gout
GOUT
Gout is a condition that resulted from deposition of monosodium urate crystals in various tissues (eg joints, connective tissue, kidney).
The patient experiences acute and chronic arthritis, soft tissue inflammation, tophus formation, gouty nephropathy and nephrolithiasis.
Primary hyperuricemia occurs when uric acid saturation arises without coexisting diseases or drugs that alter uric acid production or excretion, while secondary hyperuricemia is a condition where excessive uric acid production or diminished renal clearance occurs as a result of a disease, drug, dietary product or toxin. 

Gout Patient Education

Patient Education

  • Patient education, appropriate lifestyle advice and shared decision making are core aspects of the management
  • Give advice on possible changes of life habits that can lead to an improvement in overall metabolic profile of the patient
  • Often improves patient’s understanding and compliance when done at the start of therapy

Lifestyle Modification

  • The goal of lifestyle modification is to help prevent both gouty attacks and complications, together with its comorbidities
  • It is a part of long-term management of gout

Body Mass Index (BMI)

  • Aim to have ideal body weight through gradual weight loss (0.5-1 kg/week), with gradual caloric restriction and exercise
    • Avoid “crash dieting” and high-protein/low-carbohydrate diets since these may cause ketosis and result to hyperuricemia
    • Daily or at least 45-minute, 4-times-a-week, low-impact (eg walking, biking, swimming) or aerobic exercise is recommended

Dietary Management 

  • Dietary restriction can decrease the occurrence of gouty attacks but has little role in lowering serum urate levels in patients with gout
  • Restrict consumption of high purine foods (eg brain, liver, kidney, anchovies, sardines, mackerel, seafood)
  • Reduce intake of meat (beef, lamb, pork)
  • High intake of vegetables, nuts, legumes, vegetable protein reduces the risk of gout (lower serum uric acid)
  • Consumption of low-fat dairy products or skim milk up to 2 servings daily
  • Limit sugar-sweetened softdrinks and beverages containing fructose

Alcohol Intake 

  • Restrict alcohol consumption to <21 units/week for men and 14 units/week for women
    • Have at least 3 alcohol-free days/week
  • Avoid alcohol intake when suffering from frequent gout attacks or when gout symptoms are poorly controlled

Smoking 

  • Complete cessation of smoking is recommended

Adequate Fluid Intake 

  • Recommended fluid intake is 2-3 L/day
  • Restrict fluid intake in some patients (eg with heart failure or severe renal insufficiency)
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Rheumatology digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Jairia Dela Cruz, 3 days ago
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
06 Sep 2020
Type 2 diabetes mellitus patients taking proton pump inhibitors (PPIs) are at a higher risk of sustaining hip fractures, a recent study has found.
5 days ago
Osteoarthritis (OA) is the most common condition affecting the joints. Dr Lee Eu Jin, an Orthopaedic Surgeon from Liberty Orthopaedic Clinic at Mount Elizabeth Medical Centre, Singapore, shares his insights with Pearl Toh on how to manage OA in the primary care setting.


4 days ago
XOFLUZA – Baloxavir marboxil 20 mg and 40 mg FC tab