Treatment of joints

Causes, Symptoms and Treatment of Gout On Legs

What is gout?

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

All gums suffer from gout, ranging from the joints of the fingers to the joints of the toes.

It was known even in the time of Hippocrates and is called "disease of kings" because the main source of its occurrence is the excess in food and alcoholic beverages. Gout is often chronic.


Causes of gout

The cause of gout is an elevated and persistent level 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 small particles are deposited in the joints, which ultimately leads to partial or complete destruction of the joint. For the same reason, such situations are called microcrystalline.

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A large amount of uric acid in the body can be for two reasons: the first reason is when healthy kidneys can not cope with the withdrawal of an unusually large amount of uric acid, the second reason is when uric acid is released in normal amounts, but the kidneys are unable to remove it.

Every year, more gout is getting sick. Doctors explain this phenomenon by the fact that in recent years people are more likely to consume food rich in purines( for example, meat, fatty fish) and a huge amount of alcoholic products. This is confirmed by the fact that during wars the percentage of people suffering from gout fell sharply due to the fact that meat products, and, especially, alcohol, it was very difficult to get.


Symptoms of gout

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

Signs of gout is the appearance on the hands or feet of unusual growths, while the level of uric acid is significantly increased. When growths, in other words, tofusi burst, a person can see whitish crystals of uric acid. The patient can feel quite intense pain in the affected areas. Such salt deposits in the joints interfere with a full life.

Possible complications of

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" - it's nothing more than conglomerates of sodium urate crystals that 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, the immune response occurs, as these deposits are perceived by the body as a foreign body, which causes the accumulation of leukocytes and begins a strong inflammation called gouty arthritis.

It is worth paying special attention to the fact that gout-stones in the kidneys can become the main cause of kidney failure and can eventually lead to death.

Pain with gout

To understand the beginning of a gout you can by sudden pain in the joint. They are accompanied by severe redness, swelling and heat."Burn" can not only hit the place, but also the area of ​​the body in the immediate vicinity. At the same time, 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.

Pain, as a rule, begins at night and becomes, in practice, unbearable. In the daytime there is often some improvement, the pain recedes, but do not think that everything has passed. Such acute symptoms can torment the patient for about a week.


Gout in men on legs

Gout is a chronic disease. Cure it completely impossible. This ailment often manifests itself on the feet. 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, will make itself felt. With each attack, the time between them will be reduced. Gout will return to the person more and more often.

Damaged places on the legs are often destroyed more and more, the disease can affect the neighboring joints. With a long illness over time in the affected areas, under the skin may appear peculiar hillocks, which are called "gouty nodes" or "tofusi."

This is due to the fact that the body begins to perceive large salt deposits in the joints on the legs as a foreign body, the immunity begins to inevitably react - to accumulate leukocytes, after which a strong inflammation begins. Sometimes tofusov burst and out of them stand out whitish dust - crystals of uric acid.

Often gout 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 estrogen, female hormones, is sharply reduced in the body. Children and young guys are practically not prone to gout. There are rare exceptions, in cases of hereditary impairment of uric acid metabolism.


The role of uric acid in the development of gout

This disease severely impairs metabolism. Purines enter the human body with food, but they are also produced by him. Next, purines are split into uric acid, which is excreted by the kidneys. In people with gout, the content of this uric acid is much higher than normal. Excess uric acid is deposited in those tissues where there is no blood supply. There, crystals are easier to gain a foothold.

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

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

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


What should I do if I have an acute attack of gout?

Even with adherence to recommendations, an acute attack will not be instantaneous. But this will significantly reduce the time during which the disease will torment the person. Mainly you need to observe strict bed rest. Painful limbs are best kept in an elevated position, for example, to lay a pillow under them.

In case of intolerable pain, ice can be applied. Then it is desirable to make a compress on a sore spot with Vishnevsky ointment or dimexide. In the intake of food, it is better to restrict yourself, you can use liquid porridge and vegetable broth. But drink is worth as much as possible alkaline drinks, 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 with rheumatism and gout).You need to drink at least 3 liters a day.

Any painkillers will not help. You can take modern anti-inflammatory drugs without steroids. If you took any preventive measures prescribed by your doctor, then the procedure should be continued.


Preventing exacerbations of gout

Most often gout appears in places where the joint was injured. Therefore, treat such places with caution. Do not wear narrow and uncomfortable shoes, as it can severely damage the big toe, which so "loves" gout. Mainly to prevent the onset of gout attacks, diet and balanced nutrition are used.

The way of life will have to be completely revised, making it healthy. You should reconsider your taste preferences. Recommended diet number 6, which helps reduce the body's uric acid and urate. Strictly limited, or even excluded, products containing urine bases - the main source of urate. But poor 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, dairy products with low fat content.

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

More information on what you can eat and what not, as well as other features you can find here

Alcohol and smoking inhibit the excretion of uric acid from the body. Consequently, its crystals are more deposited in the joints. For prevention, alcohol should be completely excluded, especially beer, and also quit smoking. It is not recommended to drink tea, coffee, cocoa. In addition to dieting, 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, it is worth paying special attention to the development of their mobility. Attention should be concentrated on those sites where there are attacks of pain. Daily it is necessary to do gymnastics for joints. At first, it will be unusual, because the joints are harder to be mobile because of the deposits. It is recommended to be more often on air and to make walks.

Mineral water for gout

Mineral waters perfectly contribute to removing unnecessary purines from the body. Prefer alkaline and organic substances. They can be attributed primarily to Narzan, Essentuki and Borjomi. Remember that any liquid 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 it is unfortunately impossible to achieve a complete cure for this disease. However, timely treatment starts allows you to take gout under control, reduce painful attacks to a minimum and hedge against serious complications.

The main principle of treating gout is to control the level of uric acid in the body. For medical treatment should contact a doctor-rheumatologist. Its prescriptions will be aimed at reducing the volume of uric acid and its rapid removal from the body. Only a qualified specialist can prescribe medications that, with possible concomitant diseases, do not cause the greatest harm to health.

Most often, doctors prescribe for non-steroidal anti-inflammatory drugs for 1-2 weeks, such as methindole, diclofenac, butadione, indomethacin, naproxen. To quickly reduce the concentration of uric acid in the body, allopurinol, orotic acid, thiopurinol, hepatocatalcil, milurite can be discharged. To stop acute signs of gout, doctors recommend taking colchicine.

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

  • Reducing the level of uric acid in the patient's body;

  • Coping with acute inflammation and pain relief.

The earlier the patient undergoes the examination, reconsiders his habits and proceeds to treatment, the more likely it is to achieve a stable remission. Without adequate therapy, gout rapidly progresses, especially in patients of mature and advanced age, therefore, it is by no means impossible to reason on the principle of "caught-let-go".

Drug therapy for reducing uric acid level

Since the cause of gout is precisely the excess of uric acid, the solution of 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, responsible for the transformation of human hypoxanthine into xanthine, and then xanthine to uric acid. Thus, Allopurinol reduces the concentration of uric acid and its salts in all body environments, including blood, plasma, lymph and urine, and also promotes 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 with urine, therefore Allopurinol is contraindicated in patients with severe renal failure. Nevertheless, for the majority of patients with gout, it remains to this day a preparation of the first order. Cost: 80-100 rubles per packing 30-50 tablets;

  • Phoebusostat( Ulorik, Adenurik) is a selective xanthine oxidase inhibitor that, unlike Allopurinol, does not affect other purine and pyramidal enzymes of the human body, besides it is excreted not by the kidneys, but by the liver. Phoebusostat is a relatively new drug for the treatment of gout, it is not produced in Russia, and in Western Europe and the United States it has undergone numerous clinical trials and has shown excellent results. Febuksostat for three months completely dissolves accumulations of crystals of salts of uric acid in the region of fingers and elbows and effectively prevents their repeated formation. Can be used by patients with concomitant renal pathologies. It costs a drug not cheap - an average of 4500 to 7000 thousand rubles, depending on the country of origin;

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

  • Probenecid( Santuril, BeneMid) is a drug that prevents re-absorption of uric acid in the renal tubules and enhances its excretion in the urine. Probenecid was originally used in complex antibacterial therapy to reduce the damage to the kidneys with antibiotics. But then it began to be prescribed for chronic gout and hyperuricemia( increased uric acid in the blood).It is important to understand that Probenecid enhances the excretion of uric acid, rather than suppresses 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 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 treatment with Probeecid gout are accompanied by additional hormonal and anti-inflammatory therapy. It costs a drug from 3500 to 7500 rubles.

Treatment of gout with decongestants and pain medications

Symptomatic treatment of gout is to stop seizures, relieve edema and pain, and is performed with the following drugs:

  • Colchicine( Colchicum, Colchimine) is an alkaloid, is released from the poisonous plants of the Melantie family. The most common source of colchicine is autumn autumnal. Colchicine inhibits the formation of leukotriene, stops the cell division of granulocytes, prevents the movement of leukocytes to the focus of inflammation and prevents urates( salts of uric acid) from crystallizing in the tissues. This drug acts as an emergency aid, and is recommended for admission in the first twelve hours after the onset of an acute attack of gout. It is necessary to drink immediately two tablets of Colchicine, an hour later - another, and then one tablet three times a day for a week. The drug very often causes unwanted reactions from the gastrointestinal tract - nausea, vomiting, loose stools. The average price of Colchicine in pharmacies is from 1,000 to 2,000 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 interference of allergens, chemicals, bacteria, viruses and other foreign elements. Glucocorticoids quickly stop inflammation, but suppress immunity, so hormonal treatment of gout is advisable only if the expected benefit exceeds the potential risk. The cost of synthetic steroid hormones varies from 30 rubles( the oldest drug is Prednisolone), up 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 that of glucocorticoids. NSAIDs are non-selective inhibitors of cyclooxygenase, the enzyme responsible for the synthesis of thromboxane and prostaglandins. Thus, these drugs also suppress inflammation, but, unlike synthetic corticosteroids, do it more slowly, and are not immunosuppressants. For 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 substance) Nurofen can reach 150 rubles.

How to prevent gout attacks?

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

  • If possible, do not subject the joint to any load, periodically fix it in a raised position and apply ice for 15-30 minutes 2-3 times a day until the painsubsides;

  • Do not overuse aspirin, which can cause a jump in uric acid levels in the blood and aggravate the symptoms of gout;

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

  • Every day, devote more than half an hour to physical education: walk, ride a bike, jog, dance, swim. In the morning, do exercises. Regardless of age and weight, patients with gout should give themselves daily physical exercise - sport works with gout more effectively than any medication;

  • Drink at least two liters of clean water a day. So that the kidneys can excrete uric acid from the body, they need water first of all - not the liquid that the kidneys still need to filter( coffee, tea, juice), namely pure water. Without enough water, even healthy kidneys can not cope with the cleansing of the body;

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

  • Do not drink carbonated drinks with sodium benzoate and powdered juices with fructose, completely discard alcohol;

  • Revise your diet in favor of vegetables, fruits and cereals, eat no more than 120 grams of animal protein a day, avoid offal and fatty sausages.

On the topic: From the pains of gout can also see popular folk remedies

The newest data on the treatment of gout

According to the latest data, obesity is most likely to predispose to gout caused by excessive consumption of fatty foods of animal origin. At risk, lovers of sausages, wursts, bacon and hamburgers. It is the excess of proteins that leads to the excess of uric acid, and the extra weight creates an increased strain on the joints and, thereby, accelerates the development of the inflammatory process.

American scientists have also established a direct link between deficiency of calcium and ascorbic acid and the development of gout. With age, these important substances for the body begin to be missed even by those people who lead a healthy lifestyle and do not complain about excess weight. Therefore after forty years it is necessary to annually be examined and take multivitamins prescribed by the doctor.

Recently, a new drug, suppressing the synthesis of uric acid - Benzobromarone, has been developed. Now there are active clinical trials of this drug, and in some Western countries it has already been allowed and put on stream. But before the novelty rests on the domestic pharmaceutical market, it is likely that a lot of time will pass.

It is also known about the experimental development of new non-hormonal anti-inflammatory drugs that directly affect the protein interleukin, which provokes gouty inflammation of the joints and tissues. But the exact timing of the appearance of these drugs in a free sale is difficult to call.

Allopurinol: Pros and Cons

The most popular drug for treating gout, Allopurinol, is increasingly being sharply criticized by modern doctors, since the large number of side effects and complications associated with its regular use calls into question the advisability of such therapy. According to statistics, an average of one in two hundred and sixty patients with gout Allopurinol provokes sudden death as a result of renal coma or cardiac arrest.

However, the largest international study of Allopurinol, the results of which have recently been published in the scientific journal Annals of the eumatic Diseases, proves the high effectiveness of the drug, moreover - the ability to prevent the onset of death. This study certainly does not disprove the presence of side effects and high risk for the kidneys, and does not eliminate the need for new development. But we must admit that Allopurinol is still a first-line drug in the treatment of gout, at least because of good knowledge, reliability and affordable price.

Scientists have tracked the fate of 5,927 patients taking Allopurinol on a regular basis and the same number of patients treated with gout with other drugs that reduce uric acid levels. It turned out that the mortality in the first control group was 19% lower than in the second, and such results persist throughout the life of patients. That is, Allopurinol is still the most effective and safe drug, both for the treatment of acute, first-diagnosed gout, and for maintaining normal health in elderly patients with chronic disease.

Author of the article: Candidate of Medical Sciences Volkov Dmitry Sergeevich, surgeon

ayzdorov.ru

Features of gout in men

Gout is known since the time of Hippocrates and is the most frequent disease of the violation of protein metabolism. This disease is characterized by the deposition of uric acid salts in mucous bags, tendons, cartilages mainly in the area of ​​the joints. Most often, gout occurs in men. This is due to a penchant for kidney disease. An important role is played by the defect of the male chromosome.

The occurrence of gout is facilitated by excessive consumption of meat, especially smoked products, alcohol abuse, impaired kidney function, sedentary lifestyle. Also, the cause of gout development may be hereditary predisposition.

More often people, having relatives with a normal constitution and leading a healthy way of life, at all do not suspect of the predisposition. The disease often becomes a companion of diabetes, hypertension and obesity.

Pathogenesis of

When gout is a violation of protein metabolism, resulting in increased levels of urate in the body. Over time, they accumulate in the connective and muscular tissues and cause reactive inflammation in the joints, which is manifested by local fever, swelling, redness and severe pain.

As the disease progresses, the symptoms increase, the joints lose their mobility and are deformed. The intensity of pain is somewhat reduced, but it becomes constant. Relatively rare contracts and ankylosis. The urine diathesis can appear in the form of lesions of vessels, heart and kidneys. The exacerbation of gout directly depends on nutrition and at times of the year.

Symptoms and stages of the disease

The main symptoms of gout are inflammation of the joint of the big toe and a large number of leukocytes and neutrophils.

Depending on the course of the disease, several stages are distinguished:

  1. Acute stage, in which arthritis appears. For this stage, the following signs are characteristic: severe pain and inflammation. In the joint there is a restriction or total lack of mobility. The reverse course of inflammation can occur as quickly as its beginning. If you do not consult a doctor, the next stage develops over time.
  2. The chronic stage of gout is characterized by the accumulation of uric acid salts not only in the joint zone, but also in the subcutaneous tissue. This is one of the main signs of chronic gout. This process is manifested in the form of small dense nodules. The disease extends to large joints.

Accumulation of salts with gout

Features of the disease in men

Progression of the disease in men is faster. And if you do not start timely treatment, the disease can affect not only the joints on the legs, but the large joints of the hands. In the area of ​​the joints there is redness, swelling, a sharp unbearable pain. In the acute period, subcutaneous nodules appear. Often the urate deposits in the kidneys. With time, deformation of the joints occurs.

Treatment and rehabilitation

Treatment and rehabilitation of patients includes: drug therapy, rational nutrition, regular exercise therapy, massage and physiotherapy.

In an acute period, non-steroidal anti-inflammatory and hormonal drugs are prescribed. In the remission phase, the patient is prescribed medications that excrete uric acid. The course of treatment with such drugs is determined by the doctor, given the severity of the patient's condition.

Another advise reading:
How to cure gout at home

Exercise activates the metabolism, increases diuresis, improves blood circulation in the affected joints, increases the volume of movements, regulates the activity of the central and endocrine systems. All this leads to an increased release of uric acid salts from the body.

Do not prescribe therapeutic exercise during the attacks of the disease, i.e.in the acute period. Only after improving the state of health, patients are recommended to perform a daily set of exercises. Passive and active movements are used in affected joints. In order to improve the functions of the respiratory and cardiovascular system, prescribe breathing exercises.

Before performing a set of exercises, the patient is recommended to do a massage and undergo physiotherapy. It is advisable to enroll in the pool or simulators.

Diet therapy

The golden rule in the treatment of the disease is strict adherence to the diet. The goal of therapeutic nutrition for gout is the reduction of uric acid in the blood and the dissolution of urates. Patients are prescribed a low-calorie diet, which helps purify the blood from alkali. The intake of food should be frequent and divided into 6 receptions.

The ration includes boiled meat of low-fat varieties, dairy products, eggs. It is useful to eat cereals and flour products, as well as vegetables and berries in sufficient quantities. Good help to remove salts of uric acid from the kidneys is the consumption of sweet fruit. To normalize the metabolism and rapid dissolution and excretion of urate should drink a liquid in a volume of at least 2 liters.

With gout, you should limit the intake of vegetable proteins: peas, beans, soybeans. It is not advisable to include cauliflower, sorrel, broccoli, mushrooms, radish, spinach in the diet. Strong teas and coffee hold uric acid. Try replacing them with herbal remedies.

Great value in the diet for gout has the holding of unloading days. During the exacerbation of the disease, meat and fish products are excluded from the diet. The disease can be treated with folk methods. To remove uric acid salts from the kidneys it is useful to drink infusions of chamomile, birch buds, nettles, kidney teas. Within a month before meals you can drink no more than 30 ml of warm red wine. However, men should take into account that the abuse of alcohol can lead to a delay in urate in the body and cause an exacerbation of the disease.

Patients with gout are recommended at least once a year during remission to be treated in specialized resorts( Essentuki, Truskavets, Belokurikha, Pyatigorsk).When you follow all the recommendations and follow a diet, the disease becomes resistant to remission.

MoyaSpina.ru

Gout in men: causes, symptoms and treatments

To date, gout is commonly considered a fairly common problem. This disease is the result of a violation of normal metabolism and leads to the deposition of salts of uric acid in the joints. Statistics also confirms that gout is more often diagnosed in men, while women suffer from this ailment about 20 times less often. So what are the causes and symptoms of the disease?

Gout in men and its causes

As mentioned above, the disease is associated with a disruption of uric acid metabolism, as a result of which its compounds, in particular sodium urates, accumulate in the joint bag, leading to joint inflammation and acute pain attacks.

In some cases, the cause of the disease is increased uric acid formation. But sometimes the level of this metabolic product in the human blood corresponds to the norms - this means that the disease is the result of certain kidney diseases, as a result of which the excretory system can not cope with its basic functions.

Signs of gout in men

Immediately it is worth noting that this disease most often affects the big toes, and sometimes the hands. Nevertheless, inflammation of the elbow and knee joints can occur. Less often, urate crystals accumulate in the ankle joints.

Gout is a chronic disease in which periods of relative calm are suddenly replaced by severe exacerbations. It is worth noting that the deterioration of the patient often occurs against a background of malnutrition or strong physical strain.

Inflammation of the joint is accompanied by severe pain, which prevents movement. Along with this, redness and swelling of the skin are observed - these are also symptoms of gout in men. At the initial stages of the development of the disease, the attack lasts several days, after which it passes by itself. A few months later, there is a repeated exacerbation.

Gradually, periods of relative calm almost disappear - patients are constantly suffering from joint pain. The accumulation of a diseased amount of uric acid salts leads to a gradual destruction of the articular cartilage. In addition, urate crystals can be deposited under the skin, forming noticeable nodules of white or yellowish color.

In more severe cases, salts begin to be deposited in the tissues of the kidneys, which leads to the development of pyelonephritis, or urolithiasis.

Gout in men: treatment methods

Therapy depends on the severity of the disease. During periods of aggravation, the doctor's task is to relieve the main symptoms. For this purpose, anti-inflammatory ointments and pain medications are used. Many patients are prescribed drugs that accelerate metabolism and excretion of uric acid.

But the disappearance of the main symptoms does not mean that the disease has receded. And the only way to avoid another exacerbation is to carefully monitor the level of uric acid. It is the gout in men that is treated mainly with the help of the right diet. In particular, it is recommended to exclude meat, fatty fish, caviar, liver, lungs and kidneys from the menu. You should also limit the amount of some vegetables, including sorrel, asparagus, spinach, cauliflower, radish, eggplant, mushrooms and legumes. People with a similar diagnosis are also contraindicated in alcoholic beverages. Most often, proper nutrition and a healthy lifestyle help to get rid of the main signs of gout for a long time.

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The onset of joint pain is an occasion to immediately consult a doctor who will exclude other arthritic conditions - systemic lupus erythematosus and rheumatoid arthritis, which have symptoms similar to gout.

Fig.: joint damage in systemic lupus erythematosus

A set of diagnostic methods for the detection of this disease include:

  • blood test , which will show whether the level of urate is increased. Although there are cases in which the crystals of uric acid are contained in the blood at a normal level, but gout occurs.
  • taking a sample of tissue( under local anesthesia) or intraarticular fluid( the procedure is very painful, but necessary) for the presence of needle crystals of urates in them.
  • X-ray studies of , showing gouty bone injuries and tofusi.

The diagnosis of "gouty arthritis" is based on anamnesis and clinical examination of the patient.

Video: how gout-affected joints of the extremities look like

What provokes gout? Since the disease is directly associated with hyperuricemia, the lack of treatment leads to the accumulation of excess uric acid salts in the body and subsequent changes in internal organs( primarily in the kidneys).

In a quarter of all cases, gout patients with kidney disease develop kidney disease and kidney failure.

Fig.: urolithiasis of

Other possible complications of gout are:

  • the appearance of a gouty kidney( tissue damage);
  • complete renal failure;
  • erosive-destructive polyarthritis;
  • marked atherosclerosis.
How to get rid of salt deposits with gout? On folk methods of treatment, read in the article on how to treat the deposition of salts in the joints.

Tired of chronic pain in joints? You can remove the symptoms with an ointment with anti-inflammatory effect. Learn more about this here.

Ways to treat gout ↑

An integrated approach is important in the treatment of gout. An indispensable condition is the normalization of the balance of the metabolic process, the restoration of kidney function and the administration of medications.

The general plan of treatment includes the removal of pain and constant intake of necessary medications in order to avoid repeated attacks and prevent subsequent deposition of urates.

Medical treatment

For the treatment of acute attacks, colchicine is used, after which the pain subsides for 12 hours and disappears completely in 48 hours.

Non-steroidal anti-inflammatory drugs( ibuprofen, diclofenac, indomethacin, etc.) are used to relieve pain.

Photo: colchicine for the treatment of gout

Also widely used for treatment are corticosteroids( for example, dispropan), which are powerful anti-inflammatory drugs.

In addition, prescribed drugs that excrete uric acid( usually it's allopurinol).

There is also a treatment of gout with ointments that have a local anesthetic and anti-inflammatory effect.

It should be remembered that medical therapy, conducted in a timely manner, can solve the problem of gout once and for all.

In addition, to stop the attacks of the disease apply compresses with 50% dimexide solution, which has a pronounced analgesic and anti-inflammatory effect.

To do this, mix 1 tablespoon.dimexide solution with 1 tbsp.water and an ampoule of novocaine or analgin, compress on the affected joint for 30-40 minutes. Typically, the course of treatment with a solution of dimexide is 10-20 procedures.

Hardware treatment

This type of therapy helps to remove acute attacks of the disease.

Most often used:

  • ultraviolet irradiation of the affected area, for example, the knee joint, which can help even before the appearance of swelling and redness, i.e.stop the approaching gout attack
  • treatment with ultrasound : thus, the patient's joint is resorptive, analgesic and anti-inflammatory.
  • laser therapy : the laser destroys the accumulation of salts in joints( so-called tophi).
  • phonophoresis with hydrocortisone( sometimes combined with ultrasound therapy): helps to weaken the inflammatory process, increase lymph and blood circulation and accelerate the excretion of salts from the affected tissues.

Photo: hardware treatment of gout

Particularly helps hardware treatment when combining chronic gouty arthritis with osteoarthritis.

Homeopathy

Homeopathic remedies China, Sabina, Colchicum, Berberis are used for the treatment of this disease.

They can correct minor deformities, remove swelling, and also correct related disorders.

The necessary preparation is selected individually by a specialist homeopath.

Physiotherapy

In the remission period of the disease heat treatment is applied:

  • applications with mud;

This treatment reduces the pain, the severity of the inflammatory process and improves the function of the joints.

Photo: treatment of gout with mud

Also often as a method of rehabilitation prescribed spa treatment, which includes balneotherapy( iodide-bromine, radon, sodium chloride and hydrogen sulfide baths).

Balneotherapy promotes:

  • to improve microcirculation and circulation in tissues;
  • enhanced kidney and liver function;
  • normalization of lipid metabolism in the body.

In complex treatment can additionally apply the reception of alkaline mineral water and diet food.

Surgical treatment

Surgically, joint puncture is often performed with the simultaneous introduction of intra-articular corticosteroids.

Sometimes promptly remove urate deposits, large gouty nodes( especially in fistulas and skin ulceration).

Photo: gouty tofus

Shockwave therapy destroys kidney stones, which are then excreted in the urine.

In some cases, with significant destruction of cartilage after removal of tofus, resort to restorative joint surgery( arthroplasty).

Treatment by the method of Dr. Bubnovsky

The method of Dr. Bubnovsky uses therapeutic exercises and kinesitherapy.

A specially selected set of exercises makes the musculoskeletal system function normally, as a result of which it is possible to get rid of gout and pain accompanying it.

Video: joint exercises for Bubnovsky

New in the treatment of gout

To date, innovations in the treatment of the disease are:

  • creating new drugs from the class of non-steroidal anti-inflammatory drugs: Celebrex, Arkoksia, Nimesulide fulflex, etc., which are much milder on the gastrointestinal tractthe intestinal tract than their predecessors.
  • application of hardware purification of blood from uric acid( plasmaphoresogemosorption).This new method of treatment is considered sparing and is carried out on special medical equipment.

Photo: preparation Celebrex

Nutrition is an integral part of gout treatment, it includes compliance with a special regimen.

The menu for gout should be changed.

So, it is necessary to reduce to a minimum:

  • meat products, including liver( only lean beef is allowed)
  • fish products, including seafood( only lean large fish are allowed)
  • consumption of legumes, sorrel, eggplant, cauliflower, mushrooms, radish
  • consumption of chocolate
  • quantity of marinades, canned food,salted varieties of cheese

In addition, it is necessary to reduce the amount of milk, butter and eggs consumed.

Alcoholic beverages for gout should be completely ruled out.

The amount of carbohydrate food increases in the diet:

ruback.ru

The first signs of gout: how to identify the insidious disease

Manifestations of gout - a visual aid

What is this disease - gout?

Gout is a disease that occurs due to a violation of the metabolism of purine bases in the body. This disease has been known since ancient times. Gouty attacks are described in the writings of Hippocrates and his followers.

Gout is called "the disease of kings", its descriptions are found in classical literature and drama. This name and popularity of this disease are associated with its appearance due to a violation in the diet - the abuse of meat fatty dishes - and the widespread prevalence in old age.

In the last century after the disease of gout, people became disabled, and malnutrition caused frequent exacerbations. Know how gout is manifested, it is necessary for everyone, because its first signs are easily not noticed, and then treatment of the disease will be much more difficult.

Gout is a disease that occurs due to metabolic disorders in the body, when the production and elimination of purines, components of uric acid, is broken, and they begin to accumulate in the body. This can be caused by genetic disorders in the enzyme system or an increased content of uric acid in food. Also, the cause of gout can be abnormalities in the work of the kidneys.

Hand fingers suffering from gout

Symptoms of the disease appear with the deposition of urate salts - urate, which in their structure, resemble a needle and, deposited in the joints and kidneys, cause severe pain.

Causes of the disease

Today, doctors using modern medicines ease the condition of the patient and stop the course of the disease. But, nevertheless, it often affects older men. Women suffer from this disease much less often, and its onset often coincides with hormonal changes in the body - menopause. Predisposition to the disease is transmitted genetically, so that it can be considered a hereditary pathology.

The course of the disease is recurrent, chronic, complete cure of the patient is impossible. All methods of treatment are aimed at stopping the pathological process and preventing recurrence of the disease.

The main causes of the disease include the following:

  1. Genetically caused enzyme deficiency, leading to disruption of metabolic processes.
  2. Metabolic disorders.
  3. Diseases of the kidney and urinary system - disrupted the release of products of decay of uric acid.

Risk factors for the onset of the disease:

  • Diabetes;
  • violation of diet - eating large amounts of animal protein;
  • regular consumption of alcoholic beverages.

What happens in the body during an illness?

The occurrence of gout is associated with an increase in the content of uric acid in the body. Excess uric acid occurs when there is a violation of its secretion or increased education in the body. Not excreted in time from the body uric acid, which includes salts - urate, is deposited in the form of crystals. They cause inflammation in the joints and kidneys.

Salts form crystals, in their structure resembling needles. When they are absorbed by protective blood cells - neutrophils, they cause their destruction and the reciprocal inflammatory response of the body.

This inflammation causes severe pain and with its progression, gouty nodules are formed - salt deposits. Such deposits usually appear on the auricles, small joints of the hand and foot. Without proper treatment, these formations can completely disfigure the appearance of the joint.

sustavu.ru

Excessive use of the above products increases the risk of getting gout, so it is recommended to reduce this use to a minimum.

It should be noted that the fault is not only the excessive consumption of purines, but also their difficult elimination. This problem occurs in patients with kidney disease. Of course, the improper functioning of the kidneys leads to the delay of uric acid salts, the accumulation of which will soon lead to the appearance of gout symptoms in men.

Symptoms of the disease

No disease can flow without clearly showing signs, not an exception is and gout symptoms which in men are expressed quite well.

  • In the first place, it should be noted an attack of gouty arthritis. This definition was awarded sharply appearing pain syndromes in the joint area. Most often they are caused by the use of meat products shortly before this, as well as by leaning on alcoholic beverages. Basically, such pains begin to manifest at night.
  • The most pronounced symptom is deformity of the joint of the big toe, however gout can affect both the knee joint and the ulnar joint. During this period, there is a strong aching pain, which prevents a person from even touching the affected area even slightly. Among other things, the affected area begins to swell, redness of the skin appears, while the temperature in this area is greatly increased.

Timely contact with a doctor

In men, such signs of gout should necessarily lead to the idea of ​​an immediate visit to the doctor. It goes without saying that if the disease is started, the duration of such attacks will be several days, or even the longest. Quick access to a doctor allows you to remove the attack in the shortest period of time and relieve the patient's condition. It is worth noting that the frequency and duration of seizures can talk about the stage of the disease and encourage the patient to visit a doctor.

Treatment of the disease

It's no secret that the emerging signs of gout in men should indicate an immediate start of treatment. Like any other disease, gout treatment is done in a complex way. First of all, it is aimed at restoring metabolism and normalizing kidney function. It is important to remember that the use of antipyretic, analgesic and other medicines should be carried out exclusively according to the doctor's recommendation.

The initial stage of the disease is cured by the use of medicines and visits to various sessions of physiotherapy. During this period, the body begins to receive the necessary nutritional status, dietary supplements and other useful components that contain collagen. It is worth noting that the mineral complexes during the period of such treatment are completely excluded.

In order to eliminate the symptoms of gout in men, the patient must prescribe analgesics. Among other things, the patient is prescribed the use of non-steroidal anti-inflammatory drugs. In the absence of a positive effect, steroid preparations are acceptable, however, on the recommendation of a doctor.

Mandatory in the complex of treatment includes visiting sessions of therapeutic gymnastics, as well as therapeutic massage. The last two options are effective enough to affect the disease and promote an early cure for it. Among other things, the doctor can be appointed and stretching, as a result of which it is possible to relieve the burden on the joints by stretching the bones. Such a procedure is carried out with the help of special devices and is only permissible under the supervision and appointment of a doctor. Independently resort to it is contraindicated.

In particularly difficult cases, doctors prescribe an operative intervention, the possibility of which is discussed in advance with the patient. This treatment option is carried out in those cases when no other treatment can produce the proper result and the disease continues to progress.

zdorovuenozhki.ru

Incorrect nutrition, bad habits, excess weight - all this causes many diseases. One such violation is gout in women, as well as in men. It is caused by an imbalance in the body of urate( uric acid).This pathology begins to show itself with mild symptoms. Many ignore the dangerous "bells" of the body, reporting violations, so the disease quickly acquires a chronic form. For this reason, it is necessary to know the first signs and symptoms of gout in women and men in time to recognize the disease and begin timely treatment.

What is gout

Many diseases are at everyone's ears, and there is no clear idea of ​​what kind of abnormality it is. Elementary knowledge could help to save health for thousands of people.

Gout is a disorder in the body of the amount of uric acid. An acute attack of the disease manifests itself in the fact that joints are deposited crystals of salts of this element, which cause severe pain, inflammation and swelling. Knowing the symptoms and treatment of this disorder, which must be done after consulting a doctor, you can avoid recurrence of the attack and the transition of the disease to a chronic form.

Addition of uric acid in the joint

Most often, this disease affects men who are addicted to alcohol, as well as women during the menopause. This disease occurs in two cases: when the body for any reason produces a lot of uric acid, or when its production is not broken, but the urinary system can not cope with so many. In different cases, treatment methods are individually selected. For this purpose, various studies and analyzes are assigned. The doctor must first identify the cause of the violation. Based on the results of the examination, a set of therapeutic measures for the removal of acute symptoms of the disease occurs.

Signs of gout on the legs:

  1. The appearance of joint pain( a conditional symptom that can speak of another disease).
  2. Sharp joint edema, usually the feet.
  3. Severe pain and redness of the affected area. Most often occurs at night.
  4. Through the skin you can see the plaque of white crystals on the joint.
  5. In later stages, gouty growths burst, exposing the crystals of urate salt.
  6. Serious abnormalities occur in the kidneys.

If you find any of these signs, you should consult your doctor.

Why there is a disease in women

Different sexes the disease proceeds in different ways. Unlike women, the symptoms of gout in men are more pronounced. This is associated with the difference in the composition of hormones in the sexes. In particular, the female sex estrogens( female sex hormones) serve a good service, helping to remove uric acid. For this reason, elderly women are affected by illness after menopause, and young people practically do not know what joint pain is. From the disease they are perfectly protected by estrogen.

Tenderness of the legs

After the onset of menopause, that is, during the menopause, the hormonal background of women is noticeably changing. The development of the female hormone estrogen decreases, and, accordingly, the barrier to joint diseases associated with the level of uric acid and the deposition of its salts decreases.

In addition, there are many other causes of gout in women:

  1. Disorders in the work of the cardiovascular system, especially the increased pressure, which affects a huge number of people.
  2. Disorders of excretion of harmful substances through the kidneys. Because of them, urate is retained in the body.
  3. Taking medications designed to lower blood pressure.
  4. Use in excessive amounts of medication designed to fight pain.
  5. Presence in the food of a large number of fatty foods and smoked products. They cause an increase in the amount of uric acid in the body.
  6. Overweight.

Among the female sex in the most dangerous at-risk are women of the age. In order to avoid various diseases, they need to carefully monitor their health. The methods of treatment are at a high enough level, however, prevention is the best way to fight diseases.

How does the female gout

Despite the fact that the hormones produced by the female body are some kind of helpers in the fight against certain diseases, lifestyle and accompanying health problems are risk factors. For example, overweight, hypertension and so on.

Female gout

Signs of gout in women differ from men's, have their own specifics and complications, which add to the general symptoms of the disease:

  1. Since hormones play an important role, women prone to the disease look courageous, suffer from hirsutism, have a coarsened voice.
  2. Even during an exacerbation the disease rarely shows itself sharply expressed symptoms, it flows softer and less noticeably.
  3. Unlike the common localization of affected joints, the female often suffers an ankle, which is not typical. Also, polyarthritis in the hands may appear.
  4. Women are less likely to develop renal failure. Kidney stones are similarly less common than in men.
  5. Female gender combines gout in parallel with endocrine and cardiovascular disorders. In particular, together with this joint damage, they often have obesity and hypertension.

How to treat gout in men and women, only a qualified specialist decides.

In women, the disease occurs in 4 stages:

  • The first is mild malaise, frequent urination, aching tenderness in the joints.
  • The second - acute symptoms of the disease appear. There is almost instant redness of the joint, a tumor grows. The severity of the condition is aggravated by possible nausea and an increase in body temperature. This state lasts a short time, after which everything is normalized and the illness ceases to manifest itself for a time. At the same time, other parts of the body continue to be affected.
  • The third is "the calm before the storm".The patient does not feel a violation in the body. Joints do not bother, there are no seizures. However, urates still accumulate in the body.
  • Fourth - the most difficult stage. The disease takes a chronic form. Begin to form outgrowths of salts of uric acid on the joints, especially the legs. This condition threatens a serious disruption of the kidneys. Even the female hormonal system, which protects the body from the accumulation of urate, can not withstand such consequences.

In order to avoid neglected forms of the disease, women need to closely monitor their health and, if necessary, visit a doctor.

Why men have gout

The reasons for the appearance of the disease in the male have some differences with the causes of female gout. This is due not only to the hormonal background. Often, and the way of life is crucial.

Causes of gout in men:

  1. The lack of natural protection against the disease - estrogen. Excessive consumption of alcohol.
  2. Pancreatic and liver disorders.
  3. Use of predominantly fatty meat foods.
  4. Frequent hypothermia in the cold season.

The very way of life of men has a more common development of various joint diseases. Knowledge of their prerequisites will help to minimize the risks of their occurrence. Gout in men manifests itself more often and for the reason that the stronger sex is less prone to follow their health condition zealously. Accordingly, diseases often take on neglected and chronic forms.

Symptoms of the disease in the male

Gouty arthritis is a companion of the disease in 100% of cases. Signs of gout on the legs in men differ little from the same manifestations in women. True, they flow a little more painful and sharper. At the same time, a similar pattern is observed: puffiness of the affected area, redness of the skin in it, strong pain sensations, limitation of motor activity, salt deposits visible under the skin.

Pain in the knee joint

Given the physical stress and weight lifting that accompanies many men's professions, an attack of gouty arthritis makes it impossible to fulfill these duties, since the leg does not have full mobility, and also under stress causes severe pain.

Signs of gout in men can determine the current stage of the disease. It can be:

  • Acute - accompanied by inflammation of a specific joint, severe pain, swelling, limited movement in the affected area.
  • Chronic - characterized by involvement in the inflammatory process of large nearby leg joints, as well as fiber and tendons.

In the male gouty arthritis develops much faster than in women. He quickly captures not only the joints of the lower limbs, but also causes inflammation of the upper extremities. Therefore, treatment should be immediate. In time, the first signs of gout, and then the appropriate treatment, will allow a man to save his legs and continue his full life.

Methods of treating gout

Modern medicine offers a wide range of ways to get rid of various diseases. A variety of methods makes it possible to alleviate the condition of patients even in advanced stages. While the disease has not taken a serious form, doctors offer conservative therapy. Treatment of gout in men and women with serious damage to the joints and tendons, as well as the formation of tofusov involves surgical intervention.

Treatment is prescribed by doctors after the examination. His character depends on the identified stage of the disease, and this is different.

In the acute stage of gouty arthritis it is recommended to provide the patient with bed rest. The doctor prescribes the amount of fluid that must be drunk every day. To remove acute pain, non-steroidal anti-inflammatory drugs are used. An excellent tool is the substance colchicine. If the first signs were found and treatment was prescribed immediately, then the medications with this component had a quick and noticeable effect. A diet with restriction of acute, fatty, smoked, leguminous and so on is prescribed.

The chronic stage involves a wider range of therapies. During this period, the patient is prescribed drugs that reduce the production of uric acid, and improve its excretion from the body. It is necessary to continue to follow the diet. In the chronic stage, various physiotherapy procedures are recommended: massage, therapeutic gymnastics, paraffin baths. This will help delay the worsening of symptoms for a long time.

Treatment of gout in women and men should be timely. Conservative methods are effective only in the early stages. To avoid surgical operations to remove salt deposits, it is necessary to visit the doctor on time in the presence of the first symptoms of the disease. Then the joints will serve the body for a long time and without problems.

otnogi.ru

Gout: symptoms and treatment, photos, signs of gout

Ancient Greeks called gout "a trap for the feet."From the end of the XVII century gout is considered a separate disease. Gout was mostly male, but now it has overtaken the female half of humanity, and arises in the joints of the hands and feet. It was a consequence of the fact that people often overeat and abuse alcohol, in the treatment of diseases, many medications, diuretics( diuretics) are used. Since the withdrawal of uric acid from the body is delayed, it crystallizes and is deposited in the joints, turning into a sodium salt - sodium monourate. Modern physicians consider gout to be a systemic disease that affects the body completely. Signs and treatment of this disease, the first symptoms of gout you will learn from our article.

Causes of gout

The disease is divided into two groups, depending on the cause of the onset.
  1. 1) Primary gout in the vast majority of cases occurs as a consequence of the violation of hormonal and genetic factors, to which improper nutrition and the use of alcoholic beverages are added.
  2. 2) The secondary form is a consequence of metabolic disorders, as well as excessive intake of medications. To such medicines carry: Pyrazinamide, Aspirin, Nicotinic acid and various diuretics.
The main risk factors can be called:
  • genetic predisposition of
  • men have a higher chance of getting sick, unlike women.
  • as a rule, the disease is diagnosed up to 40 years.
  • taking medications, especially diuretics
  • , alcohol abuse increases the risk of gout, especially for beer.
  • excess weight also contributes to hyperuricemia.
From gouty pains, the lower extremities suffer first. The attack occurs after injury to the legs, playing soccer, due to surgery, long walking or long driving. After surgical operations and injuries, debrided tissue is dehydrated, so more salt and uric acid are localized in this place, they are deposited in the problem joint. With a decrease in body temperature, even by half a degree, the urate begins to turn into crystals in the joints. Gout is often a consequence of overheating in the sauna or steam room, because sweating begins in the bath and the body is drastically dehydrated. Gout is exacerbated during trips to hot countries. Podgora often suffer from hypertension due to the frequent use of diuretics. Uric acid accumulates in the blood, creating ideal conditions for the development of gout. Also to the reasons include:
  • metabolic disorders, obesity;
  • consumes high-calorie meat, fish food in fried form, abuse of vegetable and animal fats and alcohol;
  • hypothermia or overheating of joints and a large physical load on them;
  • factor of heredity.
RNA and DNA contain purine bases - adenine and guanine compounds. When metabolism is disturbed, purines are converted into uric acid in the human body.

Signs and symptoms of gout

The first phase of gout proceeds without symptoms, the level of urates gradually increases in the body, which in the future can lead to gout. This stage lasts a very long time, up to 25 years or more. The second phase is acute gouty arthritis. The first symptoms of gout in this stage are manifested by pain and swelling near the affected joint, as well as a rise in body temperature. The clinical picture of gout has pronounced signs:
  • usually exacerbation begins early in the morning, or late at night;
  • there is a sharp pain in the joint affected by acid-uric crystals, usually the thumb on the leg;
  • there is redness and shine of the skin, together with swelling in the joint and periarticular tissues;
  • the temperature rises, touching the joint is very painful;
  • general weakness and malaise of the body is also present.
In the chronic stage - tofus and nodules under the skin are formed, which is inherent in softening in attacks. Some attacks of gout initially differ sharp pain, then become frequent and can last several hours and even weeks. When the chronic stage of gout occurs, many small and large joints are affected with simultaneous development of chronic arthritis. People with gout early onset diabetes mellitus, atherosclerotic plaques are formed in the vessels, since low density lipoproteins are concentrated in the blood. Cholesterol in the blood in patients above the norm( see how to reduce cholesterol).

Diagnosis of gout

For diagnosis, consider the frequency of recurrent seizures. The diagnosis is made on the basis of:
  1. 1) The urate monosodium crystals found in the synovial fluid and the absence of microorganisms in it;
  2. 2) Confirmed tofus through chemical research or polarization microscopy;
  3. 3) 6-12 signs of gout: X-ray, laboratory, clinical;
  4. 4) Hyperuricemia, asymmetric inflammation of the joints;
  5. 5) On the roentgenogram - subcortical cysts without erosion.

Treatment of gout

Treatment of gout is reduced to relief of acute attacks, drug treatment, diet and prevention of repeated exacerbations. Coping with an acute attack:
  • prescribe a copious alkaline drink 2-2.5 l / day.) And complete rest;
  • apply compresses, applying Dimexide in solution - 50% for analgesia and against inflammation;
  • arrest an attack with non-steroidal anti-inflammatory drugs: Indomethacin, sodium diclofenac, Naproxen, Pyroxicam;
  • relieve pain and inflammation of Nimesil and Colchicine;
On the first day of treatment, the dosages of the drugs are increased, then reduced to a medial therapeutic dose. Adherence to the regimen should be in accordance with the recommendations of the doctor and take into account contraindications. For example, contraindications to the use of colchicine are severe damage to the kidneys and liver, peptic ulcer diseases of the stomach and 12 duodenal ulcer. Coping with an acute attack is possible with pyrazolone and indole preparations: Reopyrin, Butadion, Phenylbutazone, Ketazone. With increased resistance to drugs, Prednisolone is added to treatment. Take at first 20-30 mg / day, then the dose decreases. At the same time, Butadion and Indocid are taken in small doses. Uric acid is excreted from the body by Allopurinol and a specially selected diet.

Treatment of gout between attacks at home

For the treatment of gout in the period between attacks in the home they eliminate hyperuricemia, recurrences of gout attacks, prevent damage to internal organs, restore the broken function of the joints with the help of complex therapy, including drugs, diet, physical influences and sanatorium-It is important not to use long-term medication for gout at home under light attacks, and with a dubious diagnosis. The first two days should be used Colchicine( 1 mg / day) or Indomethacin( 75 mg / day). Before receiving antidotal drugs, the type of impaired purine metabolism is established. It can be metabolic, renal and mixed. Uricostatics inhibit the formation of uric acid, for example, Allopurinol: the daily dose is 100-900 mg, which depends on the degree of hyperuricemia. At a mild degree - 200-300 mg, at an average - 300-400 mg, at a heavy - 600-900 mg / day. For two days you can reduce the level of uric acid by 2-3 times. The drug is used constantly, because it does not have the durability and duration of action. The break is made in the summer for 1-2 months due to the appearance of a variety of plant products in the menu. Uricosuric means inhibits tubular reabsorption of uric acid compounds and increases production, so they are prescribed for renal hyperuricemia. Treat: Etamide, Benzbromarone, Probenecid( BENEMID) and salicylates - 4 g / day. Most often treated with Allamaron, it is convenient in the reception - 1 time per day for 1 table.and has a small number of adverse symptoms. Dissolve uric acid stones and prevent the formation of new ones - with the drug Uralit( Magurlit, Blamaren).

Menu for gout: what can you eat?

Usually prescribed for gout diet number 6, which has a full calorie, it is limited to animal fats and salt, reduced the amount of protein. The diet has many alkaline valences and it provides for increased fluid intake. The energy value of the diet is 3000 kcal. Diet No. 5 is also suitable. It is forbidden to eat:
  • by-products: liver, kidneys, tongue, brains.
  • with meat of young animals and poultry: veal and chicken.
  • with fat varieties of meat and fish, soups and broths from them.
  • beans, rich purines: peas, beans, beans, lentils, sorrel and spinach.
Restrict consumption of animal fats with saturated fats - they increase the level of uric acid in the plasma and reduce its secretion in the urine. Salt is limited to 5-7 g, including its content in products. Overeating and hungry days are forbidden, as uricemia increases and the attack of gout may repeat. It is permissible to eat:
  • with meat and fish in boiled form 2-3 times a week.
  • milk and dairy products.
  • flour and cereals, white bread( in small quantities).
  • vegetables: potatoes, cabbage, zucchini, pumpkin, melons, watermelons.
  • fruits: apples, apricots, plums, pears, peaches, oranges.
  • berries: grapes, cherries, cherries, strawberries and blueberries.
  • before going to bed you need to drink a cup of soft tea, coffee, tea with milk or lemon, juice.
  • includes curd, kefir, dairy and fruit-free days.
  • on meat days - boiled beef - 150 g or boiled fish - 150 g. You can combine meat and fish and enter that day with vitamin C and B¹.
  • during the exacerbation - only liquid food: milk, lactic acid products, kissels, compotes. And also: vegetable and fruit juices, weak tea with milk or lemon, broth of wild rose, vegetable soups, liquid porridges.
As liquids use alkaline mineral water without gas. When the disorder occurs during a period of exacerbation of medications, a sparing diet is observed. With arterial hypertension and poor blood circulation, it is necessary to drink a lot of alkaline water, fruit juices and berry compotes.

Complications of gout

Gout is indicated by the following complications:
  1. 1) Gouty glomerulosclerosis and urate stones in the kidneys. Nephropathy, gouty nephritis, pyelonephritis develops.
  2. 2) Violation of kidney function in violation of purine metabolism( gouty kidney).In the presence of arterial hypertension and diabetes mellitus, acute kidney failure develops.
  3. 3) Gouty arthritis and destructive polyarthritis with joint deformities.
  4. 4) Osteoporosis( thinning of bone tissue).
  5. 5) The formation of tofus on the joints or soft tissues: on the wings of the nose, in the auricle, fingers, feet, in the internal organs - the heart, kidneys, etc.
Gout may accompany coronary heart disease and arterial hypertension.

Prophylaxis and prognosis of

Prolonged seizures can result in complete recovery. The prognosis is favorable and depends on the level of hyperuricemia and adequate treatment. People can maintain their ability to work for many years and their quality of life does not suffer. Prevention is reduced to diet, exclusion of fasting, use of diuretics, long-term use of drugs that dissolve urate salts( Uralit), the use of sanatorium treatment. You can apply compresses to the joints of a mixture of valerian( 3 bottles) and cologne( or vodka) - 200 ml. Compress warmed with a woolen scarf. After an exacerbation the status will improve.
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