Gout arthritis is famous for its red, swollen feet and extreme pain that makes it difficult to wear socks. In such a seizure state, most of the patients actively visit the hospital because of the pain that makes it difficult to maintain daily life. The pain disappears easily when you take an analgesic and anti-inflammatory drug, but the deposition of uric acid, which is the cause, requires constant management throughout your life.
A disease caused by the deposition of uric acid around the joints
Gout is a disease in which sodium urate (monosodium urate) is deposited in or around the joints and shows various symptoms. As the global trend is increasing, Korea is no exception, and the prevalence of gout increased from 3.49 per 1000 in 2007 to 7.59 per 1000 in 2015 (Kim Ji-won et al., Rheumatol Int, 2017). In particular, in Korea, the increase in the incidence rate is higher in the young age group in their 20s and 30s than in the elderly due to the westernization of diet and changes in the living environment.
Severe pain in acute attacks and nodules in chronic attacks
Symptoms depend on the progression. When ‘acute gouty arthritis’ occurs, severe pain, redness, and swelling appear at the affected area. Acute seizures go away easily with medications such as analgesic and anti-inflammatory drugs. When acute gout attacks start to occur, the stage is shifted to intermittent gout in which these attacks occur periodically, and the frequency or intensity of pain increases as time goes by. At this time, if you only receive treatment to control painful pain or inflammation without an appropriate treatment to reduce uric acid, the stage will eventually progress to ‘chronic nodular gout’, and from then on, permanent joint destruction or dysfunction may occur. But more serious problems go on silently.
If it becomes chronic, there is a risk of complications such as cardiovascular disease and kidney disease
Recently, gout is recognized as a metabolic disease, not just arthritis. This is because uric acid, the cause of gout, is generated in the metabolic process of our body, and if gout becomes chronic and progresses to the chronic nodular gout stage, side effects appearing in metabolic diseases may accompany it. Cardiovascular diseases such as angina pectoris and myocardial infarction are typical examples. It has also been reported that cardiovascular disease-related mortality in patients with gout is higher than that in patients without gout, more than doubled. Risks other than cardiovascular disease are observed in the kidney (kidney). Since 2/3 of uric acid is excreted by the kidneys, if the uric acid in the blood is continuously high, urolithiasis may occur and further deterioration of kidney function may result.
Occurrence of metabolic diseases such as high blood pressure, hyperlipidemia, and fatty liver
In addition to the direct cause of cardiovascular disease and kidney complications, gout is often accompanied by several other metabolic diseases, contributing to the increase in the incidence of cardiovascular disease or death from it. In fact, a 2016 domestic study reported that 50.8% of gout patients had metabolic syndrome. In general, 50% to 65% of gout patients are accompanied by hypertension, and approximately 50% are accompanied by hyperlipidemia. Diabetes or fatty liver was also present in about one-fourth of gout patients. Therefore, after the diagnosis of gout, it is necessary to examine whether the metabolic syndrome is accompanied or not, and if it is accompanied, a comprehensive treatment for these is required.
Continuous uric acid suppression treatment is required even after an acute attack
In order to prevent the complications of gout and the occurrence of cardiovascular diseases, it is important to keep the level of uric acid in the blood below the standard by taking a drug that lowers uric acid. These medications are usually taken for the rest of your life. Of course, the management of chronic gout must be accompanied by exercise or diet, but the most important treatment is drug treatment. In the state in which drug treatment is basically performed, exercise or dietary control should be accompanied as an essential adjuvant treatment. This is because it is difficult to suppress uric acid to the desired level no matter how strict diet control (low purine diet, low calorie diet) is. However, since exercise and dietary control are essential to control the accompanying metabolic syndrome together, drug treatment and lifestyle management should be combined rather than giving priority to either one.
How to manage gout in daily life
Those who are overweight should lose weight to a standard weight and eat a low-calorie diet centered on vegetables. In particular, it is best to avoid alcohol, soft drinks containing a lot of fructose, and meat organs such as giblets and sundae.
When you first get diagnosed with gout and tell them what foods to avoid, most people put on a troubled expression when they tell you not to drink alcohol. However, if there is only one food that gout patients should avoid, they choose alcohol without hesitation, so it is good for gout patients to avoid alcohol. Also, there are many people who think that only beer among alcohol is to be avoided, but all alcohol is not good for gout. In particular, as the amount increases, uric acid increases a lot, so it is better to avoid all kinds of alcohol.