Gout is one of the most common inflammatory arthritis in Malaysia.
Although there is no local population-based epidemiologic study in Malaysia. There have been studies from a few tertiary care hospitals that have revealed some information about gout cases in Malaysia.
Epidemiology of Gout in Malaysia
There are no in-depth population-based studies on gout available.
Hospital-based studies from a few tertiary centres reported a peak age of gout onset from 30 to 60 years. Patients were predominantly males with a ratio ranging from 8:1 to 12:1.
Distribution according to ethnicity was dependent on the region where the studies were conducted. Although the majority of the patients were Malays, the Chinese and Indians were also affected.
The epidemiology wise is very similar to the global data.
What is the best doctor to see for gout?
When it comes to gout, there are a few things you need to consider when choosing a doctor.
For starters, you'll want to see a rheumatologist. This type of specialist is specifically trained in diagnosing and treating conditions that affect the joints, muscles, and bones. They can help you get your gout under control and figure out what's causing it in the first place.
What can be mistaken for gout?
It's not always easy to be diagnosed with gout. These other diseases can mimic gout and lead to a misdiagnosis.
Infected joint (septic arthritis): Septic arthritis is a serious infection that can develop in any joint in the body. It is most commonly caused by an infection.
Pseudogout: The condition is often mistaken for gout, as both conditions share many of the same symptoms. It is caused by the deposition of calcium pyrophosphate dehydrate (CPP) crystals in and around the joints rather than uric acid in gout.
Rheumatoid arthritis: Rheumatoid arthritis (RA) is a type of autoimmune disease that causes pain, inflammation, and stiffness in the joints.
Psoriatic arthritis: Psoriatic arthritis is a type of arthritis that affects people who have psoriasis. About 1 in 5 people with psoriasis also develop psoriatic arthritis. People with psoriatic arthritis often experience pain and swelling in their joints.
What are the common gout medications used in Malaysia?
There are a few different medications that are commonly prescribed to treat gout in Malaysia.
Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs help control inflammation and pain in the affected joint. A higher dose may be prescribed by the doctor to stop an acute attack, followed by a lower daily dose to prevent future attacks. NSAIDs are recommended to use for a short period only. Eg : ibuprofen, naproxen and indomethacin.
You may want to take some precautions when taking NSAIDs if you have the below conditions:
Heartburn and stomach pain
Ulcers in the stomach
A tendency to bleed more, particularly on aspirin medication.
History of allergy to medications. Rashes, wheezing, and throat swelling is examples of allergic reactions.
Problems with the liver or kidneys. If you have kidney problems, you should not take NSAIDs without first consulting your doctor.
Colchicine is one of the most common medications used to treat gout. It helps to reduce inflammation and pain.
Colchicine is not meant for long-term consumption. You may need to stop taking this medication as soon as the pain is relieved or at the first sign of nausea, vomiting, stomach pain, or diarrhoea.
Corticosteroids are a common medication for gout. Corticosteroids can be taken orally or injected into the joint. Corticosteroids are typically reserved for patients who are unable to take NSAIDs or colchicine.
Because corticosteroids suppress the immune system, it increases the risk of infection. It is not recommended for long-term use as it may be associated with more serious complications.
This medication has the potential to reduce the amount of uric acid in the blood. Allopurinol is a medication in this category that is commonly used to prevent gout attacks.
Inform your doctor if you noticed sensitive reactions such as skin rash or other allergic reactions (eg, trouble breathing or swallowing, swelling of your hands, face, or mouth).
Medications that enhance uric acid removal
Normally, this medication is used when allopurinol is not well tolerated. It enhances the kidney's ability to remove uric acid from the body. e.g. probenecid.
One may need to monitor kidney functions since it boosts the secretion of uric acid through the urine. Check with your doctor if you find it painful or difficult to urinate; or notice blood in the urine.
This is another OTC medication (e.g. Ural effervescent salt) that is believed to neutralise blood acidity, thus reducing the risk of uric acid crystal formation.
Why would someone keep getting gout? Should I be worried?
When you have gout, your blood contains an abnormally high level of uric acid, a substance produced by your body when it digests food. The uric acid crystallises over time and collects around joints.
Long-term consequences of gout can include joint damage, skin nodules of uric acid, kidneys and other organ injury/ damage.
Signs of Gout getting serious
Patients who have had two or more gout attacks in the last year.
Have one or more tophi (small lumps forming under the skin).
Have any gout-related joint or kidney damage?
Uric acid causes the formation of one or more kidney stones.
Uric acid normal range for Malaysian
Uric acid range
4.0-8.5 mg/dL or
2.7-7.3 mg/dL or
Can I stop gout permanently?
Patients can never be cured of gout. Here are some suggestions you can do to avoid recurrent gout:
Get to a healthy weight (without resorting to crash diets).
Consume a healthy, balanced diet.
Avoid eating animal organ meat, such as kidneys or liver, as well as seafood.
Limit your intake of sugary drinks and snacks.
Limit your intake of fatty foods.
Stop alcohol or reduce alcohol consumption at least.
Drink plenty of fluids to avoid dehydration.
Exercise on a regular basis, but avoid strenuous exercise or putting excessive strain on joints.
Consider taking a uric acid lowering supplement.
Gout is a common disease in Malaysia that can be controlled through medication, supplements and lifestyle changes. If you are experiencing any symptoms of gout, it is important to see a doctor for diagnosis and treatment.