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SINGAPORE: Middle-aged men indulging in decadent delicacies. Beer-swilling, overweight uncles chain-smoking in the kopitiam.
Mention gout sufferers and such images are likely to come to mind. But it is a myth that only middle-aged and older men are affected by gout.
According to doctors TODAY spoke to, aside from older men and some post-menopausal women, this chronic malady can hit people under the age of 30. And they may not necessarily be unfit or particularly overindulgent in alcohol or food. That they are affected could be due to a genetic predisposition.
Denny Chu is an example of a young gout sufferer. He is all of 25 years old. His father also has gout, albeit in the later stages of life.
The young Chu, a comics shop assistant, was struck by a severe attack of gout when he was 19. Prior to the episode, he was an athletic and active teenager.
“It was very sudden and I had to be rushed to the hospital,” said Chu, recounting the first incident.
“My right ankle was so swollen and painful that I couldn’t even move. I couldn’t switch on the fan because the draft resulted in pain and cramps in my legs.”
Such attacks, which occurred frequently, left him “nearly bedridden” for two years.
There are no official figures on the number of gout patients under the age of 30 here, but Dr Koh Wei Howe, a consultant rheumatologist who runs a private clinic at Mount Elizabeth Medical Centre, estimated that about five per cent of his patients belong to this category.
Dr Leslie Tay, a general practitioner at Karri Family Clinic, said that besides older gout patients, he also sees “quite a few patients in the younger age bracket”.
Dr Tay explained that gout occurs when “the kidneys have trouble getting rid of uric acid build-up”. Over time, uric acid crystals start to form and are deposited in the joints.
The most commonly affected joint is that in the big toe, which becomes red and inflamed, said Dr James Loh, a consultant at Changi General Hospital’s department of orthopaedic surgery. But gout can also affect the ankle, knee, elbow and fingers.
According to him, repeated attacks can damage cartilage and soft tissue around the joints, leading to irreversible damage.
During a severe episode, said Dr Tay, patients can be left incapacitated. “The pain experienced during an attack could be so intense that the person would not be able to move.”
Younger patients may find it especially devastating when the “pain restricts their normal activities”, added Dr Koh.
For Denny, having to cope with severe attacks have forced him to drastically change his lifestyle. Due to the persistent swell in his ankle, he has turned to wearing slippers all the time.
He also has to refrain from overindulging in the food he loves, such as kway chap (braised pig innards) — a no-no for gout patients due to its high purine content.
“Before I had gout, I would play table tennis and badminton for five to six hours a day. Now, after a severe attack, I have to virtually live in my bedroom. My mother has to look after me.”
For gout patients, dietary control is crucial to preventing attacks.
“Avoiding purine-rich foods such as red meat, legumes (peas, beans), alcohol and seafood plays an important role,” said Dr Loh.
So is a healthy lifestyle.
“Losing weight will help lower the body’s urate levels and drinking more water will help the body get rid of excess uric acid and prevent the formation of urate crystals in the joints,” added Dr Tay.
Chu, who now suffers from gout every two months on average, said he has accepted the inconvenience and pain he experiences.
“My doctors, who knew I had a very active lifestyle in the past, were initially worried that I might slip into depression and do something silly.
“But I have learnt to accept my condition. I still eat the food I like but I make sure I control my diet well.” - TODAY/ar
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