Why does the gout attack and how long does it last?Deposits of crystalline formations of uric acid( the product of processing of the genetic material of the human body) in the region of the joints and in the surrounding tissues cause such a disease as gout. This disease is always accompanied by pain in the joints, when the attack of gout begins.
This is an age-related disease, because the older a person becomes, the higher the level of uric acid in his body. Despite the fact that a person regularly hears about gout, one can not say that the disease is very common. Very often gout manifests itself as arthrosis or arthritis.
Physiology of an attack
A gout attack is a consequence of the disruption of nucleoprotein metabolism. The nuclear substance of tissues consists of protein and nucleic acids. Between them, and there is a violation of exchange. Hence gout occurs. Nucleoproteins are a source of uric acid.
During a gout attack, uric acid sodium crystallizes in the mesenchymal tissues( cartilage, articular bags, tendons, fasciae, muscles, skin, kidneys).In this case, even nodules can be formed. Urates are deposited in these tissues, because they have a high content of sodium ions. This slows down the process of splitting and solubility.
Also to the physiology of the seizures of this disease can be attributed the fact that the female gout is much less common than in men.
Women very often confuse gout with arthrosis of the thumb. For an accurate diagnosis, you should see a doctor and he will prescribe a treatment.
What is a gout attack?
Seizures depend on the complexity of the disease. Divide gout can be divided into several types:
- increased content of uric acid( MK);
- gouty arthritis;
- remission gout;
- tofusnaya gout.
For gout of the first type, a low concentration of MK in the blood is characteristic, so the symptomatology is practically not manifested. At this stage, seizures do not appear. And the initial stage of the disease can be the formation of urolithiasis, the treatment of which must be carried out immediately to prevent the development of gout. If a painful sensation arises in the joints, it is insignificant and short-term and amounts to 3-4 hours. Perhaps if you immediately pay attention to the pain and carry out the treatment, the seizures will not happen again, given that gout is a disease that is cured quite simply. The main thing is not to start the process.
For gouty arthritis, nucleoprotein crystallization occurs in a dense elastic mass that fills the joint cavity( synovial fluid).This mainly occurs in the articular tissue of the big toes. The reaction of the body is a sharp inflammatory process( gout).But not only the toes are affected by gout. This can occur in the ankle or knee joint, in the phalanges of the fingers and in the wrist. The attack lasts not for long( about a day).
After the attack is over, the pain will be gone within 48 hours. The next attack can occur at this stage only after a few years.
If the disease does not pay attention, then the seizures will increase, and over time, the intervals between them will be significantly reduced. This is how remission gout occurs. The attack becomes durable and intense. It can affect not only one joint and last 2-3 days. Gout is peculiar to exacerbation, mainly at night, which begin suddenly. Just as suddenly they pass, and this is already a warning sign. Means, it is necessary to carry out treatment.
Tofus is a granular bundle that consists of crystallized uric acid substances, it is peculiar only to gout. These subcutaneous nodules are firm, but these are not outgrowths, since they are mobile. Their color is yellow or cream. The skin in these places becomes thin and inflamed. In this case, painful feelings already accompany a person almost constantly, with breaks of 1-2 days. But tofusnaya gout is a rare disease, because, diagnosing the early stages, doctors conduct treatment and the disease goes away.
Weak seizures last no more than one day. Often people confuse short-lived pain with stretching ligaments or excessive fatigue of the legs due to stress.
It should be remembered that at the first signs of gout it is better to immediately consult a doctor to exclude the progression of the disease and to conduct gout treatment.
What to do during an attack?
According to many people, the pain in a fit of gout can be compared to a toothache or the pain of a woman in labor during a fight. But all the same it is not necessary to panic, it is better to make attack on attacks competent and to take advantage of some useful advices:
Rapid development of an acute attack
- to adhere to a confinement;
- do not allow contact with shoes or clothing;
- drink plenty of fluids;
- take an analgesic;
- if possible touching the joint, apply cold;
- to avoid the ingestion of foods that cause metabolic disturbances.
An acute attack of gout can be prolonged and painful. Therefore, you need to adhere to bed rest. The less a person will irritate the joint, the more painful it will be. It is better to keep the affected joint in a raised state, but only in a relaxed state. For example, under the foot put a few pillows.
You do not need to wear shoes during the attack and cover the area affected by the gout with clothing. It is better to leave it in the open state and lie as much as possible, because the gout is characterized by a very painful sensation.
Quickly get rid of even a sharp and violent attack will help abundant drinking( 3-3.5 liters per day).A large amount of liquid will help to remove uric acid faster from the body. But this does not mean that you need to constantly drink black tea with sugar or coffee. It is better to brew herbal tea, dog rose or cranberries. These plants contribute to the stabilization of the kidneys, which is important for the treatment of gout. Doctors speak about the innervation of the kidneys is one of the main causes of exacerbation of gout. If a person does not have problems with the cardiovascular system, you can drink alkaline drinks: celery juice or carrot juice. Alkalis neutralize crystal-like substances and promote their rapid excretion at the onset of an attack. This is a kind of treatment for gout at home, conducted before the arrival of the doctor.When the attack lasts for a long time, many want to reduce suffering and begin taking pain medication in the hope that they will help relieve pain with gout. It is necessary to know that some pain blockers can only adversely affect the course of the disease and increase the time of the attack of gout. In this case, attacks last even longer. In particular, you should avoid drugs containing aspirin. Aspirin slows the process of excretion of MC products, which makes the attack more prolonged and does not relieve pain. Not depending on how long the seizures last, you can take painkillers only after the doctor has prescribed the treatment.
In the event that the attack is not strong and the joint is not very sore, you can apply cold. But only for about 7 minutes. This is enough to make the pain a little quieter. Do not necessarily put a frozen chicken on your leg. It can be a small piece of gauze, which must first be dipped in icy water. If you apply the cold every hour, the pain will soon subside and the attack will be faster.
When the exacerbation of the disease begins, you need to limit yourself in taking high-protein fish and meat products. They contain a lot of purine, which contributes to the stagnation of uric acid. In this case, it is not said that these foods can be eaten during the calm of the disease. You do not need to completely remove them from the diet, but it is better at least to shorten and alternate with vegetable, fruit and dairy products. Such treatment is very effective and helps to quickly get rid of gout. When the exacerbation begins, under no circumstances should you take alcoholic beverages. Alcohol - one of the causes of concentration of MC in the blood. No need to think that alcohol can quench the pain. It will last only a few hours, and the attack will not go away, the pain will become even stronger, and the attack - more protracted.
Treatment of gout at home allows you to calm down the pain and end the attack for 3 days, that is, when there is an exacerbation of gout. After the attack is stopped, it is better to immediately turn to a specialist - a rheumatologist, because not everyone can endure the intolerable pain, especially at the advanced stages.
Prevention of an attack with goutOf course, in order not to bring to attacks, in addition to contacting a doctor, you must follow all the instructions of a specialist. But there are some rules that should be observed in order to avoid the next attack, especially in cases when a person is predisposed to gout or leads an incompletely healthy lifestyle:
- adhere to a stable weight - gout loves lush people;
- alcohol and diuretics are dangerous( help the gout detain salt);
- water is a guarantee of health;
- comfortable shoes;
- diet is an effective treatment.
It should be remembered that the reason for acquired gout is overweight, and, by the way, to calm the attack is not so easy for fat people. They are 70% more than people with normal weight, experience very long seizures. And if a person with a normal physique can stop an attack in a few days, then the total time person needs three times more. To the formation of uric acid lead to debilitating diets, when a person, having a weight of 130 kg, sharply grows thin to 80 kg. This is harmful not only for the whole body, but in particular for cartilaginous articular tissues.
Not only during the attack, but also in general with gout it is impossible to drink alcohol and diuretics. They can provoke an attack even in a healthy person. These substances - a barrier for the normal removal of salts from the body.
Inconvenient low-quality footwear is a stimulant for the formation of a gout attack, as it irritates the gout-affected area of the thumb. A person who already has a disease, it is better to buy orthopedic shoes.Observing a diet, any person can not only prevent an attack, but also not get sick with such an insidious disease as gout. The main products that can not be eaten contain urea( seafood and meat products).
In order not to become a hostage of a gout attack, it is necessary to thoroughly study the symptoms and causes of the disease. Only in this case a person will protect himself from illness and from terrible painful sensations. After all, it is always better to prevent or cure the disease at an early stage, so as not to rush into questions in the future: how to relieve the pain and what to do in case of an attack?
It is important to know where the gout comes from, what is characteristic of gout, to protect yourself from seizures and not undergo treatment. Malnutrition and excessive consumption of alcohol, diuretics - this is the direct route to a fast and painful attack, that is, to gout. In some cases, the disease can be transmitted at the gene level, but if you adhere to a diet, you can spend your whole life without painful attacks.
Provocative attacks can be a nervous overexertion or prolonged depression.
How does an attack occur?
The joint is destroyed by the action of urate salts
Symptoms of gout are manifested by attacks that are often confused with pain from bruising or sprain. If you do not carry out treatment, then over time there will be more severe pain, redness, inflammation, a feeling of heat in the place of gout( which, by the way, in no case can not be heated), hard neoplasms on the affected joints.
The aggravation can be protracted and last more than 7 days. How is it removed? With such symptoms, you should always contact a rheumatologist, because neglected gout can cause destruction of the joint tissue and the joint itself. And why should I suffer infernal pain when the treatment of gout is available to everyone and passes without special difficulties?
There is often a misconception that the level of uric acid can be controlled by drugs. Yes, it's true, but not during a gout attack.
What kind of diet should I follow in gout attacks?
Probably, to the person, especially during an acute attack, there is it would not be desirable absolutely because of a strong pain. Still need to saturate the body with substances that will help to remove uric acid quickly and effectively. This will help greatly reduce the time of pain. Diet is an important and main method in the fight against gout and when it is prevented. Many people who have the disease know how to relieve a gout attack with the help of mineral water. Mineral water, especially alkaline, as already mentioned above about freshly squeezed juices, quickly removes unnecessary purines from the blood, thereby purifying it. Then the pain with gout disappears.
To reduce the time of an attack and reduce it from 7 days to 2, you need to use, as soon as the pain begins, curative decoctions of chamomile( do baths).Chamomile is an excellent antiseptic, it is able to quickly and destructively affect the inflammatory process, since gout is an inflammatory disease. In addition, the decoction acts as a sedative. Brew as standard - 1 tbsp.l.for 0.5 liters of water. Decoction can be drunk, and in unlimited quantities. When there is an acute attack with gout, you can take a decoction of spruce cones to cleanse the joints.
Gout: treatment with medicines. Attack of gout
Gout occurs when violating purine metabolism in the human body. In this case, an elevated concentration of uric acid is found in the blood, and articular and / or periarticular tissues, kidneys and other organs suffer from deposits of urate - sodium urate salts.
Causes of gout
Excess uric acid is produced by increased synthesis of endogenous purines, reduced urate excretion, or a combination of these processes. Recognize the symptoms of primary and secondary disease. The latter case obliges to pay attention to medicines taken by a person who was struck by gout. The causes of the disease require detailed consideration.
Gout provoked by hyperproduction of uric acid
An excess of purine bases and nucleosides is the main reason for the high concentration of uric acid. With unlimited consumption of food, in an abundance of substrates, forming purines, the hyperproduction of acid naturally occurs.
The symptomatology of secondary hyperproduction causes an excessively high cell disintegration occurring against a background of certain diseases( for example, a hemorrhagistosis, paraproteinemia, hemolysis, alcoholism, anticancer chemotherapy becomes a provocateur).Hyperuricemia often accompanies psoriasis. However, the clinical pathology of gout in these cases develops infrequently.
Gout caused by decreased excretion of uric acid
In 90% of people who have a gout disease, reduced acid extraction is noted. The kidneys, intestines and skin integuments leave the uric acid. With reduced excretion of urate by the kidneys, they accumulate in excess in the body and crystallize. Tiny crystals are deposited in the joints, leading to inflammation and pain. A kidney in this case affects urate jade.
This phenomenon is sometimes caused by diuretics, alcohol, acetylsalicylic acid, aminophylline, caffeine, diazepam, dimedrol, L-dofa, dopamine, B12 and C vitamins in small dosages. Lead leads to epidemic outbreaks. Lead gout is caused by paints, surrogate alcohol and other sources containing heavy metal.
Symptoms of gout: signs of attacks
The onset of symptoms is associated with the deposition of salts formed by uric acid. Crystals settle in the joints and kidneys. The first attack of gout usually does not occur before the age of thirty. It is experienced more often by patients who have reached 40-60 years.
The attack is accompanied by swelling and redness of the joint, acute soreness. Without treatment, it does not go on for several days or even weeks. Evening and night - the main time of occurrence of fleeting seizures.
An attack of gout is provoked with abundant meat food, alcoholic beverages, individual varieties of fish, coffee and other products enriched with purine bases. The disease in most cases affects the big toe, although the defeat of other joints is not excluded. Its bright symptom is acute arthritis, which unfavorably proceeds with pathologies of the kidneys.
Arthritis is an acute form of gout. It is expressed in a sudden onset gouty attack - a painful inflammation of the joint. With gouty arthritis, urate crystals fall out of the tissues into the joint cavity, causing inflammation. Gouty attacks occur, usually in the middle of the night.
Provoked by alcohol, trauma, physical overload, surgical operations, a number of gout medications. Treatment with medicines allows you to relieve seizures and relieve the condition. When attacking the joint and adjacent tissues swell, the skin in the place of the hearth blushes, the pain increases.
Acute arthritis attacks disappear within a few days( sometimes weeks), even if they are not treated. Repeated attack returns after six months or a year. Although periods of calm sometimes last up to 10-20 years. In people who are not puzzled by treatment, the frequency of seizures increases, several joints are involved in them at the same time. The duration of attacks increases, they become more pronounced.
The chronic course of the disease is accompanied by the characteristic signs:
- chronic arthritis;
- a cluster of urate crystals;
- with kidney damage.
Prolonged gout accompanies all symptoms simultaneously. Chronic arthritis affects those who survived the secondary form of the disease, untimely or inadequately treated.
In affected kidneys there are 3 types of changes:
- Renal tissues are overgrown with urate crystals. They have a weak inflammatory reaction.
- Intra-urinary tracts of urine outflow are clogged with urate crystals.
- In the urinary tract formed uric acid stones.
The variations are combined in various variations, resulting in the clinical term "gouty kidney."Stones, lain in the urinary tract, are asymptomatic or show signs of urolithiasis.
Methods of treatment
The task of treatment is to prevent gouty attacks and to remove acute arthritis. Support for adequate drinking regimen, dumping excess weight, diet therapy, reducing medications that increase hyperuricemia, excluding alcohol prevents gout. Treatment with medications can eliminate inflammation and pain.
Water reduces the concentration of urates, preventing them from falling into crystals that settle in tissues and organs. In addition, it promotes their leaching and withdrawal from the body. Alcohol is capable of a diuretic effect. In large doses, it dehydrates the body, promoting the crystallization of salts, triggering gouty attacks. In addition, it slows the excretion of urates from the body, giving them the opportunity to be deposited in the joints.
Weight loss helps reduce the risk of recurrent gouty attacks. The diet should reduce fat and reduce calories. The diet is combined with regular aerobic exercises.
The main aspects of gout control are the treatment of pain relieving medications that eliminate inflammatory reactions that control an impaired metabolism leading to hyperuricemia. Anesthesia is carried out with acetaminophen( Tylenol) or other more powerful analgesics.
Of non-steroidal anti-inflammatory drugs, indomethacin is recommended. True, it is not suitable for patients with an allergy to aspirin and patients with polyps in the nose. Colchicine is suitable for the removal of a gouty attack.
Patients' reviews focus on the fact that oral medication results in serious side effects associated with the frequency of its administration( once an hour or two hours, until the soreness significantly recedes or unwanted reactions appear).
Corticosteroids, belonging to powerful anti-inflammatory agents, relieve acute attacks. To avoid severe long-term side effects, they are prescribed short courses. They are prescribed to patients who have concomitant ailments of the liver and kidneys.
Prolonged periods patients take drugs that reduce the concentration of uric acid in the blood. They promote the dissolution of heavy tofusnyh deposits, prevent the formation of stone and the development of pathologies in the kidneys. Thanks to them, gout does not occur again. Treatment with medicines from this category either increases the excretion of urates, or reduces their synthesis from purines of food.
These drugs can worsen gouty attacks, so their reception begins after the fading of the inflammatory process. If they were treated before the attack, the course is not interrupted, and try to adjust the dosage( especially after its extinction).Since many patients with a high level of uric acid are not prone to stone formation in the kidneys and are not burdened with gout, treatment with medicines that affect the level of urate is purely individual.
Using probenecid and sulfinpyrazone, uric acid excretion is enhanced. These drugs are not suitable for treating people with urolithiasis. They sometimes provoke the formation of concrements. Abundant drink, combined with their reception, promotes accelerated passage of acid through the urinary system and prevents the formation of conglomerates.
Due to allopurinol prevent the synthesis of uric acid. They block the metabolic conversion of purine bases to an acid. It is cautiously prescribed because of the risk of getting side effects to those who have weakened kidney function.
Using home remedies
Home treatment methods help to remove the symptoms of gout, the current acute. The inflamed joint is lifted upward, providing him with peace. Soreness is reduced by applying ice. Exclude the use of aspirin-containing drugs( they inhibit the excretion of uric acid).
Treated with medicinal plants: dog rose and sea buckthorn, cranberries and strawberries, rowan and blueberries, barberry and St. John's wort, birch and linden, chicory and other herbs. Use homeopathic remedies.
Diet therapy for gout
Compliance with the diet provides a stable remission. Ideally, they achieve complete elimination of products enriched with purines. If an absolute exception is not possible, the maximum restriction on their consumption is introduced. Try to balance the amount of fat and drink abundantly.
In abundance are saturated with purines anchovies, sardines, goose, chicken and any fatty meat, by-products, meat extracts, beans and dry wine. When diagnosing gout, tomatoes are eaten in moderation.
In tomatoes full of organic acids. Purines in them are not so much, as, for example, in meat. Therefore, nutritionists who are tormented by gout, do not prohibit tomatoes. On the contrary, they believe that a reasonable amount of tomatoes and dishes from them is beneficial to such patients.
How to treat gout at home
- 4 Prevention of attacks and relapses
Gout is a chronic systemic disease with quite frequent bouts of exacerbation associated with impaired purine metabolism and the accumulation of uric acid and its salts in the body. Most patients have a natural and natural question about how to cure gout at home.
It should be noted right away that the task is almost impossible to cure forever, but it is possible to achieve persistent remission, get rid of joint pain and significantly reduce the number of gout attacks.
In addition, the main course of therapy can be performed on an outpatient basis.
Which doctor treats gout?
It is absolutely not recommended to take any medications for gout, use ointments, do compresses without consulting a specialist. Assessment of clinical symptoms, diagnostic tests, the formulation of the appropriate diagnosis and the appointment of a specific treatment should be done either by the local therapist or by a rheumatologist.
How to treat gout at different stages at home?
At home, you need to cope not only with acute attacks of gout, but also learn to prevent relapses. And also to achieve a stable remission, having previously received a consultation from the attending physician. The treatment of gout with medicines is aimed at such factors:
- Combating acute articular pain and getting rid of common symptoms of inflammation.
- Reducing the frequency of relapses as much as possible.
- Prevent further accumulation of uric acid salts and elimination of already existing foci of urate deposition.
How can I remove a gout attack with leg joint damage?
For the removal of an attack of gout, relief of pain and elimination of signs of inflammation in the joints on the legs, medications are used, as well as local therapy( applications and compresses).Before using any of the listed therapeutic methods, be sure to get approval from a medical specialist.
According to the common practice, from the attack of gout and joint pain at home, only proven and effective medications should be used, preferably in the form of tablets, capsules and soluble powders. With the permission of the supervising physician, you can take:
- Non-steroidal anti-inflammatory drugs( diclofenac, ibuprofen, naproxen, nimesulide).
- In case of ineffectiveness of NSAIDs or presence of contraindications - colchicine.
- If the above medicines for gout do not help, then go on to taking glucocorticoids in tablets( prednisolone).
Despite the fact that aspirin belongs to non-steroidal anti-inflammatory drugs, it and other salicylates are not recommended for exacerbation of gout and clinical symptoms of the disease. As some studies show, soluble aspirin tablets taken ingestion can increase the level of uric acid and provoke an increase in the attack.
For the treatment of any form of gout, when it is aggravated, local therapeutic procedures are actively used. Excellent effect:
- Application to the affected joints( metatarsophalangeal toe, knee, ankle, elbow, wrist) dimexide solution. The effectiveness of the procedure is significantly increased when combined with a glucocorticoid drug.
- Heating compresses, which usually need to be done after the pain subsides.
After performing medical treatment of gouty arthritis at home, and not having achieved the disappearance of the clinical symptoms of joint inflammation on the legs, it is necessary to always contact the attending physician again.
What ointments are used for gout when joints on legs are inflamed?
Clinical experience shows that with inflammation of any joint on the legs( knee, ankle or metatarsophalangeal joint of the big toe) treatment of gout with anti-inflammatory ointments is practically not effective.
Quickly to remove joint pain in the diagnosis of gout, using a variety of ointments or gels, usually also fails.
Folk remedies for acute gout attack for home treatment
To non-traditional methods of therapy of gouty arthritis that can cope with both articular pain and normalize uric acid level, applies:
How to relieve a gout attack: calm the pain |I am treating myself
- Useful food
How to relieve gout
This illness can be called ancient as the world, because the diagnosis of gout was first put in the fifth century by Hippocrates, and only then the definition firmly established in all medical textbooks of the world. People from time immemorial are looking for ways to relieve a gout attack, because there are a lot of patients suffering from this disease. In a certain period, gout was termed a disease of aristocrats, so it was believed that among the population of the Soviet Union, this disease is not there.
Gout therapy is devoted to a lot of scientific work, and at the same time, over the past three decades, no new drugs have been developed that heal this disease. In addition, there are no therapeutic recommendations that are unified, while taking into account the individual characteristics of the patient, genetically determined metabolic processes, as well as the type of diet and lifestyle.
How to determine if you have gout, not signs of another disease? Some patients complain that sometimes after a dense supper, supplemented with alcohol, they wake up at four or five in the morning, from the fact that in the big toe there is a sharp pain. Moreover, it is so strong that it is simply impossible to find a place that facilitates such a state. In this case, you can assume that you have a gout attack. In this situation, you should immediately "carry" a sick finger to the therapist, and it is better to show yourself to a specialist in rheumatology who will be provided with professional help.
How to soothe the pain
It is known that sometimes when referring to a surgeon the doctor makes a diagnosis of phlegmon or purulent arthritis, which requires an operation to remove pus. As a result, the incision is made, but there is no pus. After such an operation, it is possible to detect scarring in many patients who were not diagnosed with gout immediately. If the attack still hit you, you should be patient, wait for such a painful attack. How to remove an unexpected attack of gout, what should I do? It is important to remember that the duration of such attacks is not more than three days, therefore, you can use home methods.
Begin by ensuring that the joint rest, and then proceed to "wash away" from the body of uric acid. In a day you will need to drink enough fluids, up to eight glasses. It can be water, or herbal teas, rose hips infusion. It is very good, in this case, to take cranberry juice without the addition of sugar.
If you can touch the joint, then attach the ice pack to the sore spot, hold it for ten minutes or longer, do not need it to stop chilling. After the soothing effect of the ice appears, apply cabbage leaves to the diseased finger.
You can also sew a bag, pour in it three hundred grams of salt, heat with an iron, attach to the diseased area. If the pain still does not calm down, use a specially prepared ointment. This will require half a cup of yogurt, one hundred grams of rye bread, and half a spoonful of soda. All components are mixed, the resulting mixture is applied to the aching finger.
Than gout is dangerous.
Often physicians call gout "delayed action".Statistics show that in recent years there have been more cases of gout. The basis of the disease is the disturbed metabolism and accumulation in the joints of salts of uric acid. This happens for many reasons. Basically, this is an unbalanced diet, frequent use of beer, champagne, and other drinks.
As is known, the main source of education in the body of uric acid are purines, they are contained in protein products. For example, in meat. If purines abundantly enter the body with food, the level of uric acid becomes higher. At the same time, alcohol aggravates the situation, since it slows the release of acid by the kidneys.
How is a gout attack removed, in what conditions does it occur more often? Attacks of gout are often suffered by fishermen and hunters, and first of all, it is caused by hypothermia of the feet, also influenced by a plentiful meal for the night, supplemented with alcohol. Suppose the body temperature has decreased by two degrees, so the uric acid circulating in the body crystallizes in the coolest zone.
Magnetic resonance imaging shows that the first attack of gout causes crystallization. In the coronary vessels, the aorta, and other tissues, tofusov - crystallites, hardly visible under the microscope, falls out.
It should be remembered that the inflammation of the finger on the leg, of course, will pass, but in other parts of the body there is a "delayed-action mine".The number of tofus continues to increase, gout becomes chronic. The ailment is a stepping stone to diabetes, atherosclerosis and other dangerous diseases.
With gout, even a slight violation of diet by the amount of alcohol consumed causes an exacerbation of the disease. How to relieve a gout attack, quickly help yourself? The insidiousness of the disease in the rapidity of the stage, with periodic seizures. Many are sure that if it has been easier and has passed, then there is nothing to worry about, it means everything is fine. But, it happens that very soon gout begins to host in the body.
This is a serious illness, but treatable. It's never too late to start therapy, unlike other systemic diseases. If you overcome yourself, and start to observe the malopurinovuyu diet, the tofus will begin to disappear, attacks will occur less often, then cease.
On the one hand, the problem is serious, but it is completely cured. The most important condition of treatment is the rejection of red wines, vodka, beer. Traditional medicine calls for a comprehensive impact. It is necessary to drink medicinal herbal infusions, take baths, exercise, and you can count on a positive result.
The strongest and most radical medicine is the root of the fighter, the infusion that treats rheumatism, relieves gout. One hundred grams of raw material is poured with a liter of vodka, and for three days put in a warm place. The tincture is used for grinding, when it acquires the color of brewed tea. For one rub use not more than a teaspoon of the remedy.
The agent strengthens blood circulation, and if it is required to treat joints on both legs, then one leg is rubbed in one day, and only the next day another is treated.
If the gout is painful, with tumors, then tincture is rubbed before going to sleep for four weeks in a row. It is important to be persistent, and gout will retreat forever.
© 2015, I'm flying myself. All rights reserved.Warning! Consult your physician before using any traditional medicine.
Description of a typical attack of gout
Description according to the sources from foreign sources( Wyngaarten J., 1976):
"The victim goes to bed and falls asleep in good health. About two o'clock in the morning she wakes up from a pain in the big toe, less often in the heel or ankle. This pain is similar to what happens when a joint is dislocated. Another part of the patients compares the pain with a sensation of cold water poured onto the joint. Then follows a chill and a feeling of trembling with a low temperature. Pain, which is initially mild, gradually becomes intense. As the pain increases, chills and tremors increase. After some time, the peak of attack comes, bones and ligaments of the metatarsus and tarsus are involved. Now this is an incredible strain of ligaments and a feeling that the latter are tearing apart. This is already a gnawing pain. So an exquisite and cheerful person, struck by the disease, is knocked down, he can not put on an aggravating night dress, can not walk around the room, everything is getting on his nerves. The night passes in torment, without sleep, the patient constantly changes position, which leads to unceasing pain in the joints and worsening of the outbreak. Since that time, all efforts to alleviate pain by changing the position of the trunk and limbs, remain vain. "
More than half of patients with the first attack start with monoarthritis I metatarsophalangeal joint, but eventually this joint suffers in 90% of patients with gout. Often the ankle, knee, wrist, wrist joints, etc. are also affected.
Currently, there are some features of the clinical course of gout, in particular, the first attack. They consist both in the atypical localization of arthritis( ulnar and ankle joints) and in the nature of the course in the form of acute or subacute polyarthritis.
In the first years of the disease, joint damage proceeds according to the type of acute arthritis with complete reverse development of all joint manifestations and restoration of joint function.
With an acute gouty attack for several hours, the affected joint swells, the skin over it blushes, becomes hot, stretched, shiny. The patient feels a slight chill, possibly raising the body temperature to febrile. Pain syndrome is so intense that it is often not controlled by analgesics. The pain is aggravated even from an easy touch to the inflamed surface of the joint. There comes a restriction of mobility in the affected joint. By the morning the intensity of pain is noticeably weakening.
The duration of an acute attack can be different and depends on its severity. The attack of moderate severity ends within two days, with a more severe form, the pain syndrome reaches a peak in a few hours and at this level it can persist for 3 days, and then slowly decreases within 7-10 days.
It may take several weeks to fully recover a heavy attack. In a significant number of patients, a second attack is observed within the next 1-2 years. Over the years, the frequency of seizures increases, they become longer, but less acute. With each repeated attack, as a rule, new joints are involved in the pathological process.
To provoke a new attack of gout, use of alcohol or a large number of products containing high purine bases, as well as neuropsychic stress, physical exhaustion, acute respiratory viral infections( ARVI), hypothermia, trauma, bruising, taking medications that promote developmenthyperuricemia.
More than half of patients indicate the characteristic sensations that precede an acute attack of gout. In the prodromal period, there may be psychoemotional disorders( mood worsening up to depression, anxiety, fear, increased irritability, nervousness, etc.), dyspeptic disorders( loss of appetite, hypersalivation, lagging of the tongue, eructation, pain and heaviness in the epigastrium, unstablechair).Part of the patients as precursors can be a feeling of weakness and aches in the body, fatigue, dysuric disorders, pain in the heart, increased blood pressure. Many of the listed symptoms and syndromes are also noted during an acute attack.
There are atypical forms of gout:
- rheumatoid-like - symmetrical arthritis of proximal interphalangeal joints of brushes;
- periarthritic - localization of the process in the tendons and bursa in intact joints;
- pseudo-reflux - monoarthritis with bright inflammation of the periarticular tissues, fever.
Intermittent gout is characterized by the occurrence of repeated attacks of acute gouty arthritis and the presence of asymptomatic( light) gaps. Pain syndrome is less pronounced than with acute gouty arthritis. Patients are diagnosed with joint stiffness, light articular crunch and defiguration due to proliferative changes in the soft tissues of the joints. Frequent repetition of seizures involving many joints is prognostically unfavorable. The defeat of the joints with intermittent gouty arthritis is characterized by a complete reverse development of all joint manifestations and the restoration of joint function in the interictal period.
CHRONIC PODAGRIC ARTHRITIS
Chronic gouty arthritis is characterized by incomplete elimination of symptoms in the affected joints. Infiltration of articular tissues with urate is accompanied by an inflammatory response of the tissues surrounding the joint. After 4-6 years after the first attack of gout, pain and limitation of movements in the joints, swelling and deformation of them become more resistant. Against the background of chronic gouty arthritis, seizures increase, often become less acute, but more prolonged than in the early period of the disease.
Against the backdrop of chronic gouty arthritis, there may be occasional acute seizures that last for several weeks. In this case, the most severe clinical picture of the so-called gouty condition takes place, when continuous intense attacks of MOHO-, OLIGO- or polyarthritis with a moderate inflammatory reaction can be observed up to several months!
With this form, the formation of tofus and lesions of internal organs. By the time tofusov development of the joint syndrome may already include destructive signs and deformities of the joints.
Tofuses( tissue aggregations of urates) usually occur 4-5 years after the appearance of the first articular manifestations of gout in the form of yellowish-white grains. Their most frequent localization is the inner surface of the auricles, the area of the elbow joints, the joints of the feet and brushes, less often they are located in the region of the knee joints, Achilles tendon, etc. It is possible to detect tofus on the sclera and cornea.
Gouty nodules in the auricles are usually formed unnoticeably and unexpectedly for the patient, in the joint region - more often after acute gouty inflammation. The size of tofus can be from 1-2 mm to 10-12 cm in diameter. Separate tofus can merge, forming large conglomerates. At the opening of the gouty node, a white curdled, gruel-like mass consisting of uric acid salts is released. Unsealed nodes usually do not become infected, but they heal slowly. The frequency of tofusi is directly proportional to the duration of the disease.
DIAGNOSTICS OF PODAGRICAL ARTHRITIS
X-ray gingival manifestations in gout were first described as early as 1896. Many studies have been carried out later, which showed that at the early stage of the disease there are no characteristic radiographic changes. Then, radiographs show signs of destruction of bones and cartilage, caused by the deposition of sodium urate crystals in the subchondral bone.
There are several classifications of radiological changes in gout:
I - large cysts in the subchondral bone and in deeper layers. Sometimes soft tissue tightening;
II - large cysts near the joint and small erosions on articular surfaces, permanent compaction of periarticular soft tissues, sometimes with calcifications;
III - large erosions, but less than 1/3 of the joint surface, osteolysis of the epiphysis, significant consolidation of soft tissues with lime deposition.
A later classification is proposed by M. Cohen, B. Emmerson( 1994), according to which the main radiographic features for gout include the following:
- in soft tissues - seals;
- bones( joints) - articular surface is distinctly represented;
- juxtaarticular osteoporosis is absent,
Thus, the presented classifications are significantly different and require the unification of a number of radiologic signs for gout.
Instrumental and laboratory diagnostics of gout
In clinical blood analysis during acute gout attacks, leukocytosis with neutrophil shift to the left and an increase in ESR are revealed in patients.
Serum contains an increased uric acid content: in men more than 7 mg%( 0.42 mmol / l), in women - 6 mg%( 0.36 mmol / l).
Urinary acid excretion should be studied after a 3-day diet that excludes purines( meat, broth, fish, poultry, legumes, tea, coffee, cocoa, alcohol, beer).Determine the volume of daily urine, pH, the concentration of uric acid and creatinine in urine and serum. Normally excreted 300-600 mg( 1.8-3.6 mmol / l) of uric acid per day.
In the contents of tofus, crystals of uric acid are found. Typical are intraosseous cystlike formations of various sizes, due to tofus. Chronic gouty arthritis can be accompanied by destruction of cartilage( narrowing of the joint gap) and development of marginal bone erosions. A characteristic symptom - "puncture symptom" - marginal bone or cyst formations of regular shape with distinct, sometimes sclerotized contours, over time, severe destruction is formed not only in the subchondral portion of the bone, but also in the epiphysis and even in the diaphysis, forming intraarticular osteolysis. Radiologically the most pronounced pathology is observed in the joints of the feet( first of all, in the joints of the thumb).Rarely, but there can be x-ray changes in the shoulder, hip, sacroiliac joints and spine.
Bone changes in gout rarely decrease on the background of specific therapy.
Investigation of synovial fluid. Current literature on the composition of synovial fluid in patients with gout indicates the importance of its study for the diagnosis of joint diseases. According to many researchers, the detection of urate crystals in the synovial fluid and especially in leukocytes is specific for gout. Diagnostic value is the detection of needle crystals of urates, located intracellularly and birefringent light when examined by means of a polarization microscope. The threshold concentration of urate crystals in the synovial fluid, still available for identification, is about 10 μg / ml. The sensitivity of this test varies between 85-97%.
Another important for an acute attack of gout is an indicator of synovial fluid is its cellular composition, mainly the number of leukocytes.
VISCEROPATHIES - ACCOMPANYING PATHOLOGY OF INTERNAL BODIES
Of gouty visceropathies, kidney damage is most common( in 50-75% of patients), sometimes hepatopathy is caused by the formation of gouty nodes in the liver.
The risk of kidney damage in patients with gout is proportional to the duration of the disease and the degree of hyperuricemia. However, in some cases, urate nephropathy can precede the development of joint syndrome.
The incidence of kidney damage with gout according to different authors varies in a fairly wide range - from 30 to 60-70%.
It is known that the clinical manifestation of impaired purine metabolism is isolated urate nephropathy, often long latent and precursory to gouty arthritis. Often, it can remain the only manifestation of impaired metabolism of purines.
Research conducted in the 1980s at the Institute. IM Sechenov, showed that the violation of purine metabolism, in particular long-persisting hyperuricemia, causes clinically latent glomerulonephritis with a predominance of hematuria and a steady progression toward chronic renal failure.
Thus, the gouty kidney is a collective concept, including the entire kidney pathology observed with gout: tophi in renal parenchyma, urate stones, interstitial nephritis, glomerulosclerosis and arteriolosclerosis with the development of nephrosclerosis.
Diagnosis of gout
In 1963 in Rome at an international symposium criteria for the diagnosis of gout were developed:
1) increased serum uric acid levels( more than 0.42 mmol / L in men and 0.36 mmol / L in women);
3) crystals of sodium urates in synovial fluid or tissues, detected by microscopic or chemical examination;
4) acute attacks of arthritis that occur suddenly with complete clinical remission within 1-2 weeks.
The diagnosis of gout is established when there are two criteria. Among the listed criteria pathognomonic for gout is the third sign.
The presence of tofus, as is known, is not an early sign of the disease, so this feature is not so informative in the early years of the disease.
Criteria for greater diagnostic value were later proposed( Wallace S., 1977):
A. The presence of characteristic monosodium urate crystals in the synovial fluid.
B. Approved tofus( chemical analysis or polarization microscopy).
C. Presence of 6 of 12 clinical, laboratory and radiological signs:
1) maximum inflammation of the joint on day 1;
2) the presence of more than 1 attack of arthritis;
5) pain and inflammation of the metatarsophalangeal joint( PPS) of the 1st finger;
6) asymmetric inflammation;
7) unilateral lesion of the tarsal joints;
8) suspicion of tofu;
Gout on the legs - the main symptoms and effective therapies
When a chronic inflammation develops in the area of the joints of the big toe, which causes a delay in the blood of a large amount of uric acid, and also the deposition of its salts in thejoints, gout is diagnosed on the legs. This condition provokes the emergence of severe pain, from which there is sometimes no salvation.
Symptoms of the disease
As a rule, the acute form of gout on the legs proceeds without pronounced symptoms, therefore, a person learns about it only when the attack begins. Over time, seizures become more frequent, and, in the absence of adequate treatment, become stronger each time.
The main cause of the development of the disease is the accumulation of microscopic crystals of uric acid in the blood, followed by their fall into the joint cavity.
When they accumulate there in a significant amount, the affected joint becomes very painful.
- As a rule, before a gouty attack the patient is nervous, a frequent change of mood occurs, he becomes very excited and restless. Often in this state, the appetite disappears and pressure rises, as well as changes in stool, nausea and heartburn.
- A gout attack on the legs develops deep at night or before dawn. At first, aching pain appears in the affected joint, which gradually grows in 2 to 3 hours and becomes almost intolerable. The joint swells, turns red and starts to shine. Often this condition is accompanied by a rapid pulse, chills, fever and sweating.
- In the morning and afternoon hours the pain is noticeably weakening, but by night it returns again. These symptoms of gout on the legs can occur for several days or a week, after which the disease recedes for several months or years.
- In the case when the development of the pathological process of accumulation in the joints of uric acid begins to take the form of granules, the disease passes into a chronic form called gouty polyarthritis. This period is characterized by the appearance of gouty nodes( tofus), which can be localized from different areas, not only in the upper layers of the skin, but also in the subcutaneous tissue. If tofus appear in the knee area, the gout knee is diagnosed when they are found on the elbows, it is about the elbow joint lesion. However, such formations very often can appear in bones, muscles and tendons.
- This form of the disease is characterized by stiffness of movements and a crunch in the joints, severe pain and total loss of efficiency. Also at this stage, urolithiasis and acute renal failure are attached to the gout.
- As noted above, in the period of exacerbation of the patient assigned to bed rest.
- Of the drugs most often experts recommend colchicine, rheopyrin, ketazone and indocid. These medications are prescribed for both short-term and long-term treatment.
- In the chronic form of gout, the patient is recommended a special low-calorie diet and abundant drink.
- Also during this period, medications are prescribed that prevent the formation of uric acid and promote its excretion from the body( anturane, allopurinale, benemide).
- Corticosteroids are prescribed to the patient only when colchicines and non-steroidal anti-inflammatory drugs remain powerless in the fight against the disease. At the same time, corticosteroids are prescribed for patients who are contraindicated with NSAIDs.
As a rule, in the event of an attack of gout, with timely treatment started, it can be dosed almost in 24 hours. At this time, experts prescribe the maximum dose of a drug, as a method of short-term treatment, and, after improving the condition, it( dose) is necessarily reduced.
How to relieve an acute attack of gout
- During an acute attack of the disease, non-steroidal anti-inflammatory drugs are prescribed to the patient that help reduce pain and relieve inflammation from the joint. However, immediately I would like to note that aspirin for gout is categorically contraindicated, since it is capable of increasing the level of uric acid in the blood and increasing the attack.
- In parallel, the patient is recommended to take medications that help normalize metabolic processes.
- In the period of acute attack the patient needs complete rest and bed rest. The affected limb is placed on an elevation and completely immobilized.
- Very well helps to remove the pain package with crushed ice, which must be applied to the inflamed joint to reduce inflammation and reduce the pain syndrome.
Fortunately, science does not stand still, and scientists constantly conduct research on the latest drugs to treat gout, figuring out which ones are the safest.
At the same time, to prevent gout attacks, rheumatologists and nutritionists recommend completely switching to a healthy diet, starting an active fight against excess weight and giving up alcohol, which helps delay uric acid salts in the body.
Do not forget to treat gout and folk methods. In the arsenal of folk healers, there are many recipes on which you can prepare ointment from gout, as well as special rubbing, infusion or compress.
Unfortunately, the path to getting rid of the disease is very difficult and long, and in order to overcome it, one must have persistence and aspiration. In the case when a person approaches the treatment of gout in a complex way, using almost all means available to him, even the most extraordinary, the disease necessarily recedes.
She recoils before the perseverance, courage and will of the patients, not afraid of their diagnosis and not afraid of difficulties.