The number of gout patients, a disease known to be so painful that even a light breeze can cause tremendous pain, is steadily rising. The number of young gout patients in their 20s and 30s, in particular, is rapidly increasing. According to the Health Insurance Review and Assessment Service, the number of patients in their 20s seeking hospital treatment for gout has increased by 49% over the past five years. Previously, gout was understood as a disease common in middle-aged and older people, but that no longer seems true.
Sudden pain in the big toe
Gout is a disease in which urates deposit in the joints and surrounding soft tissues due to a high concentration of uric acid in the blood. If uric acid is not properly excreted, it accumulates in the body, leading to gout. Gout is accompanied by swelling, redness, and heat in the big toe. When a storm occurs, non-steroidal anti-inflammatory or steroid drugs are used to quench inflammation.
Is a light breeze enough to cause excruciating pain?
Gout, also known as the king of diseases, got its nickname because it is so painful. Even a light breeze can cause discomfort. Urate crystals are sharp, like needles, and can cause severe pain. If gout is not properly treated when the pain first occurs, the frequency of pain increases over time and eventually leads to joint damage and chronic kidney diseases, such as kidney stones.
What’s the reason behind the increasing number of young gout patients?
Changes in dietary habits and drinking culture can be cited as reasons for the recent increase in young gout patients. In particular, the trend of eating a lot of fried chicken or delivery foods and drinking mixed alcoholic beverages such as highballs is likely to be the main cause. Physical activity is diminished while the intake of high-fat, high-protein foods is increased, leading to a rise in obesity rates. Mixing alcoholic drinks makes the body more acidic with alcohol, hindering the excretion of uric acids. Further, mixed drinks contain carbonic acid and fructose, which can excessively increase the concentration of uric acid in the blood and, therefore, increase the risk of a gout storm.
Does a high uric acid level always signal gout?
Not everyone with high uric acid concentrations has gout. If your uric acid level exceeds 7, you have “hyperuricemia” and should suspect gout. If the figure exceeds 9, you can be certain you have gout. A gout diagnosis is made only when the uric acid level is high and reasonable clinical evidence is found through ultrasound or X-ray tests. “Asymptomatic hyperuricemia,” which shows no symptoms despite high uric acid levels, is mostly harmless. Still, in some cases, it eventually exhibits symptoms such as gouty arthritis or kidney stones after a long period of asymptomatic stage.
The symptoms of a gout storm are divided into four stages
Gout is divided into four stages according to its symptoms. The first stage is known as “asymptomatic hyperuricemia,” where the uric acid level has risen but no visible symptoms. The second stage is “acute gouty arthritis,” where hyperuricemia suddenly turns into acute gout. The third stage is “intermittent gout,” an asymptomatic period following an inflammation storm. Storms can occur repeatedly if the management is poor at this stage or if there are certain constitutional factors. The final fourth stage is “chronic tophaceous gout,” where poor care leads to nodules and joint deformities a few years after the initial storm.
Maintaining an appropriate weight is the key
To prevent gout, you must maintain an appropriate weight through regular exercises. Exercises that can be done sitting or lying down, such as swimming, yoga, and indoor cycling, are recommended, and doing more than 150 minutes of aerobic exercise per week can help you lose weight.
Rapid dieting is a no-no
Rapid dieting to maintain weight is a big no-no! Intense exercises or dieting can trigger a gout storm. If you undergo extreme fasting to lose weight, although the concentration of uric acid in the body may decrease, the uric acid will stick to the joints. This can lead to severe arthralgia, and if the concentration of uric acid in the blood fluctuates greatly instead of remaining constant, the risk of gout can increase.
Even eating a lot of chicken breast can be dangerous
Protein produces a lot of waste when it is digested. If you consume too much protein, “uric acid,” a waste product of protein metabolism, is produced excessively. When the concentration of uric acid in the blood increases, uric acid reacts with sodium to crystallize into urate. Urate accumulates in the joints and the surrounding tissues, causing an autoimmune inflammatory response and pain, which can lead to gout.
Who is at risk of gout?
The risk groups for gout include patients with metabolic syndromes such as obesity, diabetes, and hyperlipidemia. Obese men with a lot of visceral fat are at a higher risk of gout and need to be particularly careful. This is because visceral fat inhibits metabolism and increases the risk of gout. In addition, fat cells produce a substance called “adipokine,” which induces inflammation and can cause gout.
A disease that requires life-long management
If you have gout, the pain can be relatively easily controlled with anti-inflammatory analgesics and steroids. However, the fundamental treatment is more difficult because urate crystals cannot be removed, and the joints are slowly destroyed. At first, you take medication to ease the severe pain, but once the pain disappears, you return to your unhealthy lifestyle as if nothing had happened and repeat the vicious cycle. Since gout can be treated simply by changing your habits, it’s important to have patience and prevent recurrence.
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