Gout increases in summer... must be managed consistently like a chronic disease

 

Gout is a disease caused by the excessive accumulation of a substance called uric acid in the joints or other tissues. In the past, gout was incurable and had no treatment other than dietary therapy, ultimately leading to death from complications. However, now uric acid-lowering medications have been developed, making it a chronic disease that can be sufficiently managed while enjoying daily life, similar to hypertension or diabetes.

 

Especially around this time of year, the risk of developing gout increases, requiring special caution. This is because factors that affect uric acid levels, such as alcohol consumption and dehydration, become more prevalent in summer. In fact, according to statistics from the Health Insurance Review & Assessment Service, the number of gout patients increases from June to August each year, then decreases after this period.

 

What exactly is uric acid that causes gout?

 

Uric acid is the final metabolite produced when a substance called 'purine,' a type of protein, is excreted from the body through urine and feces. It is naturally generated in our bodies through food intake and cellular metabolic processes.

 

Uric acid crystals, which should dissolve in the blood and be excreted through the kidneys via urine and feces, can become too excessive and fail to dissolve, forming small needle-shaped crystals. These can accumulate in all organs of the body, cause inflammation, and lead to joint pain.

 

Gouty arthritis has been called the "king of diseases" since ancient times due to its severe pain. Gout begins with hyperuricemia, a condition characterized by an excess of uric acid in the body. Normally, the blood level of uric acid is 6.8 mg/dL, and levels exceeding 7.0 mg/dL are defined as hyperuricemia. This condition occurs due to decreased uric acid excretion caused by hypertension, obesity, kidney disease, or due to excessive alcohol consumption, continuous intake of foods high in purines, and genetic factors.

 

Asymptomatic hyperuricemia, if it persists for a long time, leads to uric acid buildup and the first symptoms of gouty arthritis appear. Acute gouty arthritis attacks can be triggered by various causes such as heavy alcohol consumption, overeating, overexertion, stress, medication use, traffic accidents, or injuries.

 

Continue treatment even after symptoms disappear... reduces risk of complications

 

Gout typically begins with intense and severe pain in one side of the big toe, accompanied by redness and warmth of the skin in the affected area. Subsequently, pain appears in more joints, including the big toe, ankle, top of the foot, and fingers.

 

Symptoms usually pass within 7 to 10 days or are asymptomatic, but about 60% relapse within a year. If proper treatment is not provided, the frequency and severity of attacks can gradually increase. In severe cases, tophi may form around the joints, leading to extensive joint damage and large subcutaneous nodules, which can progressively cause disability.

 

Professor Kim Sung-soo warned, "Most patients stop treatment after their first acute gout attack because there are no symptoms during the asymptomatic period, but if left untreated, it can progress to chronic tophaceous gout, leading to fatal complications such as chronic kidney disease, hypertension, diabetes, hyperlipidemia, arteriosclerosis, stroke, and heart disease."

 

It has been reported that if gout patients do not receive proper treatment, their risk of death from heart disease doubles, and chronic tophaceous gout patients have a threefold higher mortality rate compared to healthy individuals.

 

Be cautious with foods high in purines... Abstinence is a must!

 

Caution is also needed in daily life. In particular, high-risk groups for gout such as ▲people whose blood uric acid levels do not decrease easily despite medication ▲people who frequently experience recurrent arthritis ▲people who develop acute arthritis symptoms immediately after overeating should be careful with foods high in purines (see TIP below).

 

In addition, increasing fluid intake to raise urine output to about 2 liters can also be helpful. However, alcohol must be strictly avoided. Alcohol increases the synthesis of uric acid in the blood and suppresses its excretion through urine, thereby increasing the risk of acute attacks. Among alcoholic beverages, beer contains a large amount of purines and is worse than spirits.

 

Professor Kim Sung-soo said, "Gout is a disease that is difficult to cure with just one or two treatments, but it can be easily managed to prevent recurrence if you consistently take a few medications and maintain a healthy lifestyle."