ARTHRITIS – GOUT: Symtoms, Prevention and Treatment

Hanoi French Hospital takes a multi-disciplinary approach to all patient concerns when possible and Gout is no different. Specialists from both the Family & General Medicine Dept. and the Nutrition Dept. have advice on how to spot, treat and manage Gout should it flare. As Hanoi’s only Western hospital, HFH specialists are experienced in treating each case with a patient-centred philosophy, combining their experience to help you better understand your body and create a bespoke treatment plan that suits you and your family’s needs.

Dr. Shun Kubo, General & Family Medicine expert at HFH begins:

“Gout is a condition caused by elevated levels of uric acid in the blood, leading to inflammation in the joints. In many cases, it causes sudden and severe pain, most commonly affecting the base of the big toe. During an acute attack, patients should avoid forcing movement and seek medical attention promptly to receive appropriate treatment.

Gout should not be regarded as a condition that ends once an attack has settled; ongoing management of uric acid levels is essential. Regular monitoring of uric acid, along with adequate hydration and reviewing dietary and alcohol habits, plays a key role in preventing future attacks.”

Uric Acid is formed when your body breaks down “purines”, chemicals found in specific foods and drinks. It is completely harmless at regular levels and your body flushes it out when you pee. Gout occurs when your body can’t flush it out quickly enough as a result of too much Uric Acid being produced. The acid crystalises as it flows through your blood stream and can settle on your joints. The most common place for these crystals to settle is your big toe.

It’s important to remember that having high Uric Acid levels does not mean you have Gout, or that you will suffer an attack, but as the level rises so does the risk. 

There are a few things to note about Gout:

• Men are three times more likely to experience Gout
• Women usually don’t experience Gout until after Menopause
• You are more likely to experience Gout if you are overweight or obese
• It is genetic, so check with your parents/grandparents if they have experienced it previously

Understanding what foods cause and exacerbate the condition (and other Uric Acid related crystals eg. Kidney Stones) can be the difference between suffering attacks and continuing life as normal. Any food or drink that produces high levels of purine will affect your body’s production of Uric Acid. H

Dr. Ho Thu Mai of HFH’s Nutrition department has highlighted some of the worst offenders:

• High fructose/sugary drinks/sweets – anything with high sugar creates Uric Acid
• Alcohol – especially beer, due to its yeast content. Spirits are lower but still contain high levels of purines.
• Organ meats – including sausages, which are often made with “off-cuts”
• Game meats – not especially common in Vietnam, but goose and veal are both high in purines
• Red meats – Beef, lamb, pork and bacon
• Vegetables/Legumes – Mung beans, soy beans, broccoli and raisins

While all of these foods are high in purines, there are delicious options that produce low amounts of purines too. Consider expanding your diet to include more:

• Cherries
• Rice, pasta & cereals (not oats)
• Fish & chicken
• Eggs
• Peanut butter
• Coffee
• Lots of water each day

Lastly, what should we do in the case of a Gout attack?

While management rather than a definite “cure” is the best way to prevent attacks, they do happen and cause immense pain. NSAIDS reduce pain and swelling and can be taken during an attack as long as you do not suffer from kidney disease or stomach ulcers. Your Family Doctor can advise you on what NSAIDS are appropriate for your specific needs. In extreme cases your Doctor may prescribe you corticosteroids to reduce swelling and inflammation too. They are a more powerful form of medication that can be injected intramuscularly in severe cases. Your Doctor may also prescribe a medication to bring your Uric Acid levels down to an acceptable rate, however more often than not this is achievable with careful diet management and working with your Doctor to accurately track Uric Acid production.

Dr. Kubo continues:

“How often uric acid levels should be checked depends on symptoms and treatment, but in general, blood tests are often done every 1-3 months when treatment has started, or when lifestyle changes are first introduced. Once levels are stable, a follow-up can be done every 1 to 2 years.

Lifestyle changes such as improving diet, reducing alcohol (especially beer) intake, and increasing fluid intake can affect uric acid levels quite quickly, sometimes within just a few days. However, the response varies from person to person, so it’s important not to focus on a single result. Long-term, consistent management is key to preventing gout attacks.”

Due to the intensity in pain, and possible swelling/discolouration around the pain site, Gout attacks can be confused other pathologies and infections. It is therefore important to understand what is and is not a Gout attack. As always, if you have any doubt about what is happening to your body, do visit your Doctor or attend A&E Services in extreme cases.

Gout is common, manageable and, with the help of Hanoi French Hospital’s specialists, a disease that you can tackle and be victorious over.

If you think you may be suffering from attacks of gout or have other questions about arthritis or nutrition you can contact our teams in the following ways:

Hanoi French Hospital (HFH)

Address: No. 1 Phuong Mai, Kim Lien, Hanoi

Hotline: 024 3577 1100

Emergency Hotline: 024 3574 1111

WhatsApp: +84 903 497 078