Gout used to be thought of as a disease that's more common in middle-aged men. But gout sufferers have gotten younger in recent years, with some getting it in their 20s and 30s.
"A 2015 study done in Singapore revealed that while the average age for developing gout was 42 years old, there were patients as young as 20," shares Dr Stanley Angkodjojo, Consultant, Department of Rheumatology at SKH.
As society becomes more affluent, younger people are consuming more high-purine foods, like red meat and seafood, and drinking more alcohol that cause gout. A 2016 national study estimated 14% of Singaporeans binge drink, while youths aged 18 to 34 are more likely to binge-drink compared to older people. Beer and hard liquor, especially, are associated with higher gout risk and recurrent attacks.
"Many have also turned to fruit juices, thinking it is a healthier alternative to soft drinks. Whether fresh, cold-pressed or pre-packaged, juices contain high amounts of fructose which produce more uric acid that can lead to gout," reveals Dr Angkodjojo.
When uric acid builds up in the blood, it leads to sharp crystals forming in the joints. Gout usually starts in the big toe before affecting the feet, ankles, knees and other joints. Symptoms include the affected joint feeling hot, tender and swollen — and unbearable pain when anything touches it. If not controlled, attacks can become more frequent and intense, with patients feeling they are in constant pain.
Most of the time, patients mistake gout symptoms for early signs of a sprain. A key sign of gout is sudden joint pain and swelling which can last a few days. The pain is also intermittent. If symptoms occur, see a doctor as soon as possible as untreated gout may lead to the formation of tophi, which are large deposits around affected joints that cause joint deformation and disfigurement.
With recurrent attacks, joint damage can become irreversible. Contrary to popular belief, diet alone does not cause gout. Dr Angkodjojo says that only up to 30% of uric acid burden is attributed to diet.
Other contributing factors include genetics, being male and older, obesity, having diabetes and high blood pressure, and taking certain medications.
People with gout are encouraged to eat in moderation, drink more water and take less sweetened drinks and juices. In a recent study by the Saw Swee Hock School of Public Health, consuming soya beans and legumes does not increase the risk of gout, despite general public misconception.
The good news is, gout can be managed with the right medications, diet and exercise. "It's possible to live normally, without painful attacks, with the right modifications to lifestyle and diet," advises Dr Angkodjojo.
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