Gout cannot be permanently "cured", but it can be very well controlled. With consistent urate-lowering medication that keeps uric acid below target, plus lifestyle changes, most people can become free of attacks and prevent long-term joint damage. The benefit lasts only as long as the uric acid stays low, which is why treatment is usually long-term.

Should I start allopurinol during an attack?

No - urate-lowering medicines like allopurinol are generally not started during an active flare, because a sudden change in uric acid can worsen or prolong the attack. They are usually begun after the flare has settled, under a doctor's guidance. If you are already taking allopurinol when an attack happens, you normally keep taking it and treat the flare separately.

Is gout common in Singapore?

Yes. Gout is one of the most common forms of inflammatory arthritis in Singapore, affecting roughly 4% of adults, and it is more frequent in men and with increasing age. Diet and other lifestyle factors contribute, which is why prevention advice is widely emphasised here.

Do I have to give up all meat and seafood?

Not entirely. The aim is to cut back on the highest-purine foods - organ meats, a lot of red meat, and certain shellfish and oily fish - rather than eliminate everything. Reducing alcohol (especially beer) and sugary drinks, drinking enough water, and losing excess weight also help. For many people with recurrent gout, diet alone is not enough and medication is still needed.

GP or rheumatologist - who should I see?

A GP can diagnose gout, treat acute attacks and start long-term therapy for many patients. A referral to a rheumatologist is helpful if the diagnosis is unclear, attacks are frequent or hard to control, you develop tophi or kidney stones, or you have kidney problems that complicate medication choices.

Gout in Singapore: Causes, Attacks & Long-Term Treatment

Written & reviewed by the BestDoctors.sg editorial team · Last updated 2 Jul 2026 · General information, not medical advice

Quick answer. Gout is a common form of inflammatory arthritis caused by a build-up of uric acid that forms sharp crystals in joints, triggering sudden, severe attacks of a hot, red, swollen and painful joint – classically the big toe, but also the ankle, knee, foot, wrist or fingers. It is often triggered by purine-rich foods (red meat, organ meats, seafood), alcohol (especially beer), sugary drinks, obesity and some medicines such as diuretics. Treatment has two parts: settling the acute attack with anti-inflammatories (NSAIDs, colchicine or corticosteroids), and, for people with recurrent attacks, tophi or kidney stones, long-term urate-lowering medication such as allopurinol or febuxostat, taken consistently alongside lifestyle changes. See a doctor to confirm the diagnosis – especially for a first attack.

Gout is one of the most common forms of inflammatory arthritis in Singapore, affecting around 4% of adults, and is more frequent in men and with increasing age. It happens when high levels of uric acid in the blood form needle-like crystals inside joints, causing intensely painful flares. The good news is that gout is highly treatable: acute attacks can be settled with medication, and long-term flares and joint damage can usually be prevented by lowering uric acid and adjusting lifestyle. This guide explains what causes gout, how attacks are managed, why long-term urate-lowering therapy matters, and when to see a doctor.

At a glance

Gout at a glance: causes, attacks and the two-part treatment approach
Aspect	Detail	Notes
Cause	Build-up of uric acid forming crystals in joints	From high purine intake, alcohol, sugary drinks, genetics, obesity, kidney disease, diuretics
Typical attack	Sudden hot, red, swollen, very painful joint	Classically the big toe; also ankle, knee, foot, wrist, fingers
Acute treatment	NSAIDs, colchicine, or corticosteroids	Settles pain and inflammation; choice depends on other health conditions
Long-term treatment	Urate-lowering therapy: allopurinol, febuxostat or probenecid	For recurrent attacks, tophi or kidney stones; taken consistently, long-term
Target uric acid	Below 360 micromol/L (below 300 micromol/L if tophi present)	Reached by gradually adjusting medication dose
If untreated	Joint damage, tophi, kidney stones	Linked with kidney and cardiovascular disease

What causes gout and who is at risk

Gout develops when there is too much uric acid in the blood (hyperuricaemia). Uric acid is a waste product made when the body breaks down chemicals called purines. When levels stay high – because the body makes too much or the kidneys cannot clear enough – uric acid forms sharp crystals that settle in joints and tissues, triggering inflammation.

Common risk factors include:

High uric acid levels and a family history of gout (genetics plays a strong role).
Diet: purine-rich foods such as red meat, organ meats (liver, kidney) and certain seafood; alcohol, especially beer; and sugary or fructose-sweetened drinks.
Being male and older – gout often first appears in men in their 30s to 40s; women are at higher risk after menopause.
Obesity, high blood pressure, diabetes, heart disease and kidney disease.
Certain medications, particularly diuretics (“water pills”).

What a gout attack feels like

A gout flare typically comes on suddenly, often overnight. The affected joint becomes intensely painful, red, warm, swollen and so tender that even a bedsheet can hurt. The big toe is the classic site, but gout can also strike the foot, ankle, knee, wrist or fingers. Early attacks usually affect one joint and settle within days to a couple of weeks, but if uric acid stays high, attacks tend to become more frequent and can involve several joints.

Because other conditions – such as a joint infection (septic arthritis) – can look similar, a first attack should always be assessed by a doctor to confirm the diagnosis, sometimes with a blood test or by examining fluid drawn from the joint.

Treating the acute attack

The first goal during a flare is to settle the pain and inflammation as quickly as possible. Doctors in Singapore generally use one of three options, chosen to suit your other health conditions:

NSAIDs (anti-inflammatory painkillers such as naproxen, diclofenac, indomethacin, or COX-2 inhibitors).
Colchicine, which works best when started early in an attack.
Corticosteroids, such as a short course of oral prednisolone or a steroid injection into the joint, often used when NSAIDs and colchicine are unsuitable.

Rest, elevating the joint and applying an ice pack can also help. Importantly, long-term uric-acid-lowering medicine is not started or stopped during an acute attack without medical guidance, as sudden changes in uric acid can trigger or prolong a flare. If you are already on urate-lowering therapy, you usually keep taking it through an attack.

Long-term urate-lowering therapy

Settling an attack does not remove the underlying problem – the high uric acid level. The mainstay of long-term gout control is urate-lowering therapy (ULT), which dissolves existing crystals over time and prevents new ones from forming, reducing future attacks and protecting joints.

ULT is usually recommended for people with recurrent attacks, tophi (lumps of urate under the skin) or uric acid kidney stones. The most commonly used medicine is allopurinol; alternatives include febuxostat and probenecid. These are started at a low dose and gradually increased to reach a target blood uric acid level – generally below 360 micromol/L, or below 300 micromol/L if tophi are present.

Two points matter for safety and success:

ULT must be taken consistently and long-term – often for life. Stopping when you feel well lets uric acid rise again and attacks return.
When starting allopurinol, flares can briefly become more likely, so a doctor may prescribe a low dose of colchicine or an NSAID as cover for the first months. Because the HLA-B*5801 gene (common in some Asian populations) raises the risk of a rare but serious skin reaction to allopurinol, your doctor may consider a genetic test before starting it, especially if you have reduced kidney function.

Lifestyle, diet and self-care

Lifestyle changes support treatment and can reduce how often attacks occur, although many people with recurrent gout still need medication to reach a safe uric acid level. Helpful steps include:

Lose excess weight gradually and stay physically active.
Limit alcohol, especially beer and spirits.
Cut back on purine-rich foods (red meat, organ meats, shellfish and certain oily fish) and on sugary and fructose-sweetened drinks.
Stay well hydrated – aim for around 6 to 8 glasses of water a day unless your doctor advises otherwise.
Manage related conditions such as high blood pressure, diabetes and kidney disease.

Complications and when to see a doctor

Untreated or poorly controlled gout can cause lasting harm: repeated attacks can lead to permanent joint and tendon damage, hard urate lumps called tophi, and uric acid kidney stones. High uric acid is also linked with kidney and cardiovascular disease.

See a doctor if you have a first suspected attack (to confirm the diagnosis), if attacks become frequent or affect several joints, if you notice lumps near joints, or if you have fever with a hot swollen joint (which needs urgent assessment to rule out infection). A GP can diagnose and start treatment, and may refer you to a rheumatologist if gout is severe, hard to control, or you have complications such as tophi or kidney involvement.

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Osteoporosis & bone health

Sources

Last updated 21 June 2026. Prices are typical market ranges gathered from the cited sources and vary by clinic, doctor and individual case — they are not quotes. This guide is general information, not medical advice; always consult a qualified, MOH-accredited doctor before any treatment.

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