The Season of Chimaek to Beat the Heat... The Worst Enemies for Gout

Daedong Hospital, "Severe Pain Even with a Breeze, Prevention through Dietary Therapy Including Abstaining from Alcohol"

Beer is one of the foods that are contraindicated for patients with gout.

[Asia Economy Yeongnam Reporting Headquarters, Reporter Kim Yong-woo] It is the season that makes you think of crispy chicken and cold beer enjoyed at outdoor tables to forget the summer heat, the so-called ‘chimaek’.

Although beer sales increase every summer, this year especially, due to reduced outdoor activities caused by COVID-19, the population enjoying beer at home has increased, predicting a sharp rise in beer and chicken sales compared to previous years.

Daedong Hospital pointed out ‘gout’ as a representative disease to be cautious of with increased beer consumption in summer. According to the Health Insurance Review & Assessment Service, the number of gout patients was highest in July and August in 2016, showing about a 36% increase compared to January.

By year, the number of gout patients increased by 38.1% over the past five years from 2015 to 2019, and in 2019, 93% of all patients were men, significantly more than women.

Gout, named because even a breeze can cause pain, is an inflammatory disease caused by excessive uric acid buildup in the body.

Excessive uric acid circulates in the body in crystal form and enters joints or ligaments, which the human body recognizes as harmful substances, prompting the immune system to attack the uric acid crystals. This process causes joint swelling and pain.

A Daedong Hospital official said, “The reason why gout is more common in men than women is that men’s kidney ability to remove uric acid decreases with age, whereas women maintain this ability due to female hormones until menopause.”

Not everyone with high uric acid levels shows symptoms. Depending on the natural course, it can be divided into four stages: asymptomatic hyperuricemia, acute gouty arthritis, intermittent gout, and chronic tophaceous gout. ‘Asymptomatic hyperuricemia’ refers to a state where blood uric acid concentration is elevated but no symptoms appear.

The causes of gout include obesity, hypertension, diabetes, hyperlipidemia, excessive alcohol consumption, Westernized dietary habits, and continuous stress. Additionally, menopause, high fever, joint trauma, kidney disease, and genetic factors can also contribute to gout. Rarely, overwork, overeating, rapid weight loss, and intense exercise can increase blood uric acid levels.

The pain of gout is characteristically severe beyond description. In ‘acute gouty arthritis,’ various joints such as the big toe suddenly become red, swollen, and painful. If untreated during this period, the condition can progress through the symptom-free ‘intermittent gout’ phase to the ‘chronic tophaceous gout’ stage.

In chronic cases, mild pain persists continuously, and nodules formed by uric acid crystals appear on the body.

Treatment of gout involves a combination of medication and dietary therapy. Treatment methods vary slightly for each patient, and even for the same patient, acute phase treatment differs somewhat from long-term treatment.

In acute cases where joints suddenly become painful and swollen, nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, known as anti-inflammatory analgesics, can be used.

However, for those who do not frequently experience gouty arthritis or whose blood uric acid is not very high, symptoms are controlled as much as possible without medication through weight control, moderation of alcohol consumption, avoiding overeating, and appropriate dietary therapy.

In particular, to maintain normal uric acid levels, it is advisable to avoid foods containing a lot of ‘purine,’ the substance that is a precursor of uric acid. Meat, seafood, and especially beer must be avoided by gout patients. On the other hand, milk promotes uric acid excretion and prevents accumulation in the joints, thus helping in the prevention and treatment of gout.

Dr. Park Ji-hye, Rheumatology Department at Daedong Hospital, advised, “Gout is closely related to alcohol. Drinking alcohol increases uric acid production in our body and interferes with its excretion through urine. Especially beer contains purine, which is antagonistic to gout, so abstaining from alcohol is important.”

She also said, “Foods often eaten with beer, such as fried chicken, red meat, and high-calorie foods, also contain purine, the precursor of uric acid, so special caution is needed in their consumption.”