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, 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 areas 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, hepatocatalcas, milurite can be prescribed. 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, so it is by no means impossible to reason on the principle of "caught-let-go".

Drug therapy for the reduction of uric acid level

Since the root 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 area 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 recent 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 triggers 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, as a large number of side effects and complications in its regular application raises questions about the usefulness 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.

Nevertheless, 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 negate 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 who regularly took Allopurinol 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

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Gout

Gout is one of the most common types of arthritis( inflammation of the joints) and occurs more often in men( mostly middle-aged).Gout occurs more often in men( mostly middle-aged) than in women.
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Causes of

The onset of the disease is closely related to the amount of uric acid that occurs as a result of the processing in the body of certain foods rich in purines.

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Normally uric acid is excreted by the kidneys in the urine. However, in patients with gout of uric acid or too much is formed, or it is poorly excreted by the kidneys, as a result, the body accumulates its excess. When uric acid is too much in the body, it begins to be deposited in the joints in the form of tiny crystals, which leads to inflammation and pain. It should be borne in mind that there is no clear connection between the level of uric acid in the blood and the development of gout - in some cases, attacks of gout develop in people who have uric acid levels within normal limits.

An increase in the level of uric acid in the body can be associated with impaired renal function, as well as with the intake of certain medications.

Symptoms of gout

Acute pain, swelling and redness of the joint( usually one or two).This acute condition( often referred to as by gout ) can last for several days or weeks( if no treatment is given). The attack of gout often occurs at night, the joint becomes hot to the touch and very sensitive even to light touches.

Very often the joints of the thumb on the foot are affected, but other joints( ankle, knee, fingers and hands) may be involved. In some cases, joint tendons become inflamed at the same time.

Complications of

If attacks of gout occur frequently and for a long time, it can lead to serious damage to the joints and to limiting their mobility. In some cases, white nodules( tophi) are noted under the skin of the joints or around the auricle, which are a cluster of uric acid crystals.

What can you do

You should consult a doctor to make a diagnosis. The sooner you go to the doctor, the sooner the treatment will begin. With properly selected therapy, exacerbation of gout takes place 1-2 days later. If you really have gout, then, in addition to meeting all the prescriptions of the doctor, you should follow the diet very strictly.

You should not eat( especially during an exacerbation) all products rich in purines: meat by-products( heart, kidneys, liver, brains, etc.), fatty fish( especially during the exacerbation period), salted and fried fish, canned foodmeat and fish), sharp and salty cheeses, red meat and products from it, lard, soups on meat, chicken, fish, mushroom broth;smoked meat products, beans( lentils, peas, beans, beans, soybeans).

Do not consume alcoholic beverages, which increase the uric acid content and worsen its excretion by the kidneys( beer, cognac drinks, fizzy and dessert wines).

It is recommended to drink plenty of water, green tea.

When attacks gout , it is necessary to provide sufficient rest for the affected joints and try to injure the joint as little as possible with clothing or shoes.

Keep track of your weight. However, any program for weight loss should be carried out under the supervision of a doctor, tk. A sharp weight loss can lead to an exacerbation of gout.

Be sure to tell your doctor about all medications that you are taking.

What the doctor can do

The physician should make a diagnosis by conducting various additional studies( including a blood test and determining the level of uric acid).With prolonged gout, an X-ray examination of the joints may be required.

The doctor will prescribe drug therapy during the period of exacerbation, give recommendations on the diet and the regime of physical activity and motor activity.

Based on the results of the additional studies, the doctor will select a treatment aimed at reducing the level of uric acid in the blood. Keep in mind that drugs prescribed during the period of exacerbation are not intended for long-term use and, as a rule, do not affect the level of uric acid.

Prevention of gout

If your family has cases of gout, then you are at risk. In this case, it is recommended to monitor the level of uric acid in the blood regularly, and also try to adhere to a healthy lifestyle. Gout often occurs in individuals with high body weight and high blood pressure. Proper nutrition with the restriction of meat and other purine-rich foods plays a crucial role in the prevention of gout.

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Gout - symptoms, treatment, photos, diet for gout

The causes of the disease also include malnutrition( with a predominance in the diet saturated with purine products), excess weight, endocrine disorders in the body, certain pathologies of the circulatory system. Provoke another attack of gout can use alcohol, taking certain medications( antibiotics, diuretics), but most often the disease worsens for no particular reason, usually at night.

Symptoms of gout

Initially, the disease affects the large joints of the lower extremities, first of all the toes suffer. Gout on the legs is a common occurrence in the life of an elderly person who, in his youth, abuses alcohol and neglects his food. The disease begins with an inflammation of the joint of the big toe. The so-called gouty arthritis is accompanied by:

  • increase in joint size;
  • severe pain in the place of localization of the inflammatory process;
  • by local body temperature increase;
  • redness covering the diseased joint of the skin.

The first attack of gout is usually short-lived, in the absence of treatment passes within a week. The second such attack can occur several years later, more rarely - decades. Such signs of gout as joint deformity, proliferation of its tissues are noted with the advanced form of the disease. To change the appearance of the joint leads to the gradual accumulation in it of salts of uric acid. In particularly neglected cases, gout becomes the cause of the patient's disability.

Treatment of gout

The basis of therapy is a special diet, aimed at reducing the diet of patients with purine-rich foods. Medications prescribed during the period of gout exacerbation help to alleviate the patient's condition, reduce the risk of complications. To eliminate the symptoms of arthritis, anti-inflammatory( nonsteroidal) drugs( Colchicine) are shown, with severe pain, pain medications.

The drugs prescribed for the treatment of gout include Uralit and Allopurinol, which help to reduce the level of uric acid in the blood by its natural excretion from the body. Regular reception of these funds helps to avoid exacerbations of the disease in the future.

Painful gout in the period of exacerbation recommended mud baths, applications with Dimexide. With severe deformation of the joints, surgical intervention is performed.

Treatment of gout with folk remedies

Traditional medicine can be used as an auxiliary therapy in this case. Such therapy gives, as a rule, very good results. Elimination of severe joint pain is promoted by compresses from cabbage leaves. Leaves are thoroughly washed with warm water, dried and applied to the sore spot for the night, from above covered with bandage or gauze. Long-term use of this tool( daily, for a month) helps to reduce the risk of an attack in the future.

Also folk medicine recommends in the therapy of gout to use dogrose, garlic, ginger, baking soda, decoctions of medicinal herbs( chamomile, marigold, St. John's wort, turns).Decoctions in this case can be used not only as a compress to a sore spot, but also as a drink.

Diet for gout

Patients with a similar diagnosis should take a more careful look at their diet, in particular to exclude from the diet saturated with purine products, because uric acid deposited in the joints and provoking their inflammation, is a derivative of these compounds. Nutrition for gout should be organized in such a way that the body does not suffer from the lack of some of the usual food for him. For example, fat red meat should be replaced with boiled chicken breast, white bread - bran, etc.

The diet should be observed for a long time. Otherwise, the risk of gout and progression of the disease increases.

What should not be eaten with gout

When gout should be abandoned:

  • fatty meat;
  • by-products( kidney, liver, language of farm animals);
  • of red fish;
  • alcohol;
  • of sweet carbonated water.

There are products, the use of which is acceptable, but not desirable. Chicken eggs, boiled lean meat, bread, mushrooms, cereals, peas, and beans are allowed in small quantities.

What you can eat with gout

The daily ration includes:

  • vegetables. It is desirable in a boiled form, steamed, baked in the oven with a small addition of salt;
  • dairy products;
  • berries, mainly currants of different varieties, watermelons;
  • bran, bread from bran;
  • nuts, fruits and dried fruits;
  • mineral water.

There are products that reduce the level of uric acid in the blood. It is primarily red and black currants, strawberries, raspberries. Also recommended for use are morsels, broths from currant leaves, dried raspberries.

Drug for gout

Drugs designed to fight gout, a lot, they all have a similar effect - reduce the level of uric acid in the blood of a person.

Traditionally, allopurinol is prescribed in the form of tablets in the therapy of the disease. The drug interferes with the synthesis of uric acid in the body, contributing to the development of the enzyme xanthine oxidase, removes from it the already existing deposits of salts with urine. The drug is not contraindicated in the presence of kidney diseases, it is recommended for the prevention of gout in elderly people. Among its side effects, the greatest danger to the body is a violation of liver function and an increase in the level of sugar in the blood, but such effects in the case of proper administration of the medication, as a rule, do not arise.

In the presence of significant deposits of salts of uric acid in joints, the use of drugs Solimok, Orthofen, Indomethacin( with pronounced pain syndrome and joint inflammation) is indicated.

Ointment from gout

Local preparations for gout give a good therapeutic effect, their use helps to eliminate the pain symptom, reduce the inflammatory process in the patient's joint, facilitate the general condition of the patient.

In the treatment of inflammatory joint diseases, a 2% Diclofenac ointment based on the active ingredient, diclofenac sodium, is widely used. The product has a slight anti-inflammatory effect, quickly eliminates pain, is recommended for use in exacerbating gout.

Fulflex ointment has a similar effect. It is worth remembering that such drugs are struggling with the manifestations of gout, but in no way hamper the progression of the disease, and therefore, as the main remedy can not be appointed.

Prophylaxis of gout

Prevention of disease can be considered correct nutrition in youth, not abuse of alcohol, especially after 40 years. Individuals who have already been diagnosed with the same condition must be constantly under the control of specialists, regularly undergo an examination of the body. In half the cases, the neglected form of the disease leads to complications from the excretory system( renal dysfunction) and disability.

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Gout - Diseases of the Joints - Rheumatology

What is it?

Gout( gouty arthritis) is a joint disease, which is caused by the deposition of uric acid salts( urates) in them. It affects any joints: fingers, hands, feet, elbows, knees. Most often, the joints of the toes suffer from gout.

About one in a thousand people suffer from gout. Men are sick 20 times more often than women. The disease usually develops after 40 years in men and after menopause in women.

Why does this happen?

In the development of gout, heredity plays a certain role. Predisposing factors: excessive nutrition, monotonous meat food, consumption of alcoholic beverages( especially beer and grape wines), a sedentary lifestyle. Often the disease develops against a background of kidney failure and blood diseases.

Consultation of rheumatologist in Moscow + 7( 495) 230-7048

What happens?

Normally, uric acid, which is the final product of the metabolism of certain substances, enters the bloodstream and is excreted by the kidneys. In some cases, the concentration of uric acid in the blood can increase significantly. This occurs as a result of inadequate excretion or increased uric acid formation. Her salts( urates) crystallize and are deposited in the joints, causing inflammation and severe pain. In addition, urates can accumulate in the skin, forming nodules( tofuses), and in the kidneys, forming concrements( stones).

How is this manifested?

As a rule, a gout attack develops against the background of drinking alcohol( especially beer) or overeating. The disease manifests itself by sudden and intense pain, redness and "heat" in the joint. Attacks of gout occur, as a rule, at night. The pain is so strong that many patients can not stand even the weight of the sheet on the affected joint. A repeated attack of gout is usually preceded by a tingling sensation in the affected joint. If gout is not treated, seizures become more frequent, and periods of exacerbation are longer. Arthritis affects all new joints, kidneys and urinary tracts are often affected.

Diagnosis

Diagnosis is established by a rheumatologist when examining and distributing the patient. As a rule, a high content of uric acid is determined in the biochemical analysis of blood. In some cases, a puncture( puncture) of the joint with examination of the joint fluid or an X-ray photograph is necessary.

Treatment of

Unfortunately, gout can not be completely cured, but it can be controlled. To do this, first of all, it is necessary to change the nature of food - to exclude products such as beer, wine, meat of young animals, by-products( liver, kidneys, etc.), legumes, mushrooms, sardines, fish caviar.

Drug treatment includes anti-inflammatory drugs, and drugs that inhibit the formation and stimulate the excretion of uric acid.

Physiotherapy greatly facilitates the well-being. Surgical methods of removing uric acid deposits in soft tissues are also used.

Treatment includes body mass correction and treatment of all metabolic diseases( atherosclerosis, diabetes) that are gout companions.

Prevention

To prevent exacerbations of gout it is recommended to follow a diet( see above).It is necessary to drink a lot of liquid( at least three liters per day).Dehydration worsens kidney function and leads to an increase in the concentration of uric acid in the blood plasma. Treatment in Moscow( 86 clinics) - Department of Pediatrics

medportal.ru

Gout - Causes, symptoms and treatment. MF

Gout is one of the oldest diseases described in medicine. In the 5th century BC, Hippocrates called "gout"( from the Greek words "under" - foot, "agra" - the trap) acute pains in the foot. It was called "the disease of kings and the king of diseases", a disease of aristocrats, even considered a sign of genius. She suffered such famous people as Leonardo da Vinci, Alexander of Macedon, many members of the Medici family from Florence, Isaac Newton, Charles Darwin. And this list is far from complete.

Gout is a disease associated with impaired purine metabolism, which leads to an elevation in the blood of uric acid( hyperuricum) and its deposition in the tissues of the musculoskeletal system and internal organs.

In the human body, purine bases are broken down to uric acid and excreted by the kidneys. When the limit of uric acid concentration in tissues is exceeded, the deposition of its crystals in the form of sodium monoaurate in the joints, kidneys, soft tissues begins. There are clinical manifestations of arthritis( inflammation of the joint), there are formations in soft tissues( tofus), urate nephropathy( kidney damage) and nephrolithiasis( formation of kidney stones).

Changes in dietary habits and lifestyle led to the fact that in industrialized countries, 1-2% of the population suffers from gout.

Causes of gout

1. Drug administration: diuretics( thiazide diuretics), low doses of aspirin( 1 g per day), cyclosporins. Diseases and conditions that lead to the appearance of gout: diabetes, obesity, ischemic heart disease, arterial hypertension, metabolic syndrome, chronic renal failure, lead poisoning, organ transplantation, psoriasis, blood diseases. The intensification of gout is facilitated by intravenous contrast( with radiological examinations), trauma, surgical interventions. The risk of gout is extremely high among people who are in the habit of consuming products containing a large number of purine bases( fatty meats, seafood, alcoholic drinks, carbonated drinks).Gout more often develops in men( age 30-60 years), in women gout develops much less frequently and mainly in the menopausal period.

Symptoms of gout

Acute gouty arthritis begins with the lesion of one joint, most often the thumb of the foot. The emergence of acute arthritis can be preceded by heavy eating, alcohol intake, trauma, and surgical intervention. The disease develops suddenly, early in the morning there is a sharp pain, swelling and redness, the symptoms quickly increase and reach a peak within 24 - 48 hours. The pain becomes severe, patients often can not wear socks or touch a sick joint. Acute gout can be accompanied by an increase in body temperature to 38 degrees. Sharp weakness, general malaise. Even in the absence of treatment, exacerbation of gouty arthritis disappears gradually within 5 to 7 days.

Acute gouty arthritis

As the disease progresses and in the absence of adequate treatment, attacks of arthritis become more frequent and prolonged, new leg joints are involved. There is deformation of the joints due to nodular deposits and bone growths, tophi.

Tofusi are uric acid crystals that are deposited in the periarticular tissues, are painless, dense nodules of yellowish color. Most often located in the area of ​​the auricles, elbows, ankles, joints of hands and feet.

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

In general, uric acid is excreted by the kidneys, the deposition of uric acid salts in the renal pelvis leads to the development of urolithiasis. Departure of stones( stones) is manifested by intense pain in the lumbar region - renal colic.

Diagnosis of gout

1. Biochemical blood test. Detection of hyperuremia: increased uric acid levels in men over 0.42 mmol / l, in women over 0.36 mmol / l. Definitions of the level of the creatinine of the blood - for the detection of renal failure. Investigation of the synovial fluid of the affected joint. When a chemical or microscopic study determine the crystals of uric acid, in the sowing there is no bacterial flora. Radiography of the joints determines changes in chronic gouty arthritis. Kidney ultrasound. Detection of X-ray negative stones( stones).

Radiography of joints - gouty arthritis

Consultation: rheumatologist, nephrologist, surgeon.

Treatment of gout

Adherence to dietary recommendations is important for preventing gout exacerbation. This restriction of consumption: meat and fish products, beans, sorrel, spinach, cauliflower, raspberries, figs, chocolate, strong tea, coffee. It is forbidden to drink alcohol, especially wine and beer.

It is recommended to increase the volume of liquid to 2 liters per day, if there are no contraindications. This is cranberry juice, juices, alkaline mineral water. Gradual normalization of body weight is mandatory for the patient, as it helps to reduce the level of uric acid in the blood.

The purpose of drug treatment is to reduce pain during an attack and to treat disorders of purine metabolism.

During an acute attack of gout, the patient is recommended complete rest, especially a sick limb. It should be given an elevated position of the foot, attach a blister to the joint with ice, and after the abatement of pain - a warming compress. For treatment of an attack non-steroidal anti-inflammatory drugs( NSAIDs) are used. The drug, its dose, the frequency of reception, duration is recommended by the attending physician.

To achieve a persistent reduction in uric acid, which prevents the progression of gout, antipodal drugs( alopurinol, sulpharperazone, uralite etc.) are used. These drugs are used for a long time( years).The necessary drug is chosen by the attending physician individually for each patient, depending on the age, concomitant diseases, the level of uric acid in the blood.

In the formation of large tophi, with ulceration of the tissues, the presence of fistulas, surgical treatment is recommended - the removal of tofus, since they can no longer dissolve when taking antidotal drugs, and can significantly limit the function of the joints.

Physiotherapy for gout

In an acute period, applications of a dimexide solution on the affected joint are used. It has an analgesic and anti-inflammatory effect. Before the beginning of the procedure, samples for sensitivity to dimexide( the presence of an allergic reaction) are conducted, after 24 hours after the procedure begins procedures. For applications, a 30-50% solution of dimexide is used( dilute pure dimime with boiled water).A napkin soaked in a solution is put on a sick joint. Initially, the duration of the procedure is 10 minutes, later it is increased to 2 hours. In the period of remission apply applications with mud, paraffin, ozocerite, which improves the function of joints, reduces the urate content in them.

During the remission period, the patients are shown sanatorium-and-spa treatment. On the health status of patients, the course of the disease has a beneficial effect of health activities: diet food, intake of alkaline mineral water, balneotherapy, mud therapy.

Phytotherapy for gout

In complex treatment with diet and antidotal drugs, phytotherapy is used. Infusion of leaves of cranberries( 1/2 glasses 3 times a day).Infusion of leaves of black currant( ½ cup 4-5 times a day).Infusion is prepared: 1 tablespoon of dry leaves for 500ml of boiling water, 2 hours, drain. Apply the fruits of blueberries.

Diet for gout

From the diet it is necessary to exclude or minimize foods and dishes containing large quantities of purines, since purines form uric acid.

Foods that need to be excluded: liver, kidneys, brains, lungs, meat of young animals, chicken, meat and fish broths. A patient with gout should refuse to take alcohol, as it inhibits the excretion of uric acid by the kidneys and thus helps to increase its concentration in the blood.

Foods that need to be restricted: beans( beans, peas, beans), sorrel, spinach, eggplant, radish, cauliflower, asparagus, mushrooms, crustaceans, caviar, fish( Baltic herring, sardines, etc.).Large fish are allowed.

The need for calories for gout should be met mainly by carbohydrates. In small quantities, the diet can contain eggs, flour and cereal dishes, low-fat fish, beef, lamb. Fish and meat dishes should be eaten in boiled form, not more often 2-3 times a week. One portion should not be more than 250 g. During an attack of arthritis, fish and meat must be completely ruled out. Food should contain the necessary amount of vitamins, so the broths of dogrose, lemons, apples, black currants are useful. Without restrictions, you can consume milk and dairy products, cereals( bread, cereals, bran), most vegetables( potatoes, carrots, cabbage, cucumbers, tomatoes, pumpkin, onions, carrots, beets, radish, celery), nuts, watermelons, melons,berries and fruits, spices. It is known that cherries, strawberries, currants and other dark red and blue berries reduce the concentration of uric acid in the blood, so it is useful for gout in any form. In the absence of diseases of the kidneys and the heart, an abundant alkaline drink( 2-2.5 liters per day) is necessary, fruit and berry compotes, alkaline mineral water, are suitable for this purpose.

Prevention of gout

Patients suffering from gout are observed by a rheumatologist and a therapist( family doctor).Twice a year, they undergo a comprehensive examination( determination of the level of uric acid, creatinine).Kidney ultrasound and joint radiography are performed once a year.

Complications of gout

Early abnormalities in purine metabolism are reversible, provided timely diagnosis and treatment, but at the stage of chronic gout with organ damage( heart, brain, kidneys) the prognosis of the disease is unfavorable. Kidney damage develops in 30-50% of patients with gout. With persistent increase in the level of uric acid in each 4 patients with gout develops chronic renal failure.

Consultation of a doctor on the subject of gout

Vopr: Why does an exacerbation occur when taking antipodal drugs? Answer: At the beginning of treatment with antipodal drugs( more often allopurinol), acute gouty arthritis can occur due to the excretion of uric acid from the body's tissue depots. Therefore, in order to prevent, it is necessary to prescribe simultaneously NSAIDs.

Question: How long should antipodal drugs be taken if the uric acid level is normal? Answer: Anti-gouty drugs are taken within a year, after which you can take a break for 2 months( with normal uric acid in your blood), provided that you follow a diet.

Physician therapist Vostrenkova I.N.

# 4Anna13.02.2016 17: 31 can the use of paracetamol lead to an exacerbation of gout?. . edema on the legs do not pass for the third month, that is, the swelling of the legs decreases, and then again appear. Accept allopurinol and NSAIDs # 3andrey07.11.2015 03: 28All medications prescribed by doctors cause changes in the human body: Men become impotent and look like women, women, they have breasts, they stop shaving, hangs lower abdomen and pubis. What kind of life is this? !Nothing good. But you can help! There are mechanisms triggering the disease in the opposite direction. Write. I'll try to tell. I myself am ill with this disease.# 2 for Victorians 01.14.2015 11:26 I have severe pains of 15 years suddenly can not stand upright 6 years of them missing the coccyx of the spine at this moment, too, and I'm saved by prayer, it calms the body and I apply gel for horses long ago and recentlybegan to take Chinese little green pills from ortrrose super all obezbalivaet # 1Raisa 09.05.2014 15: 53also 6 months as a bone appeared near the thumb on my left foot now something strongly began to hurt please tell me how you can treat at home, the tests showedall normal

medicalj.ru

gout. What is it? From what?

malikahon 78

Gout is a disease that causes, in typical cases, painful swelling of the joints.
Gout is characterized by a sharp increase in the level of uric acid in the blood( hyperuricemia) and the deposition of crystals of this acid or its salt, sodium urate, in the tissues of the body. With such deposits in the joints, especially in the joints of the fingers and toes, a serious and extremely painful inflammation occurs.
Most forms of gout are hereditary. In the United States about 1% of the population, or about 2.5 million people, suffers from gout. Approximately 95% of them are adult men;the rest are women and only rarely are children.
Gout is known since ancient times. The Greek physician Hippocrates mentioned it about 2400 years ago. The term itself comes from the Greek.podagra - a trap for the feet. A classic description of this disease was given about 1660 by an English physician Thomas Sydenham, who himself suffered from it.
Uric acid in the body. Uric acid and its salts( mainly sodium urate) are the final products of the metabolism of nucleoproteins. Excess intake of food rich in nucleoproteins, in particular meat and meat products, leads to a marked increase in the level of uric acid in the blood. Uric acid is formed in the human body, so even without consuming a large number of nucleoproteins, the blood normally contains high concentrations of nucleoproteins.
Causes of gout. Gout is a consequence of the accumulation of uric acid in the body. Its excess can arise in two ways. In one form of gout, the kidneys are unable to excrete uric acid produced in normal amounts. In the second form, the amount of uric acid produced in the body exceeds the ability of healthy kidneys to remove it. Some patients with the second form of gout have congenital metabolic defects - for example, the absence of a key enzyme( hypoxanthine-guanine-phosphoribosyltransferase), which reduces the formation of uric acid in the body. Excess of the latter can also be an indirect consequence of many conditions associated with metabolic disorders, for example pernicious anemia, fasting or taking certain medicines. Gout, developing in such cases, is called secondary. Symptoms. The main manifestations of gout are gouty nodes, gouty arthritis, and urolithiasis, in which stones consist of urates or crystals of uric acid itself. Gouty knots( tophus) are conglomerates of sodium urate crystals;they can be deposited in almost any part of the body. When such deposits occur in the joints or periarticular tissues, they ultimately cause an immune response( as an alien body), at which the accumulation of leukocytes occurs and acute inflammation develops. This condition is called gouty arthritis.
A typical attack of gouty arthritis, the most characteristic manifestation of gout, occurs in one joint, usually in the big toe, ankle or knee joint. The attack develops, as a rule, in the early morning in the form of sudden severe pressing pain in the affected swollen joint. The skin above it becomes crimson and shiny. During the day, the pain weakens somewhat, but again intensifies by night;This lasts for a week. When the process is repeated, other joints may be involved, leading to partial destruction of the bones.
When excess urate in the blood they crystallize in the kidneys, forming urate stones. In other cases, such stones consist mainly of crystals of uric acid itself, rather than urate sodium. The stones that arise in the kidney in the kidney can cause kidney failure and death.
Treatment. In acute attacks of gout, colchicine is successfully used. Other effective agents include phenylbutazone( butadione), indomethacin, and corticosteroids. In the inter-attack period, to reduce the frequency of attacks use means that reduce the content of urate in the body;such drugs as probenecid and sulfinpyrazone, stimulate the excretion of

Coma

PodAgra( Greek podos - leg, Greek agra - seizure, literally "leg in a trap") is a disease that is caused by an increase in the concentration of uric acid in the blood(hyperuricemia).

Igor Krylov

More common disease occurs in men, but recently the prevalence of the disease among women is increasing, with age, the prevalence of gout increases. About 2% of the elderly suffer from gout.

Sokolov Vitaliy

Chronic disease associated with impaired urine metabolism - elevated blood uric acid( urate), which is clinically manifested by recurrent acute arthritis and the formation of gouty nodes( tofusov).T. Sydenham compared it with the pains from a clip in the press. The exceptional cruelty of acute gouty arthritis was the reason for the appearance of numerous frightening allegorical images.
Statistics
The spread of gout in the most developed countries is associated with a significant consumption of foods rich in purines( meat, fish) and alcoholic beverages.
Mostly men are ill. The first attack can be at any age, but more often after 40 years. In women, gout is observed in the menopause.
Normal exchange of urate
Uric acid is the final product of cleavage of purines. Stocks of uric acid in the body are in the norm of 1000 mg at a rate of their renewal within 650 mg / day, that is daily from the store 650 mg of acid decreases and the same amount is replenished. It is excreted by the kidneys, the clearance is 9 ml / minute.
The source of uric acid formation in the body is purine compounds. The immediate precursor of uric acid is guanine and xanthine. Normal content of sodium urate in serum( calorimetric method):
For women: 0,24-0,36 mmol / l;
For men: 0.30-0.42 mmol / l.
The uric acid content above these figures is regarded as hyperuricemia with a high risk of developing gout.
Etiology
Risk factors for gout:
Male gender.
The elderly.
Propensity to consume meat, alcohol, especially beer and wine. They contain molybdenum, which is a cofactor of the enzyme xanthine oxidase, which transfers xanthine to hypoxanthine( the immediate precursor of uric acid).
Fluctuations in the pH level of blood and synovial fluid.
Physical overloads, including static ones - in close shoes especially frequent defeat of the big toe.
Subcooling.
Reduces the excretion of uric acid by the kidneys.
a. The function of the kidneys can be adversely affected by NSAIDs, especially those containing phenacetin( they are used to relieve migraine pain, whose seizures are typical of persons with gout).
b. One of the epidemiologically important factors that reduce renal excretion of uric acid is the excessive accumulation of lead. In England, local epidemics of gout associated with the consumption of wine from Portugal have long been documented and clearly documented( wine was delivered in containers that were covered with a lead-containing composition).
c. It is important as a risk factor has a partial decrease in renal excretion of urates under the influence of alcohol, diuretics. The widespread use of diuretics, in a pathology such as GB, significantly increases the number of people with hyperuricemia and the risk of developing gouty crises.
The main cause of gout is hyperuricemia, which results from
Elevated uric acid formation;
Reduced excretion of uric acid;
Combinations of 1 and 2 factors.
Pathogenetic types of hyperuricemia
Primary hyperuricemia. The most common cause of primary gout. This is a constitutional dyspurinism, that is, a family-genetic anomaly of purine metabolism, determined by several genes. Causes of primary hyperuricemia:
Increased synthesis of endogenous purines, the so-called metabolic type of hyperuricemia, characterized by high uricosuria and uric acid clearance( the most common form).
Disturbance of excretion of uric acid by the kidneys( kidney type of hyperuricemia), is caused by low uric acid clearance.
Combination of 1 and 2 reasons.
The main role in the pathogenesis of primary hyperuricemia is attributed to genetically caused abnormalities in the enzyme system, primarily the inadequacy of the enzyme involved in the resynthesis of nucleotides from purines. An increase in the activity of this enzyme leads to insufficient use of purines in the body and thus to an increase in the level of urate. This type of hyperuricemia

Vladimir Svetlogradov

Gout is a disease of intelligent and talented people. The increased concentration of uric acid in the blood contributes to the deposition of salts in the joints. Gout - the deposition of salts in the thumb of the foot or hand. Causes severe but short-term pain in the thumb of the foot. Although salts of uric acid are deposited in the joints of the hands( fingers).than very much resembles all sorts of arthroses and arthritis. Gout can be detected only by the analysis of blood( increased concentration of uric acid) and to appoint the right treatment. With gout, foods such as liver, tomatoes, black( rye) bread, coffee, chocolate and other other foods are undesirable. Desirable - lemons, tea, fruit( vegetables - not particularly desirable).Although, if there is gout, nothing will help. ...

Inga

is from inheritance. Mostly men are ill. Gout is the accumulation of purine( uric) acid in the body. It is deposited in joints, causes severe pain, inflammation. Treatment stationary. The patient is strictly forbidden to eat meat and fish broth, canned food, smoked products and drink wine.

What is gout?and is it contagious?

Ying. .

Not contagious. .

Alex U

joint disease

Sewerka

Pod'gra( alp-poc.t. ἄγρα - foot tracheal from πούς-leg and ἄγρα-seizure) is a heterogeneous by origin disease characterized by deposition invarious tissues of the organism of urate crystals in the form of sodium monoaurate or uric acid. At the heart of the occurrence is the accumulation of uric acid and a decrease in its excretion by the kidneys, which leads to an increase in the concentration of the latter in the blood( hyperuricemia).Clinically, gout is manifested by recurrent acute arthritis and the formation of gouty nodes - tofusov. More often the disease occurs in men, but recently the prevalence of the disease among women increases, with age the prevalence of gout increases. For the treatment used drugs that affect the pathogenetic mechanism of the disease, as well as drugs for symptomatic treatment.
if that's what it gave you.

alina polshkova

Poda'gra( another Greek-pokyagra - foot tracheal from πος-leg and ἄγρα-capture) is a heterogeneous disease that is characterized by the deposition of urate crystals in the form of mono-urate sodium or uric acid in various tissues of the body. At the heart of the occurrence is the accumulation of uric acid and a decrease in its excretion by the kidneys, which leads to an increase in the concentration of the latter in the blood( hyperuricemia).Clinically, gout is manifested by recurrent acute arthritis and the formation of gouty nodes - tofusov. More often the disease occurs in men, but recently the prevalence of the disease among women increases, with age the prevalence of gout increases. For the treatment used drugs that affect the pathogenetic mechanism of the disease, as well as drugs for symptomatic treatment. Epidemiology
Hyperuricemia is detected in 4-12% of the population, 0.1% of the Russian population suffers gout [1].In the US and Europe, gout suffer from 2% of the population, among men aged 55 to 65 years, gout suffer from 4 to 6%.
The ratio of men to women is from 2: 1 to 7: 1.The peak incidence is 40-50 years in men, 60 years and older in women. Before menopause, women rarely get sick, probably due to the effect of estrogen on the excretion of uric acid [1].
The incidence of gouty arthritis in different populations varies from 5 to 50 per 1,000 men and 1 to 9 per 1,000 women, and the number of new cases per year is 1-3 per 1000 in men and 0.2 per 1000 in women [1].
An acute attack of gout in adolescents and young people is rarely observed, usually it is mediated by a primary or secondary defect in the synthesis of uric acid [1].
Etiology
Developmental factors of the disease
There are a number of risk factors that contribute to the occurrence and development of gout in certain individuals.
The risk factors for developing gout include arterial hypertension, hyperlipidemia, as well as:
increased intake of purine bases, for example, with a large amount of red meat( especially by-products), some fish, coffee, cocoa, tea, chocolate, peas,lentils, alcohol( especially beer [source not specified 444 days]);
increase in the catabolism of purine nucleotides( eg, for antitumor therapy, massive apoptosis in people with autoimmune diseases);
inhibition of excretion of uric acid in the urine( eg, in renal failure);
increased synthesis of uric acid, while reducing its excretion from the body( for example, with alcohol abuse, shock states, glycogenase deficiency of glucose-6-phosphatase).Symptoms and course of the disease
Complete natural evolution of gout goes through four stages:
asymptomatic hyperuricemia,
acute gouty arthritis,
intercritical period
chronic arthritic deposits in the joints.
Nephrolithiasis can develop at any stage, except the first. There is a constantly increased concentration of uric acid in the blood plasma and urine;inflammation of the joints by the type of monoarthritis, which is accompanied by severe pain and fever;urolithiasis and recurrent pyelonephritis, culminating in nephrosclerosis and renal insufficiency.

Nadezhda Khvatova

Disease of joints due to metabolic disorders. Not infectious, but there may be a hereditary predisposition.

Lisi4kaRigaja

let me beat, and put it simply - the deposition of salts is due to improper food.eat less all * ovno need.and it is not contagious.

ishua ivanov

Urolithiasis.

Nastia Kurzenyova

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