Don't take gout lightly

Photo illustration of an X-ray film.
Photo illustration of an X-ray film.PHOTO: ISTOCKPHOTO

I refer to The Sunday Times' report on gout (Gout: Old man's disease? Not anymore, Aug 10).

It is timely to highlight this illness, which affects not only the old, but increasingly, also younger adults.

Gout is associated with a less active lifestyle and a diet rich in purines and fructose drinks.

This is particularly relevant today, with lives centred on the computer, the Internet and computer games.

It is also helpful to realise that such a lifestyle and diet are closely associated with the problems of obesity, metabolic syndrome, diabetes and fatty liver, all of which contribute to ill health and subsequently to cardiovascular complications.

It is increasingly clear that many in various nations today suffer from neck pain, shoulder ache, wrist pain, headache and eye problems due to long hours on the computer and on their mobile phones after work. This is, in fact, labelled an "epidemic" of the computer age.

Some gout patients seem to take their problem lightly. After all, medications can relieve the swelling and pain rather quickly.

They do not realise that the complications involve damage to the joints and erosion of the bones. Also, uric stones in the kidneys may develop and renal damage may occur.

The report did highlight that those suffering from gout should refrain from certain food and diet. Besides red meat, wine, alcohol, nuts and sardines, in our local context, durians also can precipitate the attack of gout.

Patients should also refrain from eating "internal organs" such as liver, kidneys and other innards.

Allopurinol was mentioned as a medication to prevent attacks of gout. This is prescribed often in prevention; however, it needs to be highlighted that although it is a helpful medication in that light, allopurinol can lead to very serious skin complications such as Stevens-Johnson syndrome and toxic epidermal necrosis in some patients. These complications are rather serious and can be fatal.

It must be noted that some individuals with certain genetic make-up are more prone to such complications with allopurinol. Hence, the prescription of this medication should preferably be initiated by specialists in the field of rheumatology.

A general practitioner can then continue this medication after it has been safely initiated by the specialist.

Quek Koh Choon (Dr)

A version of this article appeared in the print edition of The Straits Times on August 16, 2019, with the headline 'Don't take gout lightly'. Print Edition | Subscribe