Middle-aged Filipino men usually attribute joint pain or swelling to gout. Although a form of arthritis, it is not the most common, with only two to four for every 10,000 suffering from attacks.

According to Dr Eduardo Cruz, osteoarthritis is the more common form of arthritis, with 80 percent of people above age 55 as the usual targets. It is a degenerative disease and results from the “wear and tear” of joints. A person with osteoarthritis may also suffer from gout attacks.

High levels of uric acid in the blood form into crystals and when these are deposited in joint tissues, the result is gout.

The big toe

The most common target of a gout attack is the base of the big toe. To distinguish gout from osteoarthritis or rheumatoid arthritis, the affected joint is typically red, swollen, hot to the touch, tender and extremely painful even with just a light touch.

Another difference is that a gout attack only occurs in a single joint, although on rare occasions it can affect other joints simultaneously. Other than the big toe, gout attacks the top of the foot, ankle or knee as well as other joints such as the elbow.

Dr Cruz adds that adult men between 30 and 60 often suffer from this form of arthritis, and more than 90 percent of people with gout are men. Pre-menopausal women and children rarely suffer from this painful condition.

Risk factors

Gout has been mostly associated with purine, found in rich foods and beverages. These include steaks, innards and seafood. Purine is converted into uric acid and if this is not properly excreted by the kidneys, it accumulates in the blood and turns into crystals.

Alcoholic beverages, such as beer, and those sweetened with fructose as well as too much caffeine from coffee, tea or sodas, may likewise trigger gout attacks. Diuretics, too, can cause gout.

A family history of the condition predisposes an individual to suffering from gout. And someone overweight is also at risk.

Since there are people with high levels of blood uric acid that do not suffer from gout attacks, a blood test for uric acid may only be misleading. Dr Cruz says a more definitive test is arthrocentesis or joint fluid analysis because this will determine the presence of uric acid crystals.

Managing gout

Physicians will advise that steering clear of purine-rich foods and alcohol will help manage gout. Some attacks may subside immediately, others last from 7 to 10 days. The severe attacks, however, can take weeks to subside.

Medication for gout comes in two forms: those that treat the attack and those that prevent future attacks. Under the former are NSAIDS such as ibuprofen, naproxen corticosteroids, as well as colchicine.

Other than avoiding rich foods and beverages to prevent attacks, maintaining an ideal body weight and consuming at least three litres of water daily is recommended. MIMS

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