If you suffer from “acute gout attack” after the holidays, be careful[약통팔달]

[이데일리 나은경 기자]Winter is coming, the fear of gout sufferers. As the name suggests, pain is felt even when the wind blows. Gout gradually worsens from autumn when the cold wind begins to blow, reaching its peak in the middle of winter. The lower the temperature, the easier it is for uric acid to solidify and build up in the joints, which is why symptoms appear more in the toes, which are the coldest parts of the body.

According to the Health Insurance Review and Assessment Service, the number of gout sufferers 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 fatty foods and alcohol during the holidays, sleeping after drinking or in the morning after suffering an acute gout attack.

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 behind after a substance called purine is not broken down or excreted even after metabolism. Normally, uric acid is excreted via the kidneys in the urine, but the kidneys have a limited ability to excrete uric acid. After that, when uric acid builds up, crystallizes and attaches itself to the joints, our body’s immune cells think they are bacteria or viruses and attack them, causing pain.

Purine is rich in refined carbohydrates, meat broth, anchovies, mackerel, mushrooms, liver, dried fish, shellfish and animal organs, and is also found in beer, makgeolli and wine. The purine content of spirits such as soju and whiskey is known to be relatively low, but it should be noted that alcohol itself is not good for gout. This is because alcohol prevents the elimination of uric acid in the urine and increases the synthesis of uric acid in the blood, making gout worse. Regardless of the main type, it is recommended that you beware of excessive alcohol consumption if you are suffering from gout.

Generally, the treatment of gout is divided into △ treatment of the gout attack (colchicine), which treats the acute gout attack, and △ treatment of hyperuricemia (allopurinol, febuxostat, benzbromarone), which lowers the concentration of uric acid in the blood. Treatment of hyperuricaemia prevents long-term complications of gout, suppresses uric acid production (allopurinol, febuxostat), or promotes uric acid excretion (benzbromarone).

During an acute gout attack, you shouldn’t take new medications to lower uric acid levels or change your medications. This is because if you change the uric acid concentration, the inflammation gets worse and the pain gets worse and lasts longer. Inflammation is first relieved with colchicine, etc., then during the period without seizures medications should be taken to lower the concentration of uric acid.

In most cases, medications are stopped when the pain subsides, but as with most medications, if treatment for hyperuricaemia is stopped, the gout will recur. The Gout Research Group of the Korean Rheumatology Society has announced the results of a survey that the likelihood of relapse within 2 years of stopping gout medications reaches 90%.

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