metabolic diseases as well.

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