Gout is a disease characterized by the deposition of uric acid in the joints and surrounding soft tissues, causing severe pain. It is common among men in their 40s and 50s, mostly occurring in the big toe, and also appears in the ankles and knees.

For gout treatment, it is most important to suppress the accumulation of uric acid or to excrete it through urine, and to lower elevated uric acid levels by taking 'uric acid-lowering agents.' Gout is a condition that is managed lifelong with medication, not surgery or procedures.

Start treatment if there are two gout attacks per year.

If gout attacks occur more than twice a year, uric acid-lowering therapy should be initiated with medication. However, in cases of chronic illness, uric acid levels of 9 mg/dL or higher, or the presence of kidney stones, it is advisable to start uric acid-lowering treatment immediately after the onset of gout regardless of the number of occurrences. According to some studies, 13% of asymptomatic patients without gout nodules who took uric acid-lowering agents for more than a year maintained a uric acid level below 7 mg/dL (normal) without recurrence for five years. However, since most tend to relapse, it is recommended to continue uric acid-lowering medication if there are no side effects.

Caution for gout patients with hypertension and hyperlipidemia regarding medication

Gout patients must take medication and manage their condition for life. When accompanied by metabolic syndrome such as abdominal obesity, hypertension, and hyperlipidemia, these medications should also be taken together, but caution is necessary. Among antihypertensive drugs, diuretics increase blood uric acid levels, so for gout patients with hypertension, medications containing diuretics such as thiazide and furosemide should be discontinued and replaced with antihypertensive drugs containing losartan, which lowers uric acid. For gout patients with hyperlipidemia, medications containing statins that promote uric acid excretion are recommended, and for triglycerides, fenofibrate should be used.

Uric acid-lowering agents are metabolized by the kidneys or liver, so the choice of medication should consider the patient's underlying conditions, and regular blood tests should be conducted to monitor liver and kidney function during medication use. Most of these medications effectively lower uric acid levels without significant side effects, and the benefits of taking the medication outweigh the risks associated with not taking it; therefore, adherence to the prescribed medication is important.

Meanwhile, there have been research findings indicating that low-dose aspirin in the past can increase blood uric acid levels. However, if you are taking aspirin for heart or other conditions out of concern, there is no need to stop it. If you need to take medication for headaches or pain, it is recommended to use a different analgesic rather than aspirin.

◇Avoid internal organs and be cautious of beverages containing liquid fructose

Uric acid, which causes gout, is a waste product formed when purines (compounds formed by the fusion of pteridine and imidazole) found in food are broken down. Since purines are broken down into uric acid, it is advisable to eat foods low in purines. In particular, it is recommended to avoid organ meats such as meats and internal organs, and among seafood, it is better to reduce intake of shrimp and shellfish.

Liquid fructose used to add sweetness to food raises uric acid levels, so beverages or foods containing fructose should be avoided. Beer increases blood uric acid levels, so it should be remembered that it is worse for gout patients than spirits. Above all, gout patients often have multiple metabolic disorders and are affected by their diet and other medications they take, so it is important to consult with a specialist to provide personalized treatment suitable for the patient.

===============

Gout is a disease so frightening that even a breeze passing by can cause pain.

A lifelong medication...

You should pay more attention during Chuseok.

Beer is a strong liquor...

It's best to avoid sweet drinks.