Gout is a disease in which there is a build-up of uric acid in the body.

  • Uric Acid is a waste product formed from the breakdown of certain proteins (called Purines).
  • It is normally removed from the body by the kidneys.
  • In gout, uric acid builds up and forms crystals which are deposited inside the joints.
  • It is one of the oldest diseases known to mankind.
  • Although it was formerly a leading cause of painful and disabling chronic arthritis, due to advances in medical research, gout can now be well-controlled.
  • It commonly affects middle-aged men , especially between the ages of 30 and 60.
  • It rarely affects women before menopause.

Signs and symptoms

  • The base of the big toe is usually affected.
  • The big toe becomes red, hot, swollen and very painful.
  • Attacks usually occur very quickly, often overnight.
  • Affected joint becomes very painful , often to the point that even the weight of a bedsheet becomes unbearable.
  • Pain may last for days to weeks if not treated.
  • May recur at intervals of weeks or months.
  • Gout can also affect other joints like the ankle, knee, wrist and fingers.


  • Uric acid may collect under the skin as tophi
  • In the urinary tract, it may collect as kidney stones.
  • People with gout usually have other diseases like
    • Obesity
    • Hypertension,
    • Hyperlipidaemia
    • Diabetes


Gout is a curable disease but you must take steps to overcome the disease.

Acute attacks

  • Rest the joint during an attack of gout.
  • Anti-inflammatory medicine is used to reduce pain and inflammation. It may have side-effects like pain in the abdomen but if used for short-term, it is generally well tolerated.
  • Other drugs like colchicine can also be given. Although colchicine is very effective, it often causes nausea, vomiting and diarrhoea. (Can be prescribed only by doctors)
  • Steroids
    • Usually injected directly into the inflamed joint
    • May be given as a short course of tablets if the patient is unable to take other medications. However, this is not to be taken long-term.
  • Always be on the lookout for early signs of attacks . The earlier you start the treatment the better the outcome.

Long-term treatment

Since gout is caused by an excess of uric acid in the body, you have to remove factors that may raise uric acid level.

  • Control your weight – Being overweight interferes with the body’s ability to remove excess uric acid (Click here to read more..)
  • Avoid alcohol
  • Diet – Avoid increased intake of purine-containing foods
  • Certain meats, seafood, dried peas and beans are particularly high in purines.


Below is a list of food high in purines, especially organ meats.

    • Internal organ like liver, lungs, kidney, brain
    • Fish like ikan bilis, kembung, sardines and herring
    • Minced meat

Meat extracts, yeast extracts (like Marmite) and stock cubes

  • Shellfish like crab, cockles, prawns, scallops
  • Asparagus, cauliflower, mushrooms and spinach
  • Peanuts, lentil, beans and peas
  • Poultry
  • Wholegrain breads and cereal


  • Modify your lifestyle to maintain a normal uric acid level
  • Maintain a healthy lifestyle to prevent the associated medical conditions
  • Allopurinol once prescribed is regular life-long treatment
  • Do not stop or change the dose of allopurinol when you have an attack
  • Drink plenty of water

Is gout a disease of the wealthy?

No, gout can affect people from all walks of life although too much alcohol and overeating can be associated with its development.

Can gout be inherited?

  • Gout can be inherited but environmental factors also play a part
  • Gout is a treatable disease. Historically, gout has been a major cause of destructive and disabling arthritis but today with proper management it can be totally controlled.
  • The main thing is to adopt a healthy lifestyle.

If you want more information on gout, visit the Arthritis Foundation Malaysia web site at www.afm.org.my

Last reviewed : 01 May 2012
Writer : Dr. Heselynn Hussein
Reviewer : Dr. Heselynn Hussein