Gout: Understanding and Managing Uric Acid in Korea

Gout is a form of inflammatory arthritis caused by the deposition of monosodium urate (uric acid) crystals in joints. When uric acid levels in the blood (hyperuricaemia) rise too high — due to overproduction or underexcretion — crystals can form and trigger intensely painful inflammatory attacks. The metatarsophalangeal joint of the big toe is the classic site, but knees, ankles, wrists, and elbows are also commonly affected. Attacks typically begin suddenly, often at night, with excruciating pain, redness, and swelling that peaks within 24 hours.

Gout is increasingly common, driven globally and in Korea by rising rates of obesity, metabolic syndrome, high-purine diets, and alcohol consumption. Certain foods significantly raise uric acid: red meat, organ meats, shellfish, and fructose-sweetened drinks — alongside Korea's frequent soju and beer culture, which is a notable contributing factor. Medications including diuretics, low-dose aspirin, and some immunosuppressants can also raise uric acid. Kidney disease impairs uric acid excretion. Chronic gout leads to tophi (uric acid crystal deposits under the skin) and joint damage.

Acute attacks are treated with NSAIDs (ibuprofen, indomethacin), colchicine, or corticosteroids. Long-term urate-lowering therapy — primarily allopurinol — is recommended for patients with recurrent attacks, tophi, or kidney stones. The target uric acid level on treatment is below 360 µmol/L (6 mg/dL). Dietary modification — reducing red meat, shellfish, fructose, and alcohol — and maintaining good hydration, especially during Korea's hot, humid summer, are important adjuncts.