Diuretics for gout

Gout treatment and green tea

Gout is a joint disease. It develops as a result of disturbed metabolism, when a large number of uric acid crystals accumulate in the body. In the first place with gout suffer joints on the toes. In the absence of treatment, the disease progresses and other joints are affected. Nutrition in the treatment plays an important role. The treatment also shows the use of liquid in large quantities.

And is it possible to drink tea with gout and what is the best grade to consume in order to get rid of uric acid accumulated in the body? It is noted that green tea contains more useful components, since it is not subjected to the same treatment as black.

How is gouty arthritis formed?


Causes of gout

When consuming food rich in purines, there is accumulation in the body of urate. It is a fatty variety of meat, fish and alcoholic beverages. Therefore gout was formerly called the disease of kings. Only wealthy people could afford such a diet. In our time, such a diet is available to most people, so the number of people suffering from this disease has increased.

Treatment for gout should be comprehensive. This includes the appointment of medications that relieve pain and inflammation around the joint. Other medicines are prescribed to speed up the excretion of urates. But no medicine will help if the patient continues to consume prohibited foods. Therefore, the first and important step is the normalization of metabolism. And tea with gout will be very useful.

Dietary nutrition is indicated. It is important to reduce to a minimum consumption meat dishes, fish and saturated with fats, legumes. This applies to the consumption of canned green peas. In the menu it is necessary to include sour-milk products, vegetables, fruits. It is important to use liquid in sufficient quantity. It can be:

  • green tea in combination with milk or lemon;
  • berry fruit;
  • teas from herbs;
  • vegetable juices;
  • compotes;
  • kvass;

Diuretics for gout attacks

Green tea is known to be useful in many ways. It is rich in vitamin C, has an antimicrobial effect, it tones well the blood vessels. Therefore, it is consumed to normalize the pressure. In general, this drink contains 300 elements, which have not been thoroughly investigated. Green tea has a diuretic property. This is very important for those who suffer from gout.

With this disease, it is necessary that the metabolism is normal, and the salts of uric acid are excreted from the body. Since green tea has a moderate diuretic effect, it will enhance the excretion of urates and normalize metabolic processes. Green tea can be with additives, for example jasmine. Such additives enhance the taste. When gout is recommended to add milk or lemon in tea to neutralize purines.

For cooking herbal tea use corn stigmas, chicory, sage. Herbs are mixed in equal parts and boiled with boiling water: 2 tablespoons are supposed to boil 2 cups of water. Take this infusion is necessary for the third part of the glass 3 times a day, 1 month.

Although tea contains many useful substances, there may be personal contraindications that do not allow its use.

What other drinks can I drink with gout?

green tea for gout

In folk medicine, a tea fungus is often used to treat many diseases. It is a combination of bacteria and yeast fungi. Due to its composition kombuchi( another name of the fungus) has a healing effect. The tea fungus has the following properties:

  • anti-inflammatory;
  • analgesics;
  • is antibacterial;
  • lowers cholesterol;
  • improves the functioning of the digestive tract, liver;
  • removes fluid from the body.

Tea mushroom can be poured with tea, juice or made on the basis of herbal dues. To do this, it is necessary to brew the herbs from the evening with boiling water, let it brew, and sweeten with sugar in the morning and pour into a jar with a mushroom. Take 0.5 st.1 hour before meals.

Treatment of gout with gout is best done together with herbs. Take birch leaves, cowberry leaves, nettle leaves, burdock roots, three-color violet. Mix in equal portions.7 tbsp.spoon mixture pour 1 liter of boiling water. Let it brew for 2 hours. Herbal infusion is mixed with kvas in a 1: 1 ratio and left for 3 days. Take 1 glass 3 times a day.

Tea mushroom can be used for compresses. Marlou pat soaked kvass and attach to the sick joint. Before starting treatment with fungus, consult a doctor.

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The best remedy for gout - self-restraint and strict discipline

Gout is a very serious illness.

People who have this disease know that gout greatly reduces the standard of living.

How to be treated from Padagra? Those who have never heard of such a disease think that it is easily curable. But this is not so.

Hyperuricemia is the main cause of the disease. If there is too much uric acid in the blood, it can not dissolve and crystallize. The organism attacks these crystals, so the tissues become inflamed. Crystals are usually located where there is poor blood circulation, especially in the joints of the limbs.

Gout attacks can be so painful that most people are willing to do anything to avoid the next outbreak. But seizures occur frequently.

Experts believe that in most people gout attacks can be largely prevented with proper treatment.

The first step in preventing repeated gout attacks is to eliminate factors that can cause gout.

For some people, lifestyle changes are sufficient to avoid outbreaks of gouty arthritis. But many people also need to take medication to reduce the level of uric acid.

Management of the development of the disease

How to treat gout at home

A patient for gout treatment can make many effective steps alone.

We need to make a treatment plan during gout attacks.

  1. Reduce pain in an acute attack.
  2. Give rest to the affected joint in the attack of gout and within 24 hours after it.
  3. Use ice to reduce swelling.
  4. Remove inflammation by taking anti-inflammatory nonsteroidal drugs( NSAIDs).But you can not drink aspirin, which dramatically changes the level of uric acid, as it will worsen the patient's condition.
  5. Prevent new attacks.

Lifestyle factors also affect the course of gout.

Development of the power supply system

diet for gout

In order to avoid the problem, for the treatment experts recommend to develop the correct power system.

  1. Adhering to a diet high in protein or fat and low in carbohydrates, a patient can get a large amount of purines, which is unacceptable.
  2. It is important to drink plenty of fluids so that the body remains well hydrated.
  3. Excessive consumption of alcohol, especially beer, is very harmful. It has many purines, which will lead to an increase in the amount of uric acid in the body.
  4. Meat and seafood should be restricted. They can increase the level of uric acid. It is better to eat a limited amount of chicken, pork. Not banned beef in small quantities. These types of meat have less purines than the liver and fatty meat.
  5. You can take cottage cheese, dairy products, skim milk.
  6. Avoid sweetened drinks, especially those that contain fructose, as this is associated with a high risk of gout.
  7. You need to eat a lot of sweet fruits. They provide the body with nutrients that can help maintain a balanced diet and a healthy weight. In addition, they usually do not have many purines.
  8. Fruits, in which there is a lot of vitamin C, can prevent the development of an attack of gout. Cherry or cherry juice also alleviate the condition of the patient with gout. You can eat lemons, oranges, tangerines.
  9. It is forbidden to use greens with a high content of oxalic acid( salad, asparagus, sorrel, green onions).
  10. Processed carbohydrates in the form of white bread, white flour products, pasta do not have many purines. But their use leads to weight gain.
  11. Useful oats, beans, vegetables, potatoes.
  12. You need to use olive oil for dressing salads.

Drugs for gout: Fullflex and Indomethacin

Fullflex for gout

What is the best medicine that will effectively help the patient?

You should take medicine prescribed by your doctor.

Usually doctors prescribe NSAIDs. Nonsteroidal anti-inflammatory drugs effectively relieve pain with gout.

Indomethacin - an effective remedy for gout, is an NSAID.It is often prescribed for acute pain in patients with gout.

Like all NSAIDs, it is not suitable for long-term use, so it is taken briefly to help reduce pain and inflammation.

Effective Drug Naproxen in pain in a patient with gout is often prescribed alone or in combination with colchicine or other anesthetic medications.

In the treatment of gout, Fullflex is widely used. He went a long way in testing his patients. Fullflex is used in the form of tablets and ointments. This drug relieves pain. Fullflex removes inflammation and helps well if the patient takes it in strict accordance with the instructions. Fullflex helps keep the disease under control and relieve suffering from gout. Fullflex can remove joint pain. Fullfleks inexpensive, but effective drug.

For the treatment of gout Fullflex is simply necessary.

It should be remembered that some drugs increase the level of uric acid.

These are some tablets commonly used at high blood pressure, chemotherapy against cancer, niacin( B vitamins), aspirin.

With gout, the doctor prescribes diuretics, antihypertensive drugs. Diuretics help to remove uric acid.

The optimal body weight should be maintained.

  1. It is necessary to control weight, as excess pounds increase the risk of developing gout.
  2. Excess weight creates an additional strain on the joints.
  3. A low-calorie diet will help you lose weight.
  4. Very low calorie diets that intensify hyperuricemia are harmful.

It is also possible to treat people with this disease in a popular way.

  1. With gout, diuretics should be used. Parsley helps. It is necessary to wash its fresh roots, grind, boil in a glass of water. This agent has a diuretic effect.
  2. Successfully used for the treatment of gout is apitherapy. The active substances of bee venom can effectively relieve pain and reduce inflammation. The functions of the affected joint are best restored after apitherapy.

Physiotherapy can be helpful for gout

bicycle for gout
  1. For joints to be healthy, they must be in motion. During reading, working, watching TV, you often have to take breaks and move.
  2. The best remedy for gout is walking, cycling, swimming. Shocks and shaking during exercise increase the risk of injury to injured organs. Classes with light dumbbells can also be included in the complex. It is necessary to exclude sharp and repetitive movements of patients joints. Before you start the exercises, you need to consult a doctor.

So, we can draw conclusions:

  1. Gout is an extremely complex disease.
  2. There is no standard way to avoid gout.
  3. The best way is a personal gout treatment plan, which is agreed with the attending physician.
  4. In this plan, the following should be established:
  • methods for controlling pain and uric acid levels;
  • medications and medications prescribed by a doctor;
  • a tough diet;
  • exercise therapy and physical activity;
  • means of traditional medicine.

Only the right way of living and fulfilling doctor appointments can provide effective gout treatment.

Prognosis for gout is favorable for human life. But the question remains about the quality of this life. It depends only on the patient himself. He must organize his own life. There is a saying: "The worse a person lives, the less he gets sick".With this you can argue. But in terms of patients, gout is not more precise. Any excesses in food, drink, lifestyle can negatively affect the health of the ill gout.

What should I do? Only self-restraint, strict discipline, the ability to force oneself to live by the rules of this disease can help the patient. This is the best remedy for gout.

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gout

Gout occurs in almost 0.25% of the population. Drug treatment is effective, but some drugs can accelerate the course of the disease.

Causes of gout

Gout is characterized by a sharp attack of arthritis caused by chronic deposition of monosodium salt of uric acid in the cartilage and kidneys, and nephrolithiasis of urates.

Urates with gout

Uric acid refers to purine bases( guanine, adeny) that participate in the formation of nucleic acids. The amount of urate in the body of a healthy man who is on a diet in which there are no purines is 1200 mg, and in women about 2 times less. In patients with gout without visible salt deposits, the amount of urate in the body increases by 2 or 3 times compared with the norm, and since this amount exceeds that which can be in the dissolved state in the extracellular fluid, their microcrystalline deposits are formed. In patients with gouty nodes, the amount of urate in the body can be 15-26 times higher than normal. Urates are excreted mainly through the kidneys. At the same time, being bound to plasma proteins by only 5%, they are freely filtered through the renal glomeruli and then reabsorbed from the lumen of the tubules, and are also secreted into it from the blood. Urate that appears in the urine is the result of excess of their secretion over absorption. Both processes are active, require energy costs, they can be influenced by drugs.

Gout attack

To develop an attack of gout , two conditions are necessary: ​​

a) precipitation of crystals of monosodium salt of uric acid from body fluids in hyperuricemia( a detailed mechanism for starting this process is not yet clear)

b) development of local inflammatory reaction with phagocytosis in response to the presencecrystals. Actively phagocytic leukocytes produce lactic acid, which contributes to the precipitation of urate into the crystals, since they are less soluble in an acid medium.

As the crystallization increases, the processes of inflammation and phagocytosis are amplified, which causes a large amount of lactic acid and self-stimulation of the inflammatory reaction. The inflammatory process is also enhanced by the enzymes involved in the digestive processes and released from the lysosomes of leukocytes.

Hyperuricemia and gout are thus caused by two major processes:

1) inadequate urate excretion as a result of primary abnormalities in the kidneys and the effects of drugs on the transformation of urates in tubules;these properties are possessed by all diuretics( except spironolactone), acetylsalicyl acid( in small doses), pyrazinamide, nicotinic acid and alcohol( the latter increases the synthesis of urates, and also forms lactic acid, suppressing their tubular secretion);

2) excessive formation of urates due to various defects in enzymes that enhance the biosynthesis of purines and the excessive decay of cells with the release of nucleic acids in the treatment of drugs or X-ray therapy in mielo- or lymphoproliferative processes.

Drugs with gout

When gout is used drugs:

a) suppressing symptoms( anti-inflammatory with analgesic action or without it, namely azapropazon, diclofenac, indomethacin, naproxen, piroxicam and sulindac; colchicine, adrenocorticosteroids and corticotropin);

b) synthesis-preventing urates( allopurinol);

c) contributing to the release of urate( uricosuric substances, namely, probenicides, sulfinpyrazone).

Colchicine

Colchicine is an alkaloid from autumn crocus, has anti-Mitotic properties and is not currently used for malignant diseases, however it is effective for gout, since it relieves pain and inflammation in a few hours. It is believed that such a rapid relief of the condition can serve as a confirmation of the diagnosis, since with non-hypogratic arthritis the drug is ineffective, although failure with its use does not mean that the patient does not suffer from gout. The reason for the special ability of colchicine to stop pain with gout is not established, but the most probable explanation is that it suppresses migration of leukocytes to the inflamed area and thus interrupts the already described inflammatory cycle.

The drug is absorbed from the intestine, part of it is metabolized in the liver, and part is excreted unchanged with bile and reabsorbed from the intestine. This increases its toxic effect on the intestines.

In case of an acute attack of gout, colchicine can be given for oral administration at a dose of 1 mg, and then 0.5-1 mg every 2 hours until the pain disappears or side effects appear. Improvement of the condition usually occurs after 2-3 hours and lasts for 12 hours. As a rule, the total dose is 3-6 mg, it is inappropriate to use more than 10 mg. If an effective dose is established, the patient can take her whole attack, and then at 0.5 mg after 1 hour. Colchicine has a preventive effect on gout, if taken 0.5-1 mg / day or every other day. It is also used as a primary remedy for Mediterranean fever, preventing exhausting bouts of fever and development of amyloidosis in these patients.

Adverse reactions can be severe and accompanied by abdominal pain, vomiting and diarrhea( blood may be present in the stool).Probably, they are caused by depression of mitosis of rapidly reproducing cells of the intestinal mucosa. Can develop kidney failure and sometimes blood diseases. Large doses cause muscle paralysis.

Allopurinol

Allopurinol inhibits xanthine oxidase, an enzyme that converts xanthine and hypoxanthine to uric acid. In patients taking it, less urate and more xanthine and hypoxanthine are released with urine. Both compounds are easily excreted in renal failure and are more soluble than urates, as a result of which xanthine stones are rarely formed. Allopurinol was first used in the treatment of patients with leukemia to prevent the oxidation of active b-mercaptopurine to the inactive metabolite, when its effect on the synthesis of uric acid was observed. The patient has a gout, treated with allopurinol;the usual doses of 6-mercaptopurine cause its potentiation.

Allopurinol is readily absorbed from the intestine, is metabolized in the liver to alloxanthin, which also has an inhibitory effect on xanthine oxidase. It is excreted unchanged in the form of alloxanthin through the kidneys.

The drug is recommended for renal insufficiency accompanied by urate lithiasis, or when a large number of gouty knots are formed in blood diseases in which spontaneous hyperuricemia occurs( due to deposition of salts around the joints) and myeloproliferative diseases, when cell destruction leads to a high urate load. Allopurinol prevents the development of hyperuricemia caused by diuretics. E can be combined with uricosuric means.

During the first 2 months of treatment, the risk of an acute attack of gout increases, despite a decrease in the level of urate in the blood.

This may be due to a decrease in the level of urate in the plasma or its fluctuations, which causes dissolution and, apparently, alternating recrystallization of urates from the foci of deposits in the gouty nodes. During this period, non-steroidal anti-inflammatory drugs or colchicine should be used as depressants, and the patient should be warned about the possibility of an attack, because otherwise he may be disappointed in the drug.

Single oral intake of 300 mg is usually sufficient for treatment, but in severe cases, the total dose can reach 600 mg or more.

Side effects, not counting exacerbations, are rare;they include a different kind of allergy, leukopenia, impaired bowel and liver function.

Uricosuric remedy for gout

Probenecid

Probenecid is available in 0.5 g form. It does not have analgesic effect. It began to be used at a time when penicillin was still difficult to access and there was a need for drugs that could prevent its active excretion by the renal tubules and thus, with the introduction of small doses, maintain a large concentration in the plasma. Probenecid provides this action, but penicillin sal is so cheap and affordable that now the same effect is achieved with increasing its dose. However, probenecid is sometimes used in infections in which an unusually high plasma penicillin level is desired, for example, in infectious endocarditis, in the treatment of children for whom frequent administration of large doses of an antibiotic is undesirable and, if necessary, obtain the maximum effect with a single administration of the drug, for example in gonorrhea.

Probenecid inhibits the transport of organic acids through the epithelium and, most importantly, through the epithelium of the renal tubules. The effect depends on the dose: small doses prevent tubular secretion and excretion of urates, but an adequate dose inhibits their reabsorption from the lumen of the tubules and has a beneficial uricosuric effect.

The drug binds to plasma proteins by 90%, partially metabolized, and is partially excreted unchanged in the urine. The half-life period varies depending on the dose within 5-8 hours.

To prevent a gout attack, the dose is 0.5 g inside once a day for the l-th week, then it increases to 1-2 g / day. The level of urate in the plasma is initially reduced and set, reaching 60% of the initial level. Because of the large loss of urate at the beginning of the treatment, the crystals may appear in the urine if the pH is not maintained at the level of

6.0 or more in the first month of treatment with probenecid( or another uricosuric agent, for example a mixture of potassium citrate with water of 12-24 g/ day or sodium hydrogencarbonate in the form of a powder of 5-10 g / day, washed with water).The patient should be prescribed a generous drink( 3 liters / day) to avoid the danger of mechanical obstruction or formation of stones. Urine should be made to have an alkaline reaction and be diluted;To this end, take a tablet( 250 mg) of acetazolamide at night. It should be monitored for a patient with renal insufficiency( in addition, potassium citrate can cause dangerous hyperkalemia).Probenecid in this case is contraindicated, since it may be ineffective or even aggravate the kidney disease.

In some patients, it causes a violation of the function of the gastrointestinal tract and sometimes allergies, blocks tubular excretion and prolongs the action of penicillins, cephalosporins, naproxen, indomethacin, and panylurea.

Gout treatment

Acute gout attack

With this form of gout, non-steroidal anti-inflammatory drugs are highly effective: the attack stops after a few hours after ingestion. It is important to begin treatment as early as possible. Indomethacin belongs to the drugs of choice;it can be taken orally 25-50 mg three times a day, for the fourth time( sometimes in a larger dose) it is taken at night. Side effects from the gastrointestinal tract develop less often if the drug is taken with food. It can be used in the form of candles( 100 mg).Naproxen, diclofenac, sulindac, piroxicam and azapropane are among the effective alternatives. With intolerance of non-steroidal anti-inflammatory drugs, colchicine is traditionally used. It can be a drug of choice for the first attack of severe monoarthritis, since its effect simultaneously helps to establish a diagnosis, which is sometimes difficult. Other anti-inflammatory drugs act indiscriminately.

If these drugs are ineffective, you can begin treatment with prednisolone at 40 mg / day with a dose reduction immediately, as soon as the symptomatology allows. Cancellation of the drug can cause a relapse, so it is advisable to add colchicine in order to pass this stage.

Urikozuric drugs and allopurinol are useless in an acute attack of gout.

Recurrent and progressive forms of gout can be prevented by convincing the patient not to take alcohol and prescribing allopurinol and uricosuric drugs if the urate level in the plasma is above 0.6 mmol / l and the patient has already suffered three or more acute attacks of the disease.

Treatment should be started in a calm period. Usually, allopurinol is more preferable, which serves as a drug of choice in reducing renal function. It can be combined with uricosuric means. Salicylates can not be administered simultaneously with other uricosuric drugs, as they interact. Paracetamol can be used as an analgesic.

Colchicine also prevents a gout attack. It does not affect the excretion of urates.

Rapid reduction of urate levels in plasma by any method can promote an acute attack, probably due to the dissolution of salts. In this regard, in the first 2 months of treatment withallopurinol and uricosuric agents, it is recommended to conduct an anti-inflammatory treatment with indomethacin in order to prevent acute attacks, while urine should be alkaline and its volume large to avoid crystalluria.

A favorable effect caused by a decrease in the level of urate in the plasma is invisible for several weeks. It is necessary to select the preparations in such a way as to maintain the level of urate in the plasma within the limits of the norm. Neglect this is not recommended. Prevention of one colchicine or indometacin is undesirable, since urate in the urine remains at a high level, which causes the progression of the disease( the formation of gouty nodes in places of salt deposition, kidney damage).

Chronic gout with the formation of gouty nodes.

Gouty sites sometimes decrease in size and even disappear when treated with allopurinol or its combination with uricosuric agents. In acute pyrophosphate arthropathy, treatment is the same as in acute gout.

Exacerbation of gout attacks with diuretics.

Any active diuresis may contribute to an acute attack of gout due to a decrease in the volume of urine, which leads to an increase in the reabsorption of all substances, including urates, normally reabsorbed from the proximal tubules;antagonistic effect have allopurinol and uricosuric substances.

Diet, alcohol and gout

Usually, patients with gout are overweight, and as it decreases, urate levels in urine decrease. However, in obese persons, gout can develop gout due to ketosis, which causes precipitation of urates in tissues( due to acid reaction);some experts recommend taking allopurinol during this period. It has long been known that alcohol induces acute attacks of gout, as it increases the formation of urates and causes lactic acidosis, which contributes to the deposition of urate in the tissues and blocking their excretion by the renal tubules.

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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( 1g 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 the joints - gouty arthritis

Consultation: rheumatologist, nephrologist, surgeon.

Treatment of gout

Adherence to dietary recommendations is important to prevent 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.

For 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 antipodal drugs, and can significantly limit the function of the joints.

Physiotherapy for gout

In an acute period, applications of dimexide solution to 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.

In the period of remission, patients are shown sanatorium 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, chickens, 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 are 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 gout

Vopr: Why does an antidepressant drug get worse? 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 tissue depots of the body. Therefore, in order to prevent, it is necessary to prescribe simultaneously NSAIDs.

Question: How long should I take antidotal drugs if the level of uric acid 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.

Doctors therapist Vostrenkova I.N.

# 4Anna13.02.2016 17: 31 can the use of paracetamol lead to an exacerbation of gout?. . edema on the legs does 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: Peasants 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

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