It's not just an old man's sickness anymore
Ervin Cariaso, 35, an architectural consultant, describes what it’s like to have an attack of gout. “It was just last May. As in major attack to and I had to take a two-day rest. Hindi [ako] makalakad, eh. This was right after our company’s dinner and dance where I was part of the musical presentation. Imagine kung umatake yun during the night of the event, di ba?
“Nagsisimulang mamula yung paa, usually malapit talaga sa toe. Masakit, parang umiinit. After siguro mga five hours, mapapansin mo parang may bumubukol na. Ayun, ang sakit na nun. Ganun na siya for two to three days usually. Masakit talaga kung sa masakit,” Cariaso adds.
Another gout sufferer, Juan Carlos De Leon, 29, an administrative personnel for a real estate company, says you can’t compare it to any other type of pain. “I cry. I shout—a lot. As in every move I make, sasakit siya nang sobrang sakit. Tapos even the pulse beats cause too much pain especially during the first two days.
Gout is an episodic painful form of inflammatory arthritis due to increased uric acid. Decades ago you would have only heard about gout from your aging parents, but these days the disease appears to be the ultimate party pooper to your enjoyment of food and drink and, increasingly, your youth.
“There is an observation that there seems to be younger patients who get afflicted [with gout],” says Philippine Rheumatology Association President Heizel Reyes. “Those with family history are also at an increased risk. Patients with comorbid diseases such as kidney impairment, blood disorders, or heart disease are also at higher risks by virtue of the disease itself or the medications used for these.”
Data from a 2015 PRA study show that there are 1.6 million Filipinos suffering from gout. THEN-PRA president Eric Amante said that they even expected the number to continue to increase because of people’s unhealthy lifestyles.
“It’s 1.6 million. But if you look at the prevalence in the Philippines, it’s increasing in the past two decades. We have a lot of breadwinners who have gout and I think it’s very important to remember that this is a chronic illness,” Amante said. “Chronic” means it stays with you— for a long time.
THE SIGNS OF GOUT
If there is one thing that Cariaso has learned from his gout, it is to be a more thinking netizen in the age of social media. “This is how I got my gout: Nagkaroon ng trend noon, yung pag-inom ng soya milk. As in every morning bago ako pumasok sa office, umiinom ako nun. Ang alam ko naman kasi is healthy naman ang soya milk.”’
That’s what he thought—until he started feeling its effects. “After a year of drinking soya milk, bigla na lang sumakit yung paa ko. Doon sa may joint ng big toe. At first I thought na-sprain o napilayan lang ako. Kaso every day, lalong sumasakit siya at mas naging swollen talaga yung paa ko,” Cariaso says.
“The only way to confirm talaga is to take a blood test. So right after office, I went to the doctor then yun na nga. Confirmed that it’s gout. Mataas yung level ng uric acid ko... Sabi niya most likely ay talagang sa soya milk yun kasi aside from that, actually ay puro healthy naman ang kinakain ko kasi medyo conscious naman ako with the food I eat. Yung sa soya milk lang talaga,”cariaso adds.
Too much of something was also the case of De Leon. He’s been suffering from gout for a decade now—meaning he got it when he was only 19. “Liver was my ultimate [favorite food] then, and huge servings of monggo. Yun, paborito ko talaga. Tapos I also occasionally drink, eh beer triggers gout. My doctor said high uric acid is caused by eating too much food that are rich in purine like beans, meat, deep-sea fishes, innards, and internal organs like liver. Eh di ba nga, paborito ko talaga nun ang liver tapos monggo pa.”
“When it first hits you, you wouldn’t know immediately that you have gout,” says rheumatologist Dr. Isagani Gabonada. “You’ll most probably think that it’s just normal body pain caused by exhaustion from your activities. Yung sa kaso nila (De Leon and Cariaso), kung sinasabi nila at aminado sila mahilig sila noon sa soya milk at laman-loob there could really be high chances na they got it from those food. You get gout from purine-rich food, no. 1 na nga diyan yung mga laman-loob.”
Cariaso considers himself still
“Parang tinutusok ng pako nang paulit-ulit, pero ang pinagkaiba lang ay hindi nagdudugo. Mabigat talaga, parang pinupwersa sa’yo yung sakit. There are times na magdadasal ka na lang na maputol yung paa mo para wala ng pain.”
lucky that his gout attacks don’t happen often. There are times when symptoms get worse, known as “flares,” and there are times when there are no symptoms at all, known as “remission.” You can never know when flares will attack. As scary as it may sound, it will happen when it happens.
“Minsan hindi mo talaga mararamdaman na may gout ka eh. Bihira lang ako atakihin, twice a year lang. Pero kapag inatake naman ako, one month ‘yun before totally mawala ang sakit,” Cariaso says.
THE CAUSES AND EFFECTS
Gout is caused by hyperuricemia, when there is too much uric acid in the body. According to the Centers for Disease Control & Prevention, the body makes uric acid when it breaks down purines, which are found in the body and the food that you eat. When you have too much uric acid, monosodium urate can build up in joints, fluids, and tissues within the body. These urate “crystals” cause the pain, which some describe as like walking on broken glass.
Gout has often been referenced as a “rich man’s disease” because you get a lot of uric acid when you eat hearty, often meat-based dishes, that the common folk usually don’t get to dig into. But modern society has changed all that. In the age of fastfood and food processing, we are all susceptible to the disease.
Dr. Gabonada sees the threat everywhere. “[For example, in food parks], I see my daughters’ social media feeds and lagi silang nasa food parks, kain sila nang kain kasama ang mga kaibigan nila. Tapos ayun, French fries na punongpuno ng cheese. Mga shake na may mga nakapatong na napakaraming cookies. Kung anu-anong street food na pinasosyal pero basically ay street
food pa rin. Sobrang daming artificial flavorings at kung anu-anong chemical. Kumbaga ay processed food. Ang gout, nakukuha talaga yan with too much intake of unhealthy food and yung mga alak at sigarilyo, lalo na yung alak. Ano ba naman ang magagawa ko at ng iba pang medical professionals para mapigilan ang trend na ganyan? Kaya ngayon, ayan ang nagiging resulta.”
PRA President Reyes concurs with Dr. Gabonada. “One factor [of having gout] may be diet and lifestyle. There is more processed food and sugared beverage that is available [in the market] and, hence, consumed.”
To say that gout affects the quality of life of those afflicted with it would be a gross understatement. If not treated or given attention, chronic gout could potentially lead to kidney stones, joint erosion and deformities, and even kidney failure.
While gout is not considered a fatal ailment, its effects are painful, hence it could affect a person’s performance in school or work. It could even potentially lead to anger, depression, and overall, poor quality of life.
“Sana mas naging aware ako noon sa mga food na kinakain ko. Too much something is bad. Too much sugar can lead to diabetes. Too much salt can damage your kidneys. Too
much uric acid can cause gout. Sabi nga nila, nasa huli ang pagsisisi. Totoo talaga yun,” Cariaso says.
WHAT TO DO
If you do not have gout yet but fear that you might be on your way to it, maybe it’s time to visit a doctor. “Gout, if caught early, is very amenable to treatment. Medications are readily available and are affordable, [although] treatment duration depends on the stage of gout,” Reyes says.
Meanwhile, those who are already afflicted with gout have to make some sacrifices, or risk the disease getting worse. In the case of De Leon, he had to give up his love for monggo and liver. Cariaso, meanwhile, no longer drinks soya milk anymore.
“Foods to avoid are those with high uric acid content [such as] mga laman-loob, sardines, red meat, processed food [and] sweetened beverages,” Reyes says. “Take a lot of water so uric acid can be flushed out of the system. There [are] also some studies that say controlled intake of dairy products is also beneficial.”
It is also important to get physically active as it helps excrete the excess uric acid from your body. Gabonada suggests that adults be active for 150 minutes every week. Some of the activities that he suggests include walking, swimming, or biking 30 minutes a day for five days a week. “Malaking bagay ang pagiging physically active kasi pwede talagang mabawasan yung risks na may ma-develop pa na ibang chronic diseases aside sa gout, gaya ng heart diseases and diabetes.”
De Leon has an advice to those who love food-binging without taking a close look at their nutrient content. “Don’t wait until it happens to you. I tell you, this [gout] is the mother of all KJS (killjoys).”
‘Ang gout, nakukuha talaga yan with too much intake of unhealthy food and yung mga alak at sigarilyo, lalo na yung alak. Ano ba naman ang magagawa ko at ng iba pang medical professionals para mapigilan ang trend na ganyan? Kaya ngayon, ayan ang nagiging resulta.” — Dr. Isagani Gabonada, rheumatologist