Where in Dubai
Dr. Subhash Ushakoyala, Specialist Orthopaedic Surgeon, sees patients with gout at Grand Infinity Medical Center in Al Muteena, Deira, Dubai. Bring a list of every medicine you take, including tablets for blood pressure, and any recent blood test results showing your uric acid level. If you can, come during an attack, when the joint can be seen at its worst.
What is gout?
Gout is a type of arthritis. It happens when there is too much uric acid in the blood, and tiny sharp crystals form in and around a joint. The body reacts to the crystals as if they were an infection, so the joint becomes hot, red, swollen and very tender, often overnight. The big toe is the most common place, but the ankle, knee, wrist, fingers and elbow can be affected too. An attack usually settles in one to two weeks. Without treatment, attacks tend to come back, more often and in more joints, and over years they can damage the joint or form hard lumps under the skin called tophi.
Common signs
- Sudden, severe pain in one joint, often the big toe, that may wake you at night.
- A joint that is hot, swollen and so tender that even a bedsheet hurts.
- Attacks that keep coming back, or now affect more than one joint.
- Hard, chalky lumps under the skin of the fingers, elbows or ears.
- A blood test showing a high uric acid level, with joint pain.
How Dr. Subhash approaches it
His services list includes the treatment of gout among the medical conditions he treats. Dr. Subhash first makes sure it is gout and not an infection in the joint, which can look the same. He examines the joint, arranges a blood test and, when the answer is unclear, an X-ray or a sample of joint fluid. He then treats the attack, and explains what triggers gout and what the options are.
What to expect
Consultation
He asks when the pain began, about earlier attacks, your diet, alcohol, other illnesses and the medicines you take.
Examination
He checks the joint for heat, swelling and redness, and looks for lumps under the skin.
Tests
A blood test measures uric acid and signs of infection. If it is still unclear, a little fluid may be drawn from the joint with a thin needle and tested for crystals.
Treating the attack
Anti-inflammatory medicine is usually first. If it is not enough, a steroid by mouth or by injection may be used.
Preventing more attacks
If attacks keep coming or uric acid stays high, he discusses medicine to lower it, taken every day, even when you feel well.
Review
He reviews how you are doing and changes the plan if needed.
Getting better
Every patient is different. These are typical milestones, not a promise; your own plan comes from your consultation.
- With treatment, an attack usually eases within a few days. Start prescribed medicine as soon as an attack begins.
- During an attack, rest the joint, keep it cool with a wrapped ice pack and drink plenty of water.
- Losing weight slowly, having alcohol-free days and cutting sugary drinks can make attacks less frequent.
- Uric acid lowering medicine needs to be taken regularly and long term to keep gout away.
Risks to know about
- Untreated gout can lead to repeated attacks, lasting joint damage and kidney stones.
When to book a visit
Book a visit if you think you have had a first attack of gout, or if your usual treatment is not working. Book sooner if attacks are coming more often, or you have lumps under the skin near a joint. Go to emergency care straight away if a hot, swollen joint comes with a high temperature, shivering, or feeling sick and unable to eat. This could be an infection inside the joint.
Where to book
Dr. Subhash sees patients at Grand Infinity Medical Center in Al Muteena, Deira, in north-east Dubai. The clinic is at Shop No. 4, next to the Grand Excelsior Hotel.
Grand Infinity Medical Center
Shop No. 4, next to Grand Excelsior Hotel, Al Muteena, Deira, Dubai, United Arab Emirates
DirectionsCall +971 58 599 7460WhatsApp
Questions patients ask
Can fasting or a hot day bring on a gout attack?
Not drinking enough fluid can make gout attacks more likely. On hot days, and when you break a fast, drink plenty of water. Large, rich meals and alcohol are also common triggers.
Is gout caused only by diet?
No. Diet and alcohol can trigger attacks, but gout also runs in families and is more likely with kidney problems, high blood pressure, diabetes and some medicines such as water tablets.
Can I stop my gout medicine when the pain goes?
Not the uric acid lowering medicine. It works by keeping uric acid low over time, so it is taken every day, even when you have no symptoms. Ask before stopping any medicine.
Can my uric acid be high without gout?
Yes. Many people with a high uric acid level never have an attack. Treatment depends on your symptoms and attacks, not on the blood test alone.
Book an appointment
His nurse answers the phone and WhatsApp.