(Special thanks to Coordinating Committee in Accident & Emergency and Coordinating Committee in Orthopaedics & Traumatology reviewing the information of this page.)

Gout occurs when urate in the body is too high and accumulates in the joints or other tissues, causing inflammation and pain.


Uric acid is formed during breakdown of purines, it is rich in many food sources and produced by the body naturally.

Uric acid passes out of the body mainly through urine and the intestine. When uric acid reaches a high level to dissolve completely in the blood, crystals will form and deposit in the joints, skin or kidneys causing gout and damage to organs.

  • Over 40 years old

  • Male has greater chance of gouty attack than female

  • Overweight

  • People with high blood pressure, diabetes, or kidney disease

  • Those who take diuretics or medications for treating Parkinson's disease

  • People who drink alcohol and eat food which are rich in purine, such as offal, shellfish and seafood

  • Hereditary factors

  • Gout usually presents with acute inflammation of a single joint, most commonly the big toe, or ankle, knee, wrist and finger.

  • Affected joint will turn red, swollen with intensive pain. Pain will only subside a few days later.

  • If the blood uric acid level is not controlled, it may affect multiple joint and recur frequently. In severe cases, joints will deform and patients may lose their working ability.

  • Excessive levels of urate can deposit in other parts of the body other than joints, such as kidneys and the skin. Kidney damage can lead to serious outcomes.

Gout is a common condition that cannot be cured. Appropriate medication and diet restriction can prevent recurrent attacks.

Purpose: To reduce severe joint pain, redness and swelling quickly.


  • Rest the affected site
  • Apply ice to relieve pain
  • Medication:
    • Nonsteroidal anti-inflammatory drugs and colchicine are commonly used.
    • Side-effects of drugs:
      • Nonsteroidal anti-inflammatory drugs can lead to stomach upset and ulcers. Use with stomach medicine (antacid) is advised.
      • Colchicine may cause diarrhea, abdominal pain, nausea and vomiting.

Purpose: To prevent recurrent attacks


  • Diet restriction (avoid certain foods) **IMPORTANT**
    Patients should avoid the following foods:
    • alcohol, especially beer
    • offal, seafood, excessive red meat
    • fish that can be eaten with bones, such as sardines, capelin and noodlefish
    • excess intake of vegetables such as dried beans, mushroom, cauliflower, spinach and fresh asparagus
    • meat stock, meat essence, chicken essence
  • Medication and food restriction should be observed for treating gout to reduce the chance of relapse.

  • When the symptoms of an acute attack are subsided, the family doctor will design an individualised care plan for the patient. If medication is prescribed, ensure drug compliance unless instructed by the doctor or side effects occur.

  • Avoid being overweight.

  • Patient would suffer from severe pain during an attack. The risk of recurrence can be minimized if high-purine foods mentioned above are strictly avoided, with appropriate use of medications as prescribed when necessary.

  • Patients should take medicines as prescribed. Follow strictly the dosing schedule as instructed.

  • If the symptoms do not subside and get worse, seek medical attention at once.

  • If drug allergies occur after taking the medicines with symptoms such as swelling of the face, lips, tongue or other membranes, difficulty in breathing or skin rash, etc., stop the medicines at once and attend a nearby clinic for treatment. In case of serious allergic reactions, go to an Emergency Department immediately.

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