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Gout is not only a very common disease, but also one of the oldest diseases ever described in medicine. So, for example, even Hippocrates defined it as acute pain in the foot (“under” - “leg” in Greek, “agra” in translation defines “trap”). It is noteworthy that a disease so widespread today was previously considered nothing more than a “disease of kings”, while at the same time introducing it to a very significant role - to the “king of diseases”. Moreover, this was not the end of its introduction to one or another feature of sick people, because gout was also considered as a disease of aristocrats, the disease fell under the definition of one of the signs of genius.

Not without reason, and, apparently, as supporting the indicated specificity of facts, there is evidence that Alexander the Great and Leonardo da Vinci, representatives of the Medici family, Darwin, Newton suffered from gout ... This list could be continued, which, however, in any case will reduce the information to one fact that is certainly relevant today: despite some selectivity of this disease, today it is “available to everyone”.

That is why we will consider in detail the symptoms of gout and those features that are generally relevant for the disease.

Causes of the disease

Gout damages all joints. However, it often develops into a chronic disease. Therefore, it is necessary to avoid this ailment, which can cause a lot of inconvenience to a person. Well, in order to protect yourself from gout, you need to know about the causes of this disease.

The root cause of gout is called an excess amount of uric acid, which circulates in the blood for a long period and accumulates. Over time, the process of crystallization starts, as a result of which deposits form in the tissues.

This causes foci of inflammation. What other causes of gout exist?

1. Often, gout is a side effect of medications or the result of their improper use. These are drugs that interfere with the normal functioning of the kidneys - Aspirin, diuretics.
2. Obesity, diabetes mellitus, psoriasis, lead poisoning, and kidney failure contribute to the development of pathology. The cause of the exacerbation is injury or surgery.
3. Gout often occurs in people who regularly consume purine-rich foods. Fatty meat, seafood, soda and alcohol contribute to the accumulation of these substances.
4. Heredity plays a big role. With the right lifestyle and a healthy diet, the disease proceeds in a latent state and progresses after a negative impact.

Gout predominantly affects men aged 30-50 years. However, the problem begins to appear more often in women, especially during menopause.

Experts distinguish between two forms of the disease. The appearance of the primary form is due to the accumulation of purines, and the second - the development of pathologies and the misuse of medicines.

Gout is caused by persistent and elevated levels of uric acid in the blood. During the course of the disease, urate crystals are deposited in organs, joints and other body systems.

Sodium urate crystallizes and is deposited in the joints in small particles, which ultimately leads to complete or partial destruction of the joints.

For this reason, such situations are called microcrystalline.

A large amount of uric acid in the body happens for 2 reasons: the first is when healthy kidneys cannot cope with the removal of a large amount of uric acid, the second is the release of uric acid in a normal amount, but the kidneys cannot remove it.

Every year more and more people suffer from gout. Doctors explain this phenomenon by the fact that people have recently been more likely to take food that is rich in purines (for example, fatty fish, meat) and a large amount of alcoholic beverages.

This confirms that the percentage of people suffering from gout decreased sharply during the wars due to the fact that alcohol and meat products are difficult to obtain.

gout symptoms

Gout is characterized by a common attack of gouty arthritis - it is usually inflammation of the joint, often the joint of the big toe, ankle or knee.

As a rule, an attack of gout occurs at night or in the early morning, it is manifested by severe pressing unexpected pain in the joints, swelling of the affected joint, fever in the joints, redness and glossiness of the skin.

Pain in the daytime is slightly less, but by night they increase again, the duration of an attack of gout lasts from 2-3 days to a week, sometimes longer.

When an attack is repeated, other joints are involved in such inflammation, which can lead to partial destruction of the joints.

Gout is manifested by such signs: peculiar growths appear on the legs or arms, the level of uric acid rises significantly. When the growths (tophi) begin to burst, a person may notice whitish crystals of uric acid.

Perhaps the appearance of quite intense pain in the affected areas. Similar salt deposits in the joints interfere with a full life.

Signs and symptoms of gout

Let's talk about the signs and symptoms of gout. The first stage of the disease has no symptoms. In the body, the amount of uric acid salts increases, which lead to the onset of the disease. The duration of the stage can be calculated in decades.

In the second phase, gouty arthritis appears. At this stage, the disease is manifested by swelling and pain in the area of ​​the diseased joint, high fever. The clinical picture is characterized by pronounced symptoms.

Signs and symptoms of gout

Arthritis, or a tendency to get arthritis, is one of those diseases that has fairly obvious symptoms. During this disease, inflammation of the joints of the big toes or knees occurs. The ankle joints may also become inflamed.

Most often, attacks that cause inflammation occur in the morning or in the middle of the night. A person suddenly begins to ache in the joints, and the affected area quickly swells and becomes redder. All this can cause an increase in temperature, so the patient can drink an antipyretic or pain reliever.

After a night attack, the pain decreases. During the day, the joints may not bother the patient at all. However, closer to the night, the pain increases markedly. Usually such attacks are observed within a few days. Sometimes the duration of an attack can be more than a week, which causes a lot of inconvenience to a person.

Symptoms of this disease can be not only internal, but also external. Usually, patients develop growths on the fingers of the extremities. This means that the level of uric acid in the cells has increased. Such growths can hurt and even burst. That is, the disease interferes with a normal life.

Uric acid accumulates in the joints gradually, and if the disease is not treated, it affects not only one joint, but can gradually spread to all.

The disease begins asymptomatically, and only a sharp attack of pain and redness of the inflamed area can tell that there are serious problems that require an immediate solution.

gout symptoms

Some people ask, gout, what kind of disease? Is it inflammation of the joints or kidneys?

In this case, both suffer. This is the accumulation of urates (salts of uric acid) in the body.

For example, in Tibetan medicine, it is believed that this disease is perfectly treated not only with diet, but also with acupuncture. In addition, the liver, pancreas, and not just the kidneys are treated.

To do this, use herbal remedies, acupressure and acupuncture.

Also, the symptoms of this disease may include not only pain and inflammation of the joint, but also other symptoms associated with the development of the disease:

• Lack of appetite;
• Nausea, heartburn;
• Increased excitability;
• High blood pressure;
• Loss of taste.

Since the course of the disease can be complicated by excess weight, then, first of all, doctors recommend getting rid of it. There is a special diet in which certain foods are excluded:

• Spicy food and smoked meats;
• Fish and meat canned food;
• by-products;
• Coffee and chocolate.

• fruit juices;
• Steamed vegetables and meat.

Of course, the patient should not drink alcohol and soda.

Usually, the signs of gout allow the patient to independently draw conclusions about the need to change the diet and lifestyle, because it not only restricts movement, but also causes severe pain.

Do not confuse this disease with problems of orthopedics, because in this case there is a violation of metabolism and kidney function.

Sometimes patients confuse this problem with valgus (bulging of the bone) or subluxation, but in fact this is a problem of a completely different nature.

Most often, gout occurs in men over 40, and very rarely in women.

Known myths with this disease:

1. Deformation and inflammation of the thumb bone is a sign of gout. It may be another disease, so it is very important to take tests and go for an x-ray.
2. Wash the kidneys well with beer. In fact, beer, like other alcohol, should not be consumed, it is better to eat watermelon. Beer contains purine, which, on the contrary, contributes to the development and progression of gout.
3. Gout is the cause of alcoholism. In fact, this is not always the case. An important role is played by the hereditary factor and metabolic disorders.
4. Some believe that gout contributes to genius. Although in fact the fact has not been proven, but this may well be. So many scientists, writers and politicians suffered from gout. Scientists believe that uric acid salts have a stimulating effect on the brain and are similar to caffeine or theobromine, which are considered powerful stimulants of activity;
5. And the last myth says that gout is not treated. However, it is not. Although it has existed for hundreds of years, doctors are finding more and more effective ways to combat this disease, and in any case, if you continue treatment, then recovery will come, or an improvement in the patient's condition. The most important thing here is self-discipline and taking the right drugs.

Doctor's appointment

So what is gout and how does it manifest itself? You may have to self-examine if the disease is not seen by a doctor.

In the absence of visible factors, such as: inflammation, fever, and others, you can visit an x-ray room and take a picture of the joint, or go for an ultrasound scan of the kidneys, which is available to everyone.

If you do not start the disease, then it will be much easier to treat it.

Recurrent attacks within 6-12 months become chronic. Therefore, it is very important not to start the appearance of symptoms and start treatment on time.

The last stage of the disease is characterized by very strong degenerative changes in the joints and even tendons, so any treatment and diet will delay the transition to the worse.

Since the disease most often captures the bone of the thumb, it is quite natural that the treatment of gout on the leg will be complicated by the large weight of the patient.

Therefore, the first step, along with taking drugs, is a diet. It should not be temporary, but permanent, so you will have to radically change your lifestyle.

Iodine treatment

The main treatment is prescribed by the doctor, he will also tell you what diet the patient should follow. In parallel with traditional treatment, you can also consult about the use of traditional medicine.

Decoctions and infusions

In order to free the body from excess uric acid, you can use healing infusions and decoctions. It is also good to include eggplant in the diet.

Diagnosis is made naturally by a doctor. In this case, it is a rheumatologist. He bases his diagnosis on an external examination, as well as the symptoms that the patient calls him.

In addition, tests are given to determine uric acid, leukocytes and creatinine.

Studies such as: ultrasound of the kidneys and x-rays can be prescribed if the disease bothers you for a long time. Since tophi destroy the joint, the doctor needs to know the degree of damage to the limbs.

The treatment of gout is that the patient's diet is completely adjusted.

It is necessary to reduce the level of uric acid, therefore, in addition to adjusting the diet, the doctor will prescribe non-steroidal anti-inflammatory drugs:

• Alopurinol;
• Sulfinperazone;
• Uralit;
• Colchicine;
• Fullflex (it happens both in capsules and in the form of an ointment).

These drugs are often taken by patients for life. They must be selected by a specialist. Self-treatment for this disease is not welcome, otherwise you can only harm yourself.

In addition, you can use ointments:

• Butadion;
• Metindol;
• Voltaren;
• Indomethacin.

indomethacin for gout

All of them will relieve inflammation and pain. In addition, the doctor decides on the appointment of additional painkillers and possibly corticosteroids. In addition, the doctor may prescribe other medicines.

Uricosuric drugs for the treatment of gout:

• Etamide;
• Ketazon;
• Anturan;
• Benemides.

With a lull in the disease, physiotherapy can be used. Applications with ozocerite, therapeutic mud and paraffins allow you to increase the mobility of the joint and make it possible to make you feel better.

Risk factors for this disease are considered not only heredity and the abuse of certain types of foods and alcohol, but also a sedentary lifestyle, obesity, diabetes and other problems.

A significant role in the treatment of gout is given, first of all, by patients' diet. It is important to limit the consumption of fish and meat products, sorrel, legumes, cauliflower, coffee, chocolate, raspberries, figs, tea, spinach, sorrel, legumes.

Do not drink alcoholic beverages, especially beer and wine.

The volume of fluid consumed daily should be increased to two liters in case there are no contraindications in this regard. Juices and cranberry juice, mineral alkaline waters can be considered as options.

As a rule, the victims of gout are people with a good job, who do not deny the pleasure of eating and who love big feasts. Periods of exacerbation of this chronic disease alternate with remissions.

Without treatment, gout attacks become more frequent and more intense. As a result, this leads to damage to large joints, disruption of the kidneys and disability.

Knowing how to treat gout will help to avoid such a fate. Modern methods of struggle are based on folk remedies and pharmacy medicines.

The main principle of treating gout is to control the level of uric acid in the body. For medical treatment, you need to contact a rheumatologist.

Its prescriptions are aimed at reducing the amount of uric acid and its rapid removal from the body. Only qualified specialists can prescribe drugs that do not cause more harm to health with a possible concomitant disease.

Doctors often prescribe non-steroidal anti-inflammatory drugs for 1-2 weeks, such as diclofenac, indomethacin, metindol, butadione, naproxen. To quickly reduce the concentration of uric acid in the body, orotic acid, hepatocatazal, allopurinol, thiopurinol, milurit can be prescribed.

To stop the acute symptoms of gout, the use of colchicine is recommended.

Gout is a rather unpleasant disease that my sister suffered from. I rarely see her, but somehow I wanted to visit her.

When I arrived at her place, I was greatly surprised that she walked around the house and garden barefoot. At first I thought that she nevertheless decided on the operation, but it turned out that she was cured with the help of traditional medicine.

I did not believe that folk recipes can be so effective. And of course, I asked her for recipes, there are two of them - for external and internal use.

An internal remedy is made from the roots of red madder. 1 tsp these roots are poured with boiling water (1 cup), infused, but it is better to boil it for ten minutes in a water bath. The infusion is taken half a glass in the morning and evening.

A little more difficult is the case with an external agent. First, three vials of valerian tincture and a bottle of triple cologne are mixed, left to infuse overnight.

Then, with this mixture, sick areas are lubricated at night, i.e. protruding bones with a cotton swab. After a few days, the joint will twist, itching may occur.

The main thing is the desire to be treated and a lot of patience.

As a result, my sister treated gout with these folk remedies until she noticed that she had no pain and the bone had decreased. It turns out that folk recipes can replace the surgeon's knife.

Savior from the forest

One woman and her friend went to the forest for berries one summer. There was a lot to collect, but on the way back, her leg swelled and her big toe blackened.

They thought that they would not even be able to reach the road, but suddenly they saw an elderly woman with a staff. As in a fairy tale appeared savior.

She immediately noticed the problem that she whispered over the sore finger, after which the pain went away, and then she said what she needed to do to make everything heal.

It was necessary to pour iodized salt (500 g) into the pan, pour it with a small amount of water and boil until the water evaporated. After the water boils away, medical vaseline or chicken fat (200 g) is added, everything is mixed.

A compress is made from the resulting solution for the night. It is better to lay the solution on a woolen cloth, securing it with a bandage.

However, in addition to the external use of the ointment, you can also take a decoction of linden inside.

Recipe number 1. This method is well suited in the treatment of classic gout, which is more common on the extremities. Iodine perfectly copes with wounds of various sizes, as well as with such growths on the skin. To increase its effectiveness, you can use aspirin.

10 mg of iodine is measured, in which five aspirin tablets are dissolved. With the direct interaction of the 2 components, the liquid begins to lose its dark brown color.

The mixture is ready when the iodine is completely decolorized. The resulting mixture is used to treat the legs or arms 2 times a day - in the morning and in the evening.

Recipe number 2. There is another way to treat gout at home, based on iodine.

You can do special iodine baths. To do this, mix 3 drops of iodine, 1 tsp.

l. soda and 1 liter of clean warm water.

The legs are lowered into the resulting mixture and held for 15 minutes. Usually, for the 1st time, three liters of the product is enough.

This treatment lasts 10 days. During this time, the growths disappear without a trace.

Mustard for gout

At home, gout can be easily cured with a special gruel. For its preparation, mustard powder is taken, 1 tsp.

l. honey and regular baking soda.

The components mix well, the resulting mixture is applied to the affected joints, which must first be steamed. The limbs are wrapped on top with plastic wrap and secured with bandages.

Such a compress is left all night on the skin. Treatment must be continued for at least 2 weeks, doing the procedure every day.

For the successful treatment of gout, it is very important to follow the simple rules of a healthy diet. You should limit the use of fish and cape, sorrel and cauliflower, exclude spinach.

Chocolate, coffee, berries, figs and strong green tea can be consumed in the first half of the day in small quantities. It is also mandatory to exclude various wines and beer from the diet.

Instead, it is necessary to significantly increase the amount of clean water consumed.

You can use freshly squeezed juices and not very sweet fruit drinks, alkaline mineral water. The patient with such a diet will begin to lose weight, which has a positive effect on the treatment of gout.

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Disease prevention

In order to protect your body from the appearance of such an unpleasant disease as gout, a person needs to reconsider his lifestyle. This is especially true for those people who have suffered injuries to the limbs, since gout first appears in such places.

Therefore, if you broke your arms or legs, then carefully consider those places where there were fractures. This will reduce the risk of developing the disease.

Do not wear uncomfortable shoes that constrain the foot. The fact is that such shoes can harm the big toe, which is so prone to gout.

You also need to watch your diet and do not abuse alcohol. Much depends on this moment, so it needs special attention and gout will not be terrible.

And earlier there was an article about worms and prevention.

In recent years, gout affects an increasing number of people, it manifests itself in women and young people, which is associated not only with malnutrition, but also with a sedentary lifestyle.

Therefore, gout on the leg is now not uncommon, and it is characterized by a sudden onset and sharp pains. Someone writes off all this for injuries, others consider shoes to be the cause, but in fact it is sick kidneys, salt deposits, and, of course, a lot of weight.

If the pain began to bother, then you should consult a doctor, and do not delay the treatment of the disease, as it quickly passes into the chronic stage.

How to prevent the onset of the disease:

• We do not allow kidney disease;
• When switching from an active lifestyle to a sedentary job, you need to play sports or gymnastics;
• We try to eat right;
• We do not start the weight;
• We try to avoid heavy physical exertion;
• We do not abuse diuretic drugs;
• Do not wear too high heels;
• We are trying to reduce alcohol consumption.

avoiding high heels

In this case, there is a greater chance that the disease will bypass.

Best of all, if there is gout on the legs, the doctor will tell you how to treat it. Do not rely only on traditional medicine. The development of the disease can lead to kidney failure, and this is already serious.

With such a disease, responsibility and self-discipline are required, as well as cooperation with doctors. Do not start the slightest symptoms, do prevention, visit your doctor.

Which doctors can help with this disease:

1. Therapist;
2. Nephropathologist;
3. Urologist;
4. Rheumatologist.

If there is no narrow specialist, then the therapist or urologist is almost everywhere.

With competent and proper treatment, the prognosis of the disease is favorable. Failure to comply with the above rules may result in disability.

Prevention of gout

Gout can be accompanied by diseases such as obesity, diabetes mellitus and hypertension, so prevention and treatment must be carried out in combination.

Almost any disease can be cured if you start it on time and follow the doctor's recommendations.

Health problems are easier to prevent than to treat. Gout is called an eating disorder. For this reason, the prevention of exacerbations involves a change in lifestyle and taste habits.

1. Watch your diet, do not abuse foods high in purines.
2. Do sport. Do not subject the body to heavy loads. walking, morning run and light exercise abound. The main thing is that the joints do not receive a large load.
3. Drink plenty of fluids, which contributes to the timely and complete removal of excess uric acid from the body.
4. When sedentary, try to compensate for the lack of activity with regular training. Additionally, it will help to get rid of extra pounds that load the joints.
5. Refuse narrow and uncomfortable shoes and clothes. Such items are harmful to the joints.

Diet for gout

In this case, the doctor may suggest limiting the intake of foods such as:

• Meat and fish;
• legumes;
• Spinach;
• Sorrel;
• Cauliflower;
• Tea coffee;
• Alcohol.

You need to drink as much liquid as possible, preferably up to 2 liters per day. Alkaline mineral waters can also be used.

Diet for gout

1. Immobilize the joint;
2. Place it in an elevated position;
3. Apply cold to it.

Gout is not completely cured. Regrettably, but there is no need to be upset, there is a way to reduce the duration and frequency of periods of exacerbation. This effect is achieved by the right diet.

1. Include vegetable soups, pasta, cereals, low-fat dairy products, lean fish in the diet. In food, you can safely add dill, seizing dishes with bread. You are allowed to eat one egg per day. Cooking is recommended in vegetable or butter. Refractory fats are prohibited.
2. Diversify the menu green apples, favorite berries (except raspberries), citrus fruits. Dried fruits (except raisins), seeds, nuts and natural honey are considered incredibly useful. From sweets, jam, marmalade and marshmallows are allowed.
3. From drinks, it is better to give preference to green tea, natural juice or herbal decoction. Good to drink fruit and berry compotes, fruit drinks, fresh cucumber juice and specialized mineral water.
4. Diet for gout welcomes fasting days. One vegetable, such as potatoes, is allowed throughout. The diet can be cottage cheese, kefir or dairy. If it is difficult to eat one product, it is combined with other fruits or vegetables. In any case, the diet will unload metabolic processes.
5. For a fasting day, a diet based on rice and apples is ideal. During the day, it is recommended to satisfy hunger with rice groats boiled in milk and snacks from apples. Such a diet welcomes the use of apple compote, but without sugar.

Nutritionists advise people with gout to spend contrasting fasting days. Complete fasting is prohibited, because it increases the content of uric acid.

megan92 2 weeks ago

Gout is a type of arthritis that usually causes inflammation in one joint that starts suddenly. Over time, the inflammation begins to move to other joints and tendons. Gout is a common condition among men. The disease occurs against the background of an increase in the concentration of uric acid in the blood, which contributes to the formation of hard crystals and the accumulation of these deposits in the joints.

Possible consequences of the accumulation of uric acid in the body include gouty arthritis (acute/chronic), urolithiasis, the formation of localized deposits (tophi). Gout can occur as an independent disease (primary gout) or occur against the background of another disease, medication (secondary gout).

What it is?

Gout is a metabolic disease characterized by the deposition of urate crystals in the form of sodium monourate or uric acid in various tissues of the body.

The occurrence is based on the accumulation of uric acid and a decrease in its excretion by the kidneys, which leads to an increase in the concentration of the latter in the blood (hyperuricemia). Clinically, gout is manifested by recurrent acute arthritis and the formation of gouty nodes - tophi.

Kidney damage is also one of the main clinical manifestations of gout along with. More often the disease occurs in men, but recently the prevalence of the disease among women has increased, with age the prevalence of gout increases. For treatment, drugs that affect the pathogenetic mechanism of the disease, as well as drugs for symptomatic treatment, are used.

Why does gout develop?

The main factor predisposing to the development of the disease is a persistently high level of uric acid in the patient's blood. Its derivatives (urates) are deposited in the form of crystals in the joints, as well as in some other organs (in particular, the kidneys), which causes the development of gout. A compound such as sodium urate tends to be deposited in the articular tissue, leading to its destruction over time.

Factors predisposing to the development of the disease include:

• genetic predisposition;
• consumption of a large amount of protein foods of animal origin;
• binge eating;
• hypodynamia;
• obesity (including on the background of endocrine disorders).

A high level of uric acid in gout may be due to its large intake into the body, when even perfectly healthy kidneys cannot cope with excretion. Another situation is also possible, when the body receives a normal amount of this compound in the alimentary way, but the functional activity of the kidneys is reduced for one reason or another.

gout symptoms

The first signs of gout begin with the defeat of one joint, most often the big toe. The onset of acute arthritis may be preceded by heavy food intake, alcohol intake, trauma, and surgery.

The disease develops suddenly, in the early morning there is a sharp pain, swelling and redness, the symptoms of gout increase rapidly and reach a peak within 24 to 48 hours. The pain becomes pronounced, patients often cannot put on socks or touch the diseased joint. Acute gout may be accompanied by an increase in body temperature up to 38 degrees. Severe weakness, general malaise. Even in the absence of treatment, the exacerbation of gouty arthritis disappears gradually over 5 to 7 days.

As the disease progresses and in the absence of adequate treatment, arthritis attacks become more frequent and prolonged, new joints of the legs are involved. There is a deformation of the joints due to nodular deposits and bone growths, tophi. These are uric acid crystals that are deposited in the periarticular tissues, which are painless, dense nodules of a yellowish color. Most often located in the area of ​​the auricles, elbow, ankle joints, joints of the hands and feet.

Gradually, stiffness of the joints appears, which makes it difficult for patients to move. The risk of fractures is high. Each new exacerbation of gouty arthritis significantly worsens the course of the disease, contributes to the rapid development of complications.

What does gout look like: photo

The photo below shows how the disease manifests itself in humans.

stages

For classification by severity, the course of gout is divided into 4 stages.

1. The first stage is asymptomatic hyperuricemia. At this stage, the patient does not notice any symptoms of the disease, but the level of uric acid in the blood exceeds 60 mg / l. This condition does not require special treatment, it is enough just to regularly monitor the level of uric acid and maintain a healthy lifestyle with a diet. With a properly organized regimen, the symptoms of gout may not even be realized, or years will pass before the first attack of the disease develops.
2. The second stage is an acute attack. At this stage, uric acid crystals deposited in the joints activate the inflammatory process, which leads to the appearance of severe pain and swelling in the area of ​​the affected joint. The pain subsides on its own, even without treatment, within 3 to 10 days. Since the first attack will be followed by others, it is recommended to immediately seek help from a specialist. The interval between attacks can last several months, but the likelihood of a second attack increases every day, so it is important to start treatment in a timely manner and control the level of uric acid.
3. The third stage is the subacute course. This stage includes the period between attacks. At this time, there are no symptoms of the disease, and the joints work normally. However, the deposition of uric acid crystals continues and this may cause repeated, more severe and painful attacks of gout in the future.
4. The fourth stage is chronic nodular gout. In advanced cases, the disease acquires a chronic form, the outcome of which is deformation and destruction of bone and cartilage tissue in the affected area. Since the ongoing inflammation continues and increases in intensity, damage to the kidneys with the development of renal failure is not ruled out.

Treatment of gout at home

The first step in treating gout is pain relief. Patients suffering from gout should know the list of activities that can reduce pain during an exacerbation:

1. Rest of the injured limb.
2. Cold on painful focus: wet towel, ice pack, bottle of cold water.
3. NSAID preparations (Ortofen, Voltaren, Naproxen, Diclofenac) in tablets or injections (injections slightly increase blood pressure, it is recommended to do it in the morning).

Only a qualified doctor will tell you how to treat gout and achieve a stable remission, based on the results of the diagnosis of a particular case. We consider general measures of therapy.

How to relieve pain in an acute attack of gout?

In acute gouty arthritis, anti-inflammatory treatment is performed. The most commonly used is colchicine. It is given by mouth, usually at a dose of 0.5 mg every hour or 1 mg every 2 hours, and treatment is continued until:

1. There will be no relief of the patient's condition;
2. There will be no adverse reactions from the gastrointestinal tract or
3. The total dose of the drug will not reach 6 mg due to the lack of effect.

Colchicine is most effective if treatment is started soon after symptoms appear. In the first 12 hours of treatment, the condition improves significantly in more than 75% of patients. However, in 80% of patients, the drug causes adverse reactions from the gastrointestinal tract, which may occur before clinical improvement or simultaneously with it.

When taken orally, the maximum plasma level of colchicine is reached after about 2 hours. Therefore, it can be assumed that its administration at 1.0 mg every 2 hours is less likely to cause the accumulation of a toxic dose before the onset of a therapeutic effect. Since, however, the therapeutic effect is related to the level of colchicine in leukocytes and not in plasma, the effectiveness of the treatment regimen requires further evaluation.

With intravenous administration of colchicine, side effects from the gastrointestinal tract do not occur, and the patient's condition improves faster. It is important to remember that the intravenous route of administration requires accuracy and that the drug should be diluted in 5-10 volumes of normal saline, and the infusion should be continued for at least 5 minutes. Both orally and parenterally, colchicine can depress bone marrow function and cause alopecia, liver cell failure, mental depression, convulsions, ascending paralysis, respiratory depression, and death. Toxic effects are more likely in patients with liver, bone marrow, or kidney disease, and in those receiving maintenance doses of colchicine. In all cases, the dose of the drug must be reduced. It should not be given to patients with neutropenia.

In acute gouty arthritis, other anti-inflammatory drugs are also effective, including indomethacin, phenylbutazone, naproxen, etoricoxib, etc.

Indomethacin can be administered orally at a dose of 75 mg, after which every 6 hours the patient should receive 50 mg; treatment with these doses continues the next day after the symptoms disappear, then the dose is reduced to 50 mg every 8 hours (three times) and to 25 mg every 8 hours (also three times). Side effects of indomethacin include gastrointestinal disturbances, sodium retention in the body, and central nervous system symptoms. Although these doses may cause side effects in up to 60% of patients, indomethacin is usually better tolerated than colchicine and is probably the drug of choice in acute gouty arthritis.

Drugs that stimulate the excretion of uric acid, and allopurinol in an acute attack of gout are ineffective. In acute gout, especially when colchicine and non-steroidal anti-inflammatory drugs are contraindicated or ineffective, systemic or local (i.e., intra-articular) administration of glucocorticoids is beneficial.

For systemic administration, whether oral or intravenous, moderate doses should be administered over several days, as the concentration of glucocorticoids decreases rapidly and their action ceases. Intra-articular administration of a long-acting steroid drug (eg, triamcinolone hexacetonide at a dose of 15-30 mg) can stop an attack of monoarthritis or bursitis within 24-36 hours. This treatment is especially useful when it is impossible to use the standard drug regimen.

New data on the treatment of gout

According to recent data, obesity, caused by excessive consumption of fatty foods of animal origin, is most predisposed to gout. At risk are lovers of sausages, sausages, bacon and hamburgers. It is the excess of proteins that entails an excess of uric acid, and excess weight creates an increased load on the joints and, thereby, accelerates the development of the inflammatory process.

American scientists have also established a direct link between calcium and ascorbic acid deficiency and the development of gout. With age, these essential substances for the body begin to be lacking even for those people who lead a healthy lifestyle and do not complain about being overweight. Therefore, after forty years, it is necessary to be examined annually and take a multivitamin prescribed by a doctor. Recently, a new drug has been developed that inhibits the synthesis of uric acid - Benzobromarone. Active clinical trials of this drug are now underway, and in some Western countries it has already been allowed and put on stream. But before the novelty settles in the domestic pharmaceutical market, it will probably take a long time.

It is also known about the experimental development of new non-hormonal anti-inflammatory drugs that act directly on the interleukin protein, which provokes gouty inflammation of the joints and tissues. But it is difficult to name the exact dates for the appearance of these medicines on free sale.

Diet for gout

The diet should reduce the level of uric acid in the blood, which will reduce the likelihood of recurring painful attacks and slow the progression of joint damage.

Prohibits the use of products:

• Mushrooms.
• Figs, raspberries, raisins and fresh grapes.
• Bean cultures.
• Chocolate, cocoa, strong brewed tea, coffee.
• Salt (complete exclusion or daily consumption of no more than 1/2 tsp).
• Cream cakes.
• Spices and spices (you can vinegar, bay leaf).
• Fatty meat / fish, smoked meats, offal dishes (especially jelly).
• Alcohol.
• Greens - spinach, cauliflower, sorrel, lettuce.

Allowed products:

• Poultry, low-fat fish (recommended boiled 2-3 times in the weekly menu).
• Unlimited sugar and honey (with normal blood glucose levels).
• Bread (white, rye), pasta.
• Vegetables (preferably fresh), fruits (citrus fruits and cherries are especially useful).
• Milk, cottage cheese, kefir, butter.
• Juice, mineral water.

Drinking warm mineral water or a glass of water with lemon juice will speed up your metabolism. Also, metabolic processes are normalized with a weekly fasting day.

Physiotherapy

Physiotherapy procedures help to finally stop the inflammation in the joints with gout. They are prescribed only after drug reduction of arthritis symptoms. In the acute period of the disease, any methods of physiotherapy are categorically contraindicated.

What methods are used:

• paraffin and ozokerite applications,
• healing mud,
• magnetotherapy,
• electrophoresis,
• phonophoresis of drugs.

Folk remedies

In addition to diet and drug treatment, there are the following folk remedies to alleviate the course of gout:

1. Poplar buds. Poplar buds crushed into a defect are mixed with petroleum jelly or another vegetable oily base in a ratio of 1 to 4. The resulting ointment is applied to the affected joint 1-2 times a day during periods of exacerbation to relieve pain.
2. Turnip applications. Boil the turnip until soft, mash it into a pulp and add, if necessary, 1 - 2 tablespoons of sunflower oil. Apply the resulting mixture to the affected areas. In the presence of skin ulcerations in the area of ​​tophi, applications are prohibited.
3. Celery root. 1 tablespoon of fragrant celery root pour 400 ml of boiling water. The mixture is infused for 2 hours. It is necessary to drink the infusion 3-4 times a day half an hour before meals to combat hyperuricemia (to reduce the level of uric acid in the blood).
4. Mullein ordinary. Dried mullein flowers are poured with vodka or medical alcohol (50 g of leaves per 0.5 liter of liquid). The mixture is infused for 5-7 hours in a place protected from the sun, and then used for rubbing into the skin over the affected joints. It also reduces pain during acute attacks.
5. Chicory. 2 teaspoons of chicory pour 200 ml of boiling water and leave for 4 - 5 hours. Infusion drink half a cup 2 - 3 times a day before meals. Chicory is also effective in combating hyperuricemia.
6. Chamomile baths. Used for gouty hands or feet. To prepare them, you will need 100 g of dry chamomile, 5 liters of warm boiled water and 10-15 g of salt. The bath is taken for 10-15 minutes until the water cools to room temperature. Further presence of limbs in the water is risky, as there is a threat of hypothermia and exacerbation of gout. Therefore, the limbs are gently wiped dry with a terry towel and kept warm. Regular baths of chamomile reduce inflammatory edema and contribute to the early onset of remission.
7. Hypericum infusion. Two tablespoons of St. John's wort pour 1 liter of boiling water and insist for 2 - 3 hours. Strained through gauze or a strainer, the infusion is drunk 50-70 ml 3 times a day. With chronic gout, the course of treatment can be several months. St. John's wort reduces hyperuricemia and relieves pain somewhat.

Lifestyle

After the pain syndrome has been eliminated, the doctor must ensure that the level of uric acid remains safe for the patient, and the dosage of allopurinol is selected correctly. For this purpose, a regular determination of the level of uric acid is carried out using a biochemical blood test. At the beginning of treatment, this should be done every 2-4 weeks, then every 6 months.

If the optimal dose of the drug is selected, the patient is on a diet, returned to physical exercises, does not experience gouty attacks, does not need to take painkillers and anti-inflammatory drugs, the dose of allopurinol can be slowly reduced under the supervision of a doctor. Practice shows that it is quite rare to completely cancel it. Unfortunately, in the vast majority of cases, patients who have canceled allopurinol are forced to return to it after a repeated gouty attack.

When is an operation needed?

Surgical treatment of gout is rare. A brief description of the possible surgical intervention and indications for them:

1. Removal of tophi - is required for their strong growth or inflammation.
2. Opening of the joint cavity, drainage of purulent cavities. An autopsy is indicated in the presence of purulent complications of gout (phlegmon, bursitis, arthritis).
3. Joint endoprosthetics. Such an operation is performed in patients with severe gouty lesions of large joints (hip, shoulder, knee).

Most cases of gout can be successfully treated with conservative methods.

It takes about a week for arthritis to go away. Anti-relapse treatment is carried out with long courses for life: it can be either dieting or a diet with basic drugs.

Gout prevention and prognosis

To prevent the occurrence of new attacks and minimize the manifestations of gout, you should follow some rules:

1. Do not take aspirin, which can cause an increase in uric acid and cause an exacerbation.
2. Do not expose the diseased joint to any load, if possible. For pain, apply ice to the affected joint for 15-20 minutes.
3. At least half an hour a day to devote to physical education, regularly do gymnastics and exercises.
4. Regularly conduct a medical examination and measure the level of uric acid.
5. Reconsider your diet in favor of fruits, vegetables and cereals, avoid eating offal, sausages, fats.
6. Drink at least two liters of water a day to help the kidneys remove accumulated acid from the body.

The prognosis is favorable and recovery depends on the degree of the disease and adherence to adequate treatment. The sooner the patient goes to the doctor, reconsiders his own lifestyle and begins treatment, the greater the chance of a stable remission. Without proper treatment, gout progresses quite quickly, especially in elderly and mature patients prone to it, therefore it is categorically impossible to treat the disease according to the “grab-and-drop” principle.

- rheumatic pathology caused by the deposition of crystals of uric acid salts - urates in the joints, then in the kidneys. The gout clinic is characterized by recurrent and progressive attacks of arthritis with intense pain and the formation of tophi - gouty nodules that lead to joint deformity. In the future, the kidneys are affected, urolithiasis and renal failure may develop. To diagnose gout, a synovial fluid is examined for the presence of urates, an X-ray examination of the affected joints. Treatment of gout is aimed at stopping inflammation (NSAIDs, glucocorticoids), lowering the level of uric acid in the blood, and normalizing nutrition.

ICD-10

M10

General information

The pathogenesis of gout is based on metabolic disorders caused by dysregulation of purine metabolism in the body and leading to the accumulation of uric acid and its derivatives - acid urate salts. An increased concentration of uric acid (hyperuricemia) in the blood plasma and the deposition of urates is a consequence of their increased synthesis and a decrease in urinary excretion. Urate microcrystals accumulate in the joint cavities with the development of gouty inflammation, as well as in the kidneys, causing gouty nephropathy. Gout usually affects patients over the age of 40, and it is 20 times more common in men than in women.

gout classification

In the gout clinic, renal, metabolic and mixed forms are distinguished. The renal form of gout is characterized by a decrease in the excretion of uric acid, the metabolic form is characterized by an excess of its formation; the mixed form combines moderate disturbances in the synthesis and removal of uric acid from the body.

Depending on the causes leading to the development of the disease, gout can be primary or secondary. Primary gout is often caused by genetic defects and hypofunction of enzymes involved in the exchange of purines and excretion of urinary salts. The factors for the development of gout include an excessive and monotonous nature of nutrition, increased consumption of meat food and alcohol, and an inactive lifestyle. Secondary gout is a consequence of other diseases - kidney pathology with impaired function, blood diseases (leukemia, lymphoma, polycythemia), psoriasis, drug therapy with cytostatics, saluretics, and other drugs.

The clinical classification identifies seven forms of gout: a typical (classic) attack of acute gouty arthritis, polyarthritis of an infectious-allergic type, subacute, rheumatoid-like, pseudophlegmonous, periarthritic and oligosymptomatic variants.

gout symptoms

In the gout clinic, 3 phases are distinguished: premorbid, intermittent and chronic.

The premorbid phase is characterized by asymptomatic uricemia and is not yet gout. At the laboratory level, hyperuricemia is detected in 8-14% of adults. The intermittent phase of gout is characterized by episodes of attacks of acute arthritis alternating with asymptomatic periods. The manifestations of the chronic form of gout include the formation of gouty nodules (tophi), the chronic course of gouty arthritis, extra-articular manifestations in the form of kidney damage (in 50-70% of clinical cases).

The classic attack of acute gouty arthritis develops in 50-80% of patients. Typically sudden onset, often at night. The primary attack of gout is often provoked by alcohol, fatty foods, trauma, hypothermia. An attack of gout is characterized by severe pain in the area of ​​the metatarsophalangeal joint of the 1st toe, febrile syndrome, swelling of the joint, luster and hyperemia of the skin over it, dysfunction of the joint. After 3-10 days, the gout attack subsides with the disappearance of all signs and normalization of functions. A repeated gouty attack can develop after several months and even years, but each time the intervals between attacks are shortened. In men, the primary attack of gout often proceeds as monoarthritis with damage to the joints of the foot, in women - oligo- and polyarthritis with involvement of the joints of the hand.

Polyarthritis of the infectious-allergic type with gout develops in 5% of patients. This form of gout is characterized by migrating pains in multiple joints, rapid regression of signs of inflammation, as in the case of infectious-allergic polyarthritis clinic. The subacute variant of the course of gout is characterized by typical localization of pain in the first metatarsophalangeal joint and moderately pronounced signs of damage. In subacute gout, young patients may develop mono- or oligoarthritis of medium and large joints.

The rheumatoid-like form of gout is distinguished by the primary interest of the joints of the hands in the form of mono- or oligoarthritis. With pseudophlegmonous type of gout, monoarthritis of various localization with inflammation of the joint and paraarticular tissues, fever are observed. According to the clinic, this option resembles the course of phlegmon or acute arthritis. The asymptomatic variant of the course of gout is characterized by mild, erased symptoms - slight pain, slight flushing of the skin in the affected area.

The periarthritic form of gout is characterized by damage to the burs and tendons (often heel) with intact joints. In the future, the phenomena of chronic gouty polyarthritis with damage to the joints of the legs, their defiguration and stiffness join; deformations of articular tissues, bone growths; contractures, crunching in the knee and ankle joints, incomplete dislocations of the fingers. Against this background, attacks of gout continue with the possible development of gouty status - an unabated exacerbation of arthritis with chronic inflammation of the paraarticular tissues due to their infiltration with salts. As a result of severe attacks of gout, patients lose their ability to work and motor activity.

With a long history of gout (longer than 5-6 years) and high-grade hyperuricemia, specific signs appear - tophi or gouty nodules, which are an accumulation of urate crystals in soft tissues. The favorite areas for the localization of tophi are the auricles, subcutaneous tissue of the forearms, elbows, fingers, feet, shins, and thighs. During attacks of gout, tophi may open with a whitish discharge coming out.

Complications of gout

Hyperuricemia and the accumulation of urate salts in gout leads to their deposition in the kidneys with the development of nephropathy; gouty nephritis, characterized by proteinuria, microhematuria, cylindruria; arterial hypertension with subsequent transition to chronic renal failure.

In 40% of patients, the development of urolithiasis with renal colic at the height of an attack of gout, complications in the form of pyelonephritis is noted.

Diagnosis of gout

Patients with suspected gout are advised to consult a rheumatologist and urologist. Complete blood count outside the gouty attack is not changed; during the attack, there is a neutrophilic shift of the leukocyte formula to the left, an increase in ESR. A biochemical blood test during an exacerbation of gout reveals an increase in uric acid, fibrin, seromucoid, sialic acids, haptoglobin, γ- and α2-globulins.

According to the radiography of the joints, characteristic changes are detected in chronic gouty arthritis. The X-ray picture reveals the presence of osteoporosis, against which foci of enlightenment are determined in the region of the epiphyses and joints up to 2-3 cm in size; with a deep neglect of the process - the destruction of the bone epiphyses with their replacement by the accumulation of urate masses. Specific signs of gout on radiographs are determined after 5 years from the manifestation of the disease.

To take the joint fluid, a joint puncture is performed. Microscopic analysis of synovial fluid with gout shows the presence of microcrystals of sodium urate in it. When examining the material obtained from the biopsy of tophi, crystals of uric acid are found. During ultrasound of the kidneys, urate stones are determined.

Diagnostic markers of gout are:

• microcrystalline urates in synovial fluid;
• laboratory-confirmed tophi with deposition of crystalline urates;
• the presence of at least six of the following signs: a history of more than one acute attack of arthritis; maximum signs of inflammation of the joint in the acute phase; redness of the skin over the inflamed joint; monoarticular type of lesion; pain and swelling of the I metatarsophalangeal joint on one side; unilateral nature of the defeat of the arch of the foot; tophus-like nodules; asymmetrical swelling of the joint; hyperuricemia; radiologically defined subcortical cysts without erosion; lack of growth of microflora during bacteriological culture of joint fluid.

Treatment of gout

The main principle of gout therapy is to control the content of uric acid by suppressing its production and accelerating excretion from the body. A diet is prescribed that excludes the consumption of fish and meat broths, animal meat, kidneys, liver, lungs, and alcohol. In the diet, a restriction is introduced on legumes and vegetables (beans, peas, beans, spinach, sorrel, radishes, eggplants, asparagus, cauliflower), mushrooms, caviar, some types of fish (sardines, Baltic herring, etc.). With gout, the need for calories is met by carbohydrate foods, so patients should control their weight. In moderation, it is allowed to eat eggs, cereals, lean fish, lamb, beef. With gout, salt load restriction and the intake of a sufficient amount of fluid (up to 3 liters per day) are required.

The drug approach to the treatment of gout is aimed at stopping acute gouty attacks, preventing them in the future, and preventing the deposition of urate in the joints and kidneys. NSAIDs (indomethacin), plant alkaloids (colchicine), topical ointments and gels are used to stop gout attacks. Low-dose colchicine or antihyperuricemic drugs are prescribed as anti-relapse therapy for gout. The goal of gout treatment is to lower the concentration of uric acid in the blood to 2 times below normal, required to dissolve the urate crystals. To activate the excretion of uric acid, uricosuric drugs are prescribed - probenecid, sulfinpyrazone, azapropazone, benzbromarone. Uric acid inhibitors include allopurinol.

With an atypical form of gout, which occurs with an accumulation of intra-articular effusion, its puncture evacuation is performed. Conducting sessions of extracorporeal hemocorrection is aimed at reducing the concentration of uric acid and urate salts, suppressing inflammation and reducing the dosage of drugs taken. Physiotherapy and spa treatment for gout is carried out in remission. Carrying out UVR of the area of ​​the joint concerned in the acute phase in some cases helps to stop the onset of a gout attack.

Prognosis and prevention of gout

Timely recognition and initiation of rational treatment gives prognostically favorable results. Factors aggravating the prognosis of gout are young (up to 30 years old) age, a combination of urolithiasis and urinary tract infections, a burdened somatic history (diabetes mellitus, arterial hypertension), progression of nephropathy.

The need for gout prevention should be taken into account during chemotherapy, as well as in patients with the risk of tumor decay and necrosis. From the first day of the course of chemotherapy treatment, it is necessary to prescribe hypouricemic drugs (allopurinol). Prevention of new exacerbations of gout depends on compliance with the water-salt regimen, diet, and weight control. In the presence of relatives suffering from gout, other family members are advised to monitor the level of uric acid.

This disease is more often diagnosed in men, but sometimes it also affects women. As a rule, it affects the legs, in most cases the ankle joint. Various causes can provoke diseases, and treatment for gout comes down to stopping symptoms and irritating factors.

What is gout

Gout is a disease that affects the joints of a person, occurs due to deposits of urate (salts of uric acid). According to statistics, pathology occurs in only 3 out of 100 people, most of them are men. The disease manifests itself, as a rule, after 40 years in guys, and in women after menopause. The disease affects any joints in the human body: knee, elbow, fingers, feet, elbows. Inflammation occurs, which creates a strong pain syndrome.

You should know which doctor treats gout - a rheumatologist, so if you have symptoms, you need to contact him. After the diagnosis, he will be able to prescribe the appropriate therapy. Gout - symptoms and treatment will be described below. People who are at risk of developing the disease are:

• suffer from diabetes, arterial hypertension;
• have a hereditary predisposition;
• with malnutrition;
• abuse alcohol.

Gout - symptoms

The most typical manifestation for pathology is acute inflammation of the joints. All other symptoms of gout are not so bright. Inflammation occurs very sharply, as a rule, it manifests itself in only one joint. Gouty arthritis is based on the penetration of crystals of uric acid salts into the joint cavity from the tissue. The pain can be localized in any part of the body, but the symptoms of gout on the legs are more common. As a rule, exacerbation of gouty arthritis begins at night, it can be provoked by:

• joint overload;
• taking alcohol, diuretics or other medications;
• surgical operations;
• injury.

Symptoms of gout in women

Many processes inside the female body are controlled by hormones. Due to the large amount of estrogen, all salts are quickly removed from the body. As long as this hormone works flawlessly, gout symptoms in women do not appear. The main symptom is a sharp pain in one of the joints, after getting out of bed. A characteristic symptom will be hyperemia (redness), swelling of the affected limb. Such signs should alert the patient.

Another typical symptom will be limited mobility in the affected area. This is especially noticeable with inflammation of the elbow and knee joints. An increase in body temperature is extremely rarely observed, but such a sign becomes a clear signal of the development of severe inflammation. Rarer manifestations include:

• loss of appetite;
• frequent mood swings due to pain;
• increased blood pressure.

Symptoms of gout in men

The stronger sex is more susceptible to this disease due to poor removal of uric acid from the body. The manifestation of this pathology occurs suddenly and also at night. For the first time, symptoms of gout in men appear after 40 years. Obvious signs of the disease are:

1. Strong, but short-term bouts of pain, localized in the joints of the knees, wrists, big toes. The skin on the affected area turns red, becomes hot. Pain may persist for 3 days, then disappear, but return again. Over time, the intervals between attacks are reduced, and the duration increases.
2. Gout can move from one joint to another over time.
3. After overcoming the attack, the affected area continues to experience discomfort.
4. Tophi appear - nodes that are filled with salt crystals.

How to treat gout

Treatment of this pathology is based on several stages. Completely get rid of gouty arthritis will not work, the disease stops. It is necessary to take preventive measures to avoid the development of complications. The scheme of how to treat gout depends on the severity of the disease, symptoms and consists of the following areas:

1. Treatment of acute attacks of gout.
2. Actions aimed at reducing the content of uric acid compounds.
3. Treatment of concomitant diseases, complications.
4. Therapy of chronic polyarthritis.

The main task of therapy is to reduce the amount of uric acid compounds in the body. It should be carried out if a recurrent form with repeated attacks of gouty arthritis is diagnosed. Treatment is carried out for life, only such a scheme will help stop the occurrence of inflammatory processes in the joints, lead to regression of the disease (in rare cases, and complete recovery).

Diet for gout

You can effectively reduce the amount of uric acid compounds using a diet for gout. The main task is to exclude from the diet foods that contain a lot of purine bases. This group includes:

• kidneys;
• language;
• liver;
• brain;
• fatty fish;
• meat of young animals;
• sprats;
• canned food;
• sardines;
• smoked meats.

Nutrition for gout may include a small amount (up to 300 g) of boiled meat per week. It is known that purine compounds pass into the broth during cooking, so the patient should not use such soups. You should limit the amount of table salt to 7 g per day. In order not to violate this rule, it is better to cook all dishes without it, and then add salt to each serving.

Treatment of gout during exacerbation

All patients who suffer from this disease should know how to relieve an attack of gout. The main task of treatment is just to relieve acute symptoms by eliminating harmful foods and medicines. Exacerbation of gout is removed as follows:

1. It is necessary to drink up to 2.5 liters of alkaline drink.
2. Give the patient complete rest.
3. Compresses are applied to the affected joint. Used for pain relief, relieving inflammation Dimexide in solution.
4. Anti-inflammatory non-steroidal drugs are used for relief: Diclofenac, Naproxen, Indomethacin, Piroxicam.
5. Pain, inflammation help relieve Colchicine, Nimesil.

Gout - medical treatment

The patient has to be treated comprehensively, in addition to dieting, it is necessary to use medications. For example, for the treatment of the chronic form of gout, the prevention of attacks, antihyperuremic drugs (Allopurinol, Thiopurinol) are used along with diet therapy. The first stage of treatment is always aimed at eliminating pain, swelling. Drug treatment of gout is carried out with the help of:

• drugs that have an analgesic, anti-gout effect;
• non-steroidal anti-inflammatory drugs;
• in the absence of positive dynamics, corticosteroid injections are prescribed.

Medicines for the treatment of gout

Medicines of the first group are aimed at reducing pain, removing inflammation from the affected joint. NSAIDs - non-steroidal anti-inflammatory drugs, as a rule, the patient is prescribed:

• Indomethacin;
• Diclofenac;
• Naproxen.

Colchicine is a gout medicine that is prescribed to the patient if the above pills did not work or they cannot be taken for some reason. They get a medicine from the herb "autumn crocus". The drug does not have an analgesic effect, the action of the drug is aimed at reducing the ability of uric acid crystals to provoke an inflammatory process in the joint membrane. This property helps relieve pain.

The last group is corticosteroids, which are hormonal drugs. They are used only in the treatment of severe types of gout, if other medicines do not help. They pierce the drugs in short courses, because their long-term use can cause:

• muscle weakness;
• obesity;
• weakening of the immune system;
• osteoporosis;
• thinning of the skin;
• bruising.

Gout - treatment with folk remedies

Medicine allows parallel treatment of gout with folk remedies at home in consultation with the attending physician. This fits into the method of complex therapy of the disease. The use of folk remedies is another way to reduce the level of uric acid in the body. You can use the following recipes:

1. Spruce cones will help clean the joints. Pour the unopened fruit with hot boiled water, leave overnight. Then drink the resulting decoction before meals for 30 minutes 3 times a day. You can drink this liquid until complete recovery.
2. A good folk remedy is a decoction of chamomile. Pour 100 g of flowers into 10 liters of water, in which 20 g of salt were previously diluted. The field of this should be done baths with this solution.
3. Bay leaf is good for cleansing the joints. Pour 5 g of the plant into 1.5 cups of water. Boil the liquid for no longer than 5 minutes, then cover with a lid and wrap in a towel for three hours. Drink the resulting decoction throughout the day.

When the acute phase of the disease has passed, it is necessary to carry out gout prophylaxis in order to reduce the frequency of recurrence of attacks. It is recommended that all sisters, brothers and immediate family members be screened at the clinic for asymptomatic hyperuricemia. For this, a blood test is taken, which is able to detect elevated levels of uric acid. If you have been diagnosed with Hyperuricemia, but so far there are no severe symptoms, it is recommended:

• reduce the amount of foods with fats, purines in the diet;
• long-term use of Allopurinol for prevention;
• attend exercise therapy classes, do walking, gymnastics.

Learn more about treating gout.

sovets.net

Main causes of gout

How gout looks on the leg can be seen in this photo. And this photo shows gout on the hands.

Depending on the causes of occurrence, gout is divided into two groups.

1. Primary gout in most cases occurs as a result of a violation of genetic and hormonal factors. Added to them is poor (improper) nutrition and alcohol abuse.
2. Gout secondary occurs due to metabolic disorders and too frequent medication. These drugs include Aspirin, Pyrazinamide, nicotinic acid and various diuretics.

The main risk factors include the genetic predisposition and gender of the patient. Men get gout much more often than women.

• The disease is usually diagnosed before the age of 40.
• Taking medications, especially diuretics, can provoke the disease.
• Alcohol abuse increases the risk of developing gout. A particular danger comes from beer.
• Excess weight also contributes to hyperuricemia.

Note! First of all, the lower limbs suffer from gouty pains. Seizures occur after injuries to the legs, long walking, playing football, surgery, or long-term driving.

After injuries or operations, dehydration of damaged tissues occurs, so uric acid salts accumulate in this place. Even with the slightest decrease in body temperature, the urates in the joints begin to crystallize.

Often an attack of gout provokes overheating in a steam room or sauna. In the bath, increased sweating begins and dehydration of the body occurs sharply. Exacerbation of gout threatens those patients who are going to travel in hot countries.

Often, gout suffers from hypertension. This is due to the regular use of diuretics. Uric acid is concentrated in the blood, and ideal conditions are created for gout.

Other causes of gout include:

• metabolic disorder;
• obesity;
• violation of metabolic processes;
• overheating or hypothermia of the joints;
• excessive physical stress on the joints;
• abuse of alcohol, vegetable and animal fats;
• the use of high-calorie, meat, fish and fried foods;
• genetic predisposition;

gout symptoms

The first stage of gout is asymptomatic. Urate gradually accumulates in the body. In the end, this necessarily leads to gout. The initial phase can last a very long time up to 25 years and even more.

The second phase of gout is called acute gouty arthritis. The first signs of gout on the legs at this stage are acute pain and swelling in the area of ​​the affected joint. In addition, the body temperature rises.

Symptoms of gout have pronounced clinical manifestations:

1. Exacerbation, as a rule, begins late at night or early in the morning.
2. A sharp pain occurs in a joint affected by acid-uric crystals. Usually it's the big toes.
3. Along with swelling in the periarticular tissues and the joint itself, there is a sheen of the skin and redness.
4. Touching the joint becomes very painful, the body temperature rises.
5. The patient feels general weakness and malaise throughout the body.

If gout has passed into the chronic stage, tophi are observed - subcutaneous nodules, which can soften at the time of attacks. This condition often begins with severe pain. Subsequent attacks become more frequent and can last from several hours to several weeks.

Important! Chronic gout is dangerous because when it appears in the body, a huge number of both small and large joints are affected. At the same time, there is the development of chronic arthritis in the hands and feet.

What arthritis looks like can be seen in the photo. People suffering from gout often have diabetes mellitus, and atherosclerotic plaques form in the vessels.

This is because low-density lipoproteins accumulate in the blood, cholesterol in the bloodstream also rises.

How the disease is diagnosed

When making a diagnosis of the disease, the doctor takes into account the frequency of seizures that occur. The final diagnosis is based on:

1. Detection of urate monosodium crystals in the synovial fluid and the absence of microorganisms in it.
2. 6-12 signs of gout: laboratory, clinical, radiological.
3. Confirmed tophus on arms or legs (photo). For this, a chemical study or polarizing microscopy is used.
4. Asymmetric inflammation of the joints.
5. Hyperuricemia.
6. Subcortical cysts without erosions found on radiographs.

How is gout treated and its manifestations

Treatment of gout is based on the relief of acute attacks. For this, drug therapy is used, adherence to the correct diet. Much attention is paid to the prevention of new exacerbations.

Therapy for a gout attack on the leg or arm:

• complete rest and plentiful alkaline drinking is shown;
• compresses with Dimexide are applied to the leg. To treat the disease, they do not use a pure medicine, but a 50% solution that relieves inflammation and anesthetizes;
• an attack can be treated with non-steroidal anti-inflammatory drugs (Diclofenac sodium, Indomethacin, Piroxicam, Naproxen).

Such treatment should begin with a high dose of the drug, after which it is reduced to a medium therapeutic dose. The regimen for taking medications against the disease should comply with the doctor's recommendations and include possible contraindications.

For example, Colchicine should not be used for severe kidney damage, duodenal ulcer and stomach ulcers.

Treatment of an acute attack is possible with the help of indole and pyrazolone drugs:

• Ketazon.
• Butadion.
• Phenylbutazone.
• Reopirina.

In the presence of high drug resistance, therapy involves the connection of Prednisolone. Initially, a dose of 20-30 mg / day is prescribed, gradually it is reduced to “no”. At the same time, Indocid and Butadion are taken in small doses.

Uric acid is removed by a special diet and Allopurinol.

How to treat the disease when there are no attacks

Treatment of the disease in the period when there are no seizures should be to eliminate hyperuricemia, recurrence of seizures, and prevent the occurrence of lesions of internal organs. In addition, with the help of complex methods of therapy, impaired joint functions should be restored.

Complex therapy includes:

1. Diet.
2. Tablets, ointment injections.
3. Spa treatment.

What is not recommended for doubtful gout or its mild attacks is long-term medication. In the first two days, the patient is shown Colchicine or Indomethacin. Before you start taking drugs against gout, the type of purine metabolism is established. It can be renal, metabolic or mixed.

Uricostatics inhibit the formation of uric acid. For example, 100-900 mg of Allopurinol is recommended per day (depending on the degree of damage).

• Mild degree - 200-300 mg.
• Moderate degree - 300-400 mg.
• Severe degree - 600-900 mg.

Thus, in two days it is possible to reduce the level of uric acid by 2-3 times. The drug is used constantly, because it does not have persistence and long-term action. In summer, due to the appearance of a variety of plant products in the diet, they take a break for 1-2 months.

Uricosuric drugs increase the production and suppress tubular reabsorption of uric acid compounds. Therefore, they are indicated for renal hyperuricemia:

• Benzbromarone.
• Etamide.
• Probenecid.
• Allamaron.

What not to eat with gout

Usually, for gout, doctors prescribe diet number 6. Its advantage is that it has a full calorie content.

It contains practically no salt and fats of animal origin, the amount of protein is reduced.

Diet number 6 provides for a large fluid intake.

Products prohibited for use with gout:

• Liver, kidneys, offal, brains, tongue.
• Fatty varieties of fish and meat, broths and soups from them.
• Meat of young animals (chickens, veal).
• Legumes, since they are rich in purines (beans, beans, peas, lentils), spinach and sorrel.

Reduce your intake of animal saturated fats. They increase the level of uric acid in the blood, reducing its excretion in the urine.

Salt should be limited to 5-7 grams, this also includes its content in products. Starvation and overeating are prohibited. As a result, uricemia rises, and a gout attack may recur.

Foods that are allowed to eat with gout:

• Milk and all dairy products.
• Eggs and walnuts.
• Cereals and flour products, white bread in small quantities.
• Potatoes, zucchini, cabbage, melon, pumpkin, watermelon.
• Oranges, peaches, pears, plums, apricots, apples.
• Blueberries, strawberries, cherries, cherries, grapes, lingonberries.
• Juices, weak coffee tea with lemon or milk.

The diet should include kefir, dairy, cottage cheese, kefir and fruit fasting days. On meat and fish days, you can consume 150 grams of the corresponding product. In one day, a combination of meat and fish is allowed, but subject to the intake of vitamin C and B.

During an exacerbation, you can eat only liquid food: lactic acid products, milk, compotes, jelly, vegetable and fruit juices, vegetable soups, rosehip broth, liquid cereals, weak tea with lemon or milk.

You can drink only alkaline mineral water without gas. If arterial hypertension and poor circulation are present simultaneously with gout, the patient is advised to drink a lot of berry compotes, fruit juices and alkaline mineral water.

Complications of gout

As a result of gout, the following complications are observed:

1. Urate kidney stones and gouty homerulosclerosis.
2. Pyelonephritis, nephropathy, gouty nephritis.
3. Gouty kidney in violation of purine metabolism.
4. Acute kidney failure in the presence of diabetes mellitus and arterial hypertension.
5. Destructive polyarthritis and gouty arthritis with joint deformity (photo).
6. Thinning of bone tissue - osteoporosis (photo).
7. Tophi on the joints and soft tissues: in the auricle (photo), on the wings of the nose (photo), on the fingers, on the internal organs.

Prevention of the disease and its prognosis

If you follow the correct treatment, the outcome of gout is very favorable. Prolonged attacks can end in complete recovery. The prognosis of the disease also depends on the level of hyperuricemia.

Patients retain their ability to work for many years, and their quality of life is not disturbed. Prevention of the disease comes down to diet; you should not visit places where the air temperature is high (bath, sauna); starvation and overeating are excluded; it is necessary to use diuretics and drugs that dissolve uric acid crystals; recommended spa treatment.

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What is gout?

Gout is a metabolic disease in which uric acid salts (known as urates) are deposited in the joints. Gout is otherwise called the "disease of kings", this is an ancient disease that was known even in the time of Hippocrates. Now considered a rare disease, gout affects 3 out of 1000 people. And most often it affects men over the age of 40, in women it most often manifests itself after menopause. By itself, gout is one of the varieties of joint diseases, the cause of which is the deposition of salts.

Gout affects all joints, from the joints of the fingers to the joints of the toes.

It was known back in the time of Hippocrates and is called the "disease of kings" due to the fact that the main source of its occurrence is immoderation in food and alcoholic beverages. Gout is often chronic.

• Causes of gout
• gout symptoms
• Treatment of gout
  • Latest data on the treatment of gout
  • Allopurinol: pros and cons

Causes of gout

Gout is caused by elevated and persistent levels of uric acid in the blood. During the course of the disease, urate crystals (a derivative of uric acid) are deposited in the joints, organs and other body systems. Sodium urate crystallizes and is deposited in small particles in the joints, which ultimately leads to partial or complete destruction of the joint. For the same reason, such situations are called microcrystalline.

A large amount of uric acid in the body can be due to two reasons: the first reason is when healthy kidneys cannot cope with the excretion of an unusually large amount of uric acid, the second reason is when uric acid is excreted in normal quantities, but the kidneys are unable to excrete it.

Every year there are more and more patients with gout. Doctors explain this phenomenon by the fact that in recent years people are more likely to consume foods rich in purines (for example, meat, fatty fish) and a huge amount of alcoholic beverages. This is confirmed by the fact that during the wars, the percentage of people with gout was sharply reduced due to the fact that meat products, and especially alcohol, were very difficult to get.

gout symptoms

A symptom of gout is a common attack of gouty arthritis - this is usually inflammation of one joint, most often it is the joint of the big toe, knee or ankle. Usually, an attack of gout occurs in the early morning or at night, it manifests itself in the form of an unexpected severe pressing pain in a particular joint, the affected joint swells, the temperature in the joint area rises, the skin turns red and begins to shine. Usually during the day the pain becomes a little less, but by night it intensifies again, the duration of an attack of gout lasts from two or three days to a week, sometimes more. With a repeated attack, other joints may also be involved in such inflammation, this can lead to partial destruction of the joint.

Signs of gout are the appearance of peculiar growths on the arms or legs, while the level of uric acid is significantly elevated. When the growths, in other words, the tophi burst, a person can see whitish crystals of uric acid. The patient may feel quite intense pain in the affected areas. Such salt deposits in the joints interfere with leading a full life.

Possible Complications

The main and most severe complication of gout is the appearance of gouty arthritis, it is also possible the occurrence of urolithiasis, in which the resulting stones consist of urate or crystallized uric acid.

Gouty nodes, also called "tophi", are nothing more than conglomerates of sodium urate crystals, which have the ability to be deposited in all parts of the body. And in cases where such deposits get stuck in the joints or periarticular tissues, an immune reaction occurs, since these deposits are perceived by the body as a foreign body, which causes the accumulation of leukocytes and severe inflammation begins, which is called gouty arthritis.

It is worth paying special attention to the fact that kidney stones that occur with gout can become the main cause of kidney failure and, as a result, can lead to death.

Pain in gout

You can understand about the onset of gout by sudden pain in the joint. They are accompanied by intense redness, swelling and fever. "Burning" can not only the affected area, but also areas of the body in the immediate vicinity. In this case, the body temperature can rise to 39-40 degrees. Symptoms in most cases develop within an hour. Most often this affects the big toe. Ordinary pain medications such as aspirin will not help.

The pain usually starts at night and becomes almost unbearable. In the daytime, there is often some improvement, the pain recedes, but you should not think that everything has passed. Such acute symptoms can torment the patient for about a week.

Gout in men on the legs

Gout is a chronic disease. It is almost impossible to cure it completely. This ailment most often manifests itself on the legs. After the onset of the disease, the symptoms may recur after six months or a year. The disease can go into a dormant state, but, without any doubt, it will make itself felt. With each attack, the time between them will decrease. Gout will return to the person more and more often.

Damaged places on the legs are often destroyed more and more, the disease can also affect neighboring joints. With a long-term illness, over time, peculiar bumps may appear on the affected areas, under the skin, which are called “gouty nodes” or “tophi”.

This happens due to the fact that the body begins to perceive large salt deposits in the joints on the legs as a foreign body, the immune system begins to inevitably react - to accumulate white blood cells, after which severe inflammation begins. Sometimes tophi burst and whitish dust is released from them - uric acid crystals.

Gout often develops in old age. In men, it occurs much more often and at an earlier age. The male population is susceptible to this disease by the age of 40. It should be noted that women begin to suffer from gout closer to 55, mainly after menopause, when the amount of estrogens, female hormones, is sharply reduced in the body. Children and young men are practically not affected by gout. There are rare exceptions, in cases of hereditary disorders of uric acid metabolism.

The role of uric acid in the development of gout

This disease severely disrupts metabolism. Purines enter the human body with food, but are also produced by the human body. Further, purines are broken down into uric acid, which is excreted by the kidneys. In people with gout, the content of this uric acid is significantly higher than normal. Excess uric acid is deposited in those tissues where there is no blood supply. It's the easiest place for crystals to get a foothold.

Joints, cartilage and tendons are most affected by this. As a result of this disease, not only these places, but also the kidneys suffer. Most often, with gout, urolithiasis develops, with a lower percentage of probability, the patient may suffer from renal colic.

This can happen for two reasons: if too much uric acid is produced and the kidneys cannot cope with the amount of output, so it has to be deposited in the human body. And the second reason is that the amount of uric acid is normal, but the kidneys cannot remove it.

However, high levels of uric acid in the body is not the only cause of gout. Here, several other factors play a decisive role: excessive nutrition, fatty foods, overweight, a sedentary lifestyle, and hereditary predisposition.

What to do with an acute attack of gout?

Even if the recommendations are followed, an acute attack will not go away instantly. But this will significantly reduce the time during which the disease will torment a person. Mainly you need to observe strict bed rest. Affected limbs are best kept in an elevated position, such as placing a pillow under them.

In case of unbearable pain, ice can be applied. After that, it is desirable to make a compress on the sore spot with Vishnevsky ointment or dimexide. In food intake, it is better to limit yourself greatly, you can use liquid cereals and vegetable broths. It is worth drinking as many alkaline drinks as possible, for example, a decoction of oats, jelly, milk, mineral water or plain water, but with the addition of lemon juice (lemon juice dissolves uric acid deposits in rheumatism and gout). You need to drink at least 3 liters per day (in the absence of kidney disease).

Any painkillers will not help. You can take modern anti-inflammatory drugs without steroids. If you have taken any prophylactic medication prescribed by your doctor, then you should continue taking it.

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Prevention of exacerbations of gout

Most often, gout appears in those places where the joint was injured. Therefore, treat such places with caution. You should not wear narrow and uncomfortable shoes, as they can severely damage the big toe, which loves so much gout. Diet and a balanced diet are mainly used to prevent the onset of gout attacks.

The way of life will have to be completely reconsidered, to make it healthy. You should reconsider your taste preferences. Diet No. 6 is recommended, which helps to reduce uric acid and urate in the body. Products containing purine bases, the main source of urates, are strictly limited, if not completely excluded. But poor in purines, and therefore allowed milk, cheese, eggs, vegetables, fruits and cereals will not leave you hungry. The patient's diet should contain whole grains, eggs, vegetables, fruits, and low-fat dairy products.

In food, you should limit the intake of meat, fish, caviar, mushrooms, legumes. In addition, you need to limit the consumption of: smoked meats, marinade, anchovies, cauliflower, asparagus, sorrel, chocolate. Such a diet will lead to the normalization of body weight and significantly reduce the stress on the joints during an exacerbation of gout.

Detailed information about what you can eat and what you can’t, as well as other features, can be found here.

Alcohol and smoking inhibit the excretion of uric acid from the body. Consequently, its crystals are more deposited in the joints. For prevention, you should completely eliminate alcohol, especially beer, as well as quit smoking. It is not recommended to drink tea, coffee, cocoa. In addition to the diet, it is worth doing at least once a week a fasting day with the use of a mono-product.

First of all, small joints are affected. Therefore, special attention should be paid to the development of their mobility. Attention should be focused on those areas where there are bouts of pain. Every day it is worth doing gymnastics for the joints. At first, this will be unusual, because the joints are more and more difficult to be mobile due to deposits. It is recommended to be outdoors more often and take walks.

Mineral water for gout

Mineral waters perfectly contribute to the removal of unnecessary purines from the body. Give preference to alkaline and organic waters. These include, first of all, Narzan, Essentuki and Borjomi. Remember that any liquids should be consumed at least 2.5 liters per day.

Treatment of gout

The diagnosis of gout means that a person will have to significantly change his lifestyle and constantly take medication, because, unfortunately, it is impossible to achieve a complete cure for this disease. However, early treatment allows you to take gout under control, reduce painful attacks to a minimum and insure against serious complications.

The main principle of treating gout is to control the level of uric acid in the body. For medical treatment, you should consult a rheumatologist. His prescriptions will be aimed at reducing the volume of uric acid and its speedy removal from the body. Only a qualified specialist can prescribe such drugs that, with possible concomitant diseases, will not cause the greatest harm to health.

Most often, doctors prescribe non-steroidal anti-inflammatory drugs, such as metindol, diclofenac, butadione, indomethacin, naproxen, for 1-2 weeks. To quickly reduce the concentration of uric acid in the body, allopurinol, orotic acid, thiopurinol, hepatocatazal, milurit can be prescribed. For the relief of acute symptoms of gout, doctors recommend taking colchicine.

Drug therapy for gout is aimed at solving two main problems:

Decrease in the level of uric acid in the patient's body;

Relief of acute inflammatory process and pain relief.

The sooner the patient is examined, reconsiders his habits and begins treatment, the greater the likelihood of achieving a stable remission. Without adequate therapy, gout progresses rapidly, especially in patients of mature and advanced age;

Drug therapy to lower uric acid levels

Since the root cause of gout is precisely the excess of uric acid, the solution to this problem in 90% of cases leads to the cessation of attacks of excruciating pain and allows you to count on a comfortable life in the future.

To reduce the level of uric acid in the body, the following drugs are used:

Allopurinol is a synthetic analogue of hypoxanthine. This substance inhibits the activity of the enzyme xanthine oxidase, which is responsible for the transformation of human hypoxanthine into xanthine, and then xanthine into uric acid. Thus, Allopurinol reduces the concentration of uric acid and its salts in all body media, including blood, plasma, lymph and urine, and also contributes to the gradual dissolution of already accumulated urate deposits in the kidneys, soft tissues and joints. However, this drug has a number of serious side effects and greatly increases the excretion of xanthine and hypoxanthine in the urine, so Allopurinol is contraindicated in patients with severe renal insufficiency. Nevertheless, for the majority of patients with gout, it is he who remains the first-line drug to this day. Cost: 80-100 rubles per pack of 30-50 tablets;

Febuxostat (Uloric, Adenuric) is a selective (selective) inhibitor of xanthine oxidase, which, unlike Allopurinol, does not affect other purine and pyramidal enzymes of the human body, moreover, it is not excreted by the kidneys, but by the liver. Febuxostat is a relatively new drug for the treatment of gout, it is not produced in Russia, and in Western Europe and the USA it has undergone numerous clinical trials and has shown excellent results. Febuxostat completely dissolves accumulations of uric acid salt crystals in the area of ​​fingers and elbows in three months and effectively prevents their re-formation. Can be used by patients with concomitant renal pathologies. The drug is not cheap - on average from 4,500 to 7,000 thousand rubles, depending on the country of origin;

Pegloticase (Pegloticase, Krystexxa) is an infusion solution of enzymes that quickly dissolve urate crystals (deposits of uric acid salts). It is used intravenously twice a month to stabilize the condition of patients with severe gout who are not helped by traditional drugs. During the procedure, anaphylactic shock is possible. This is a very expensive drug that is produced exclusively abroad and sold to order;

Probenecid (Santuril, Benemide) is a drug that prevents the reabsorption of uric acid in the renal tubules and enhances its excretion in the urine. Probenecid was originally used in complex antibiotic therapy to reduce the harm caused to the kidneys by antibiotics. But then it was also prescribed for chronic gout and hyperuricemia (high levels of uric acid in the blood). It is important to understand that Probenecid enhances the excretion of uric acid, and does not suppress its synthesis. Therefore, the treatment of gout with this drug is advisable only at the stage of remission. If you prescribe Probenecid to a patient with an acute inflammatory process, this will lead to the active dissolution of already accumulated urates, an increase in the level of uric acid in the plasma, and, as a result, to attacks of excruciating pain. To avoid this risk, the first months of gout treatment with Probenecid are accompanied by additional hormonal and anti-inflammatory therapy. The drug costs from 3500 to 7500 rubles.

Treatment of gout with decongestants and painkillers

Symptomatic treatment of gout is to relieve attacks, relieve swelling and pain, and is performed using the following drugs:

Colchicine (Colchicum, Colchimin) is an alkaloid isolated from poisonous plants of the melanthium family. The most common source of colchicine is autumn crocus. Colchicine inhibits the formation of leukotriene, stops the cell division of granulocytes, prevents the movement of leukocytes to the site of inflammation and prevents urates (uric acid salts) from crystallizing in tissues. This drug acts as an emergency remedy, and is recommended to be taken in the first twelve hours after the onset of an acute attack of gout. It is necessary to drink two tablets of Colchicine at once, an hour later - another one, and then one tablet three times a day for a week. The drug very often causes undesirable reactions from the gastrointestinal tract - nausea, vomiting, loose stools. The average price of Colchicine in pharmacies is from 1000 to 2000 rubles;

Glucocorticoids (Cortisone, Hydrocortisone, Prednisone, Prednisolone) are synthetic analogues of human corticosteroids, that is, hormones produced by the adrenal cortex. Preparations of this group break the chain of natural reactions of the body to the intervention of allergens, chemicals, bacteria, viruses and other foreign elements. Glucocorticoids quickly stop inflammation, but suppress the immune system, so hormonal treatment of gout is advisable only if the expected benefit outweighs the potential risk. The cost of synthetic steroid hormones varies from 30 rubles (the oldest drug is Prednisolone) to 1500 rubles (Cortisone);

NSAIDs (Aspirin, Analgin, Diclofenac, Ibuprofen) - non-steroidal anti-inflammatory drugs are called so in order to emphasize their difference from hormones. However, the action of drugs in this group is somewhat similar to the action of glucocorticoids. NSAIDs are non-selective inhibitors of cyclooxygenase, an enzyme responsible for the synthesis of thromboxane and prostaglandins. Thus, these drugs also suppress inflammation, but, unlike synthetic corticosteroids, do so more slowly and are not immunosuppressive. For the symptomatic treatment of gout, Diclofenac and Ibuprofen are most often used, the average cost is 10-30 rubles, the price of a popular generic (drug with the same active ingredient) Nurofen can reach 150 rubles.

How to prevent gout attacks?

To minimize the risk of new attacks of gout, follow a few simple rules:

If possible, do not expose the diseased joint to any load, periodically fix it in an elevated position and apply ice for 15-30 minutes 2-3 times a day until the pain subsides;

Do not overuse aspirin, which can cause spikes in blood uric acid levels and worsen gout symptoms;

Regularly measure the level of uric acid - it should not exceed 60 mg / l;

Every day, devote at least half an hour to physical education: walk, ride a bike, jog, dance, swim. Be sure to exercise in the morning. Regardless of age and weight, patients with gout should give themselves feasible physical activity every day - sport works more effectively with gout than any medication;

Drink at least two liters of pure water a day. In order for the kidneys to excrete uric acid from the body, they first of all need clean water. Without enough water, even healthy kidneys cannot cope with the cleansing of the body;

Take a blood test to determine the level of essential minerals and vitamins, and, if necessary, supplement the diet with a good vitamin and mineral complex. It is especially important for gout patients to provide themselves with vitamin C;

Do not drink sodas with sodium benzoate and powdered juices with fructose, completely give up alcohol;

Review your diet in favor of vegetables, fruits and cereals, consume no more than 120 grams of animal protein per day, avoid offal and fatty sausages.

Previously, gout was one of the most common causes of disability among people over the age of 40. The disease became a real tragedy, as it caused wild pain, the inability to move the affected limb, deformity of the joints, exacerbations. It is recommended to start treatment of the disease from the very first signs in order to effectively stop the disease.

Gout: what is the disease?

What is gout and how does it manifest itself? This disease occurs due to a violation in the metabolism of purine bases in the body. Gout has a second name - " disease of kings", since everything is connected with a violation of the diet, which is expressed in the abuse of fatty meat dishes.

The disease occurs at the moment when the production and subsequent excretion of purines is disturbed, they accumulate in the body. This phenomenon is sometimes caused by genetic disorders in the enzyme system of the body or an increased content of dangerous uric acid in the usual diet. Sometimes the main cause of the manifestation of the disease is a violation in the normal functioning of the kidneys.

Symptoms are actively developing after deposition of urate, which are similar in structure to games. With gout, they can be found in the kidneys, joints, where acute pain occurs.

Causes of the manifestation of the disease

Specialists with the help of modern therapy and medicines are able to stop the development of gout and its symptoms, but still the disease continues to manifest itself, since it is a hereditary pathology.

The disease is more common among men of mature age than women who have entered the menopause.

The main causes of occurrence:

• genetic deficiency of enzymes, which leads to disruption of normal metabolism;
• metabolic failure;
• kidney disease.

Higher risk factors include the following:

• hypertonic disease;
• diabetes;
• violation of the diet - an abundant amount of animal protein in food;
• frequent alcohol use.

What happens to the body?

Gradually, salts begin to be deposited in the body that resemble crystals. They can provoke the development of an acute or chronic inflammatory process in the kidneys and joints. The crystals are taken up by neutrophils, protective cells, which begin to break down and provoke an inflammatory response in the body in response.

Further observed development of tophi and gout itself. You can notice salt deposits in the area of ​​​​the auricles, on the legs in the area of ​​\u200b\u200bthe foot and on the small joints of the hand. Without timely treatment, formations can disfigure the joints and cause unbearable pain.

External manifestation of gout

Primary symptoms are often observed in people over the age of 40 years. Several factors can provoke a sharp development of the disease in the body, which must be taken into account in the form of preventive measures:

1. active physical activity;
2. joint injury;
3. alcohol;
4. the appearance in the diet of foods high in dangerous purine bases;
5. surgical interventions;
6. infections;
7. exacerbation of a chronic process;
8. radiation therapy;
9. the use of certain medications.

The patient's movements are noticeably and rather sharply limited, become very painful and sometimes simply impossible. Symptoms are localized in one joint, most often the lesion begins on the big toe. Attacks develop at night or very early in the morning, then the pain subsides, and the inflammation itself decreases. But without the necessary therapy and adherence to the right diet, everything repeats again.

At the initial manifestation of the disease, a person feels intense pain in the joint area, then a feeling of heat and redness in the affected area.

The alkaline structure of urine at the initial stages of the development of the disease rarely changes dramatically, but nevertheless, during diagnosis and analysis, it becomes noticeable that gout has begun to affect the human body. During this period, the disease is compensated, when the kidneys can still excrete a copious amount of urate. The duration of such activity depends on:

• metabolic features;
• the intake of a purine base with food into the body;
• compensatory ability of the kidneys.

The most common clinical manifestation of the disease is acute gouty arthritis.

How else is gout diagnosed?

The formation of crystals is observed in the cavities of the joint capsule and cartilage tissues, which leads to damage and the development of inflammatory processes. An attack can be triggered by any factor, it is the metatarsal joints of the lower limb that are more often affected, less often the knee or elbow joints.

After an attack, remissions occur, which sometimes last up to one year.

With complications, inflammation can go to the vessels or soft tissues, which develops phlebitis and cellulite. The aggravated period lasts from about a few hours to a couple of days. Deformation after the period of exacerbation is not observed.

In the case of the development of the disease, kidney damage can also be observed. It looks like this: uric acid leads to abundant deposition of salts in the vessels of the kidneys, which provokes the occurrence of nephritis and secondary arterial hypertension.

Stages of the disease

The manifestations of the disease are divided into several stages, which affect the patient's health in different ways.

Stages of gout	Manifestations (symptoms)
First	Runs without symptoms. There is an increased content of dangerous uric acid in the body. At this stage, the disease can cause damage to the kidneys and the deposition of salts in several joints.
Second	Acute gouty arthritis. The most common localization of the disease is the big toe. Without the necessary treatment, gout spreads to other parts of the legs and arms, wrists, knees.
Third	The stage of remission, when the attacks last no more than a few hours, the pain in the joint is insignificant, because the time of remission sometimes reaches one year. But with subsequent exacerbations, the attacks become longer and more intense, and the time between them is reduced.
Fourth	Chronic tofus gout, which occurs after 4 years, when the disease flows into a chronic form. The appearance is characterized by the appearance of typical gouty nodules on the skin and frequent attacks. If there is no proper treatment, remission can disappear forever.

It is necessary to respond as quickly as possible to the manifestation of symptoms that report changes in the body. Timely diagnosis and final diagnosis help to quickly cope with gout and its unwanted exacerbations and consequences.

If the patient has chronic problems with the joints, it is necessary to come for scheduled examinations by a specialist to monitor the state of health.

Treatment of attacks of the disease

When the manifestation of primary signs takes patients by surprise, there is no way to quickly seek qualified medical help, it is recommended to follow a couple of rules that can alleviate the current condition of the patient:

Non-steroidal anti-inflammatory drugs can reduce or completely relieve pain, inflammation. But medicines of this nature have a whole range of contraindications and side effects, so you can take them only after consulting a doctor.

It is not worth treating this disease with folk methods, as this can easily provoke complications during the course of the disease.

Various herbs and infusions are best used when allowed by the treating specialist.

After the manifestation of the primary signs of gout, it is necessary to seek qualified medical help as soon as possible. Modern medical methods allow you to completely cure the problem and avoid exacerbation of the disease. Remember that the diagnosis is not carried out independently and the treatment should not be chosen by yourself, as this entails negative and undesirable consequences.

It is better to go to the clinic and undergo an initial examination, pass the necessary tests and turn to an individual treatment method that will be selected by the attending physician.

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