[이데일리 나은경 기자]Winter is coming, the fear of gout patients. As the name suggests, the pain is felt even when the wind blows. Gout gradually worsens from autumn when the cold wind starts to blow, reaching its peak in midwinter. The lower the temperature, the easier it is for uric acid to solidify and accumulate in the joints, which is why symptoms appear most in the toes, which are the coldest parts of the body.
According to the Health Insurance Review and Assessment Service, the number of gout patients in Korea increased from 265,000 in 2012 to 490,000 last year, a 1.8-fold increase in less than 10 years. In particular, after holidays such as Lunar New Year or Chuseok, more and more people go to the hospital after enjoying oily holiday food and alcohol during the holidays, while sleeping after drinking, or the next morning after suffering an acute gout attack.
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Gout is a disease in which the concentration of uric acid in the blood rises and forms crystals, causing extreme pain, heat, and swelling in the joints. Uric acid is a kind of residue left after a substance called purine is not broken down or excreted even after metabolism. Normally, uric acid is excreted in the urine through the kidneys, but the ability of the kidneys to excrete uric acid is limited. After that, when uric acid accumulates and crystallizes and attaches to the joints, the immune cells of our body think they are bacteria or viruses and attack them, causing pain.
Purine is abundant in refined carbohydrates, meat broth, anchovies, mackerel, mushrooms, liver, dried fish, shellfish, and animal organs, and is also found in beer, makgeolli, and wine. It is known that the purine content of spirits such as soju and whiskey is relatively low, but it should be noted that alcohol itself is not good for gout. This is because alcohol prevents uric acid from being excreted in the urine and increases uric acid synthesis in the blood, which makes gout worse. Regardless of the main type, it is recommended to be careful about excessive drinking if you are a gout patient.
Generally, gout treatment is divided into △ gout attack treatment (colchicine), which treats acute gout attack, and △ hyperuricemia treatment (allopurinol, febuxostat, benzbromarone), which lowers blood uric acid concentration. Hyperuricemia treatment prevents gout complications in the long term, suppresses uric acid production (allopurinol, febuxostat) or promotes uric acid excretion (benzbromarone). .
During an acute gout attack, you should not take any new medications to lower uric acid levels or change your medications. This is because if you change the uric acid concentration, the inflammation worsens and the pain worsens and lasts longer. Inflammation is first relieved with colchicine, etc., and then drugs to lower the uric acid concentration should be taken during the seizure-free period.
In most cases, medication is stopped when the pain subsides, but as with most medications, if you stop taking the hyperuricemia treatment, gout will recur. The gout research group of the Korean Society of Rheumatology announced the results of a survey that the probability of recurrence within 2 years after stopping gout medication is as high as 90%.