Gout: treatment with medicines. Attack of gout
Gout occurs when violating purine metabolism in the human body. In this case, an elevated concentration of uric acid is found in the blood, and articular and / or periarticular tissues, kidneys and other organs suffer from deposits of urate - sodium urate salts.
Causes of gout
Excess uric acid is formed by the influence of increased synthesis of endogenous purines, reduced urate excretion, or a combination of these processes. Recognize the symptoms of primary and secondary disease. The latter case obliges to pay attention to medicines taken by a person who was struck by gout. The causes of the disease require detailed consideration.
Gout provoked by hyperproduction of uric acid
The excess of purine bases and nucleosides is the main reason for the high concentration of uric acid. With unlimited consumption of food, in an abundance of substrates, forming purines, the hyperproduction of acid naturally occurs.
The symptomatology of secondary hyperproduction causes an excessively high cell decay, occurring against a background of certain diseases( for example, a hemorrhagist, paraproteinemia, hemolysis, alcoholism, anticancer chemotherapy becomes a provocateur).Hyperuricemia often accompanies psoriasis. However, the clinical pathology of gout in these cases develops infrequently.
Gout caused by decreased excretion of uric acid
In 90% of people who contracted gout, there is a decreased acid extraction. The kidneys, intestines and skin integuments leave the uric acid. With reduced excretion of urate by the kidneys, they accumulate in excess in the body and crystallize. Tiny crystals are deposited in the joints, leading to inflammation and pain. A kidney in this case affects urate jade.
This phenomenon is sometimes caused by diuretics, alcohol, acetylsalicylic acid, aminophylline, caffeine, diazepam, dimedrol, L-dofa, dopamine, B12 and C vitamins in small dosages. Lead leads to epidemic outbreaks. Lead gout is caused by paints, surrogate alcohol and other sources containing heavy metal.
Symptoms of gout: signs of attacks
The onset of symptoms is associated with the deposition of salts formed by uric acid. Crystals settle in the joints and kidneys. The first attack of gout usually does not occur before the age of thirty. It is experienced more often by patients who have reached 40-60 years.
The attack is accompanied by swelling and redness of the joint, acute soreness. Without treatment, it does not go on for several days or even weeks. Evening and night - the main time of occurrence of fleeting seizures.
An attack of gout is provoked with abundant meat food, alcoholic beverages, individual varieties of fish, coffee and other products enriched with purine bases. The disease in most cases affects the big toe, although the defeat of other joints is not excluded. Its bright symptom is acute arthritis, which unfavorably proceeds with pathologies of the kidneys.
Arthritis is an acute form of gout. It is expressed in a sudden onset gouty attack - a painful inflammation of the joint. With gouty arthritis, urate crystals fall out of the tissues into the joint cavity, causing inflammation. Gouty attacks occur, usually in the middle of the night.
Provoked by alcohol, trauma, physical overload, surgical operations, a number of gout medications. Treatment with medicines allows you to relieve seizures and relieve the condition. When attacking the joint and adjacent tissues swell, the skin in the place of the hearth blushes, the pain increases.
Acute arthritis attacks disappear within a few days( sometimes weeks), even if they are not treated. Repeated attack returns after six months or a year. Although periods of calm sometimes last up to 10-20 years. In people who are not puzzled by treatment, the frequency of seizures increases, several joints are involved in them at the same time. The duration of attacks increases, they become more pronounced.
The chronic course of the disease is accompanied by the characteristic signs:
- chronic arthritis;
- a cluster of urate crystals;
- with kidney damage.
Prolonged gout accompanies all symptoms at the same time. Chronic arthritis affects those who survived the secondary form of the disease, untimely or inadequately treated.
In affected kidneys there are 3 types of changes:
- Renal tissues are overgrown with urate crystals. They have a weak inflammatory reaction.
- Intra-kidney outflows of urine are clogged with urate crystals.
- In the urinary tract formed uric acid stones.
The variations are combined in different variations, resulting in the clinical term "gouty kidney."Stones, lain in the urinary tract, are asymptomatic or show signs of urolithiasis.
Methods of treatment
The task of treatment is to prevent gouty attacks and to remove acute arthritis. Support for adequate drinking regimen, dumping excess weight, diet therapy, reducing medications that increase hyperuricemia, excluding alcohol prevents gout. Treatment with medications can eliminate inflammation and pain.
Water reduces the concentration of urates, preventing them from falling into crystals that settle in tissues and organs. In addition, it promotes their leaching and withdrawal from the body. Alcohol is capable of a diuretic effect. In large doses, it dehydrates the body, promoting the crystallization of salts, triggering gouty attacks. In addition, it slows the excretion of urates from the body, giving them the opportunity to be deposited in the joints.
Weight loss helps reduce the risk of recurrent gouty attacks. The diet should reduce fat and reduce calories. The diet is combined with regular aerobic exercises.
The main aspects by which gout is controlled is the treatment with medications that relieve pain, eliminating inflammatory reactions that control the impaired metabolism leading to hyperuricemia. Anesthesia is carried out with acetaminophen( Tylenol) or other more powerful analgesics.
Of non-steroidal anti-inflammatory drugs, indomethacin is recommended. True, it is not suitable for patients with an allergy to aspirin and patients with polyps in the nose. Colchicine is suitable for the removal of a gouty attack.
Patients' reviews focus on the fact that oral medication causes serious side effects associated with the frequency of its administration( once an hour or two hours until the soreness is significantly retreated or unwanted reactions appear).
Corticosteroids, related to powerful anti-inflammatory agents, relieve acute attacks. To avoid severe long-term side effects, they are prescribed short courses. They are prescribed to patients who have concomitant ailments of the liver and kidneys.
Prolonged periods patients take drugs that reduce the concentration of uric acid in the blood. They promote the dissolution of heavy tofusnyh deposits, prevent the formation of stone and the development of pathologies in the kidneys. Thanks to them, gout does not occur again. Treatment with medicines from this category either increases the excretion of urates, or reduces their synthesis from purines of food.
These drugs can worsen gouty attacks, so their reception begins after the fading of the inflammatory process. If they were treated before the attack, the course is not interrupted, and try to adjust the dosage( especially after its extinction).Since many patients with a high level of uric acid are not prone to stone formation in the kidneys and are not burdened with gout, treatment with medicines that affect the level of urate is purely individual.
Using probenecid and sulfinpyrazone, uric acid excretion is enhanced. These drugs are not suitable for treating people with urolithiasis. They sometimes provoke the formation of concrements. Abundant drink, combined with their reception, promotes accelerated passage of acid through the urinary system and prevents the formation of conglomerates.
Due to allopurinol prevent the synthesis of uric acid. They block the metabolic conversion of purine bases to an acid. It is cautiously prescribed because of the risk of getting side effects to those who have weakened kidney function.
Using Home Tools
Home treatment methods help to remove the symptoms of gout, the current acute. The inflamed joint is lifted upward, providing him with peace. Soreness is reduced by applying ice. Exclude the use of aspirin-containing drugs( they inhibit the excretion of uric acid).
Treated with medicinal plants: dog rose and sea buckthorn, cranberries and strawberries, rowan and blueberries, barberry and St. John's wort, birch and linden, chicory and other herbs. Use homeopathic remedies.
Diet therapy for gout
Compliance with the diet provides a stable remission. Ideally, they achieve complete elimination of products enriched with purines. If an absolute exception is not possible, the maximum restriction on their consumption is introduced. Try to balance the amount of fat and drink abundantly.
Anchovies, sardines, goose, chicken and any fatty meat, by-products, meat extracts, legumes and dry wine are saturated with purines. When diagnosing gout, tomatoes are eaten in moderation.
The tomato is full of organic acids. Purines in them are not so much, as, for example, in meat. Therefore, nutritionists who are tormented by gout, do not prohibit tomatoes. On the contrary, they believe that a reasonable amount of tomatoes and dishes from them is beneficial to such patients.
One of the most common joint diseases in a person is gout. This disease is associated with an incorrect metabolism, which causes the deposition of uric acid in the joints - white powder. Previously it was believed that only wealthy people could be prone to gout, because only they could afford a lot of food and alcohol. Now it is proved that any person can suffer from gout. Most often middle-aged male patients are at risk.
Gout in a man appears not without reason. Heredity is considered a fundamental factor in the onset of the disease. All the rest is only stimulating reasons for the manifestation of the symptoms of the disease. These include:
- diseases in the body that cause kidney and liver dysfunction;
- weight mismatch is normal;
- is inactive or, conversely, a very active, lifestyle.
Stages and signs of
After its appearance, gout goes through three stages: acute, interstitial and chronic. An acute attack of gout is considered the most important, because it is at this stage that you can avoid the transition to the next stage and the re-emergence of the disease. This period is characterized by atypical behavior of the patient: he begins to show excessive activity or moping. The person has problems with the digestive system. In some cases, heartbeat, pulse may also become more frequent, breathing difficulties.
Symptoms of acute
The above symptoms appear prematurely: a few days or hours before the attack. During the attack, people begin to suffer severe pain, the sore spot turns red, swells, the temperature rises. These symptoms do not disappear for several days or weeks, depending on the treatment. The next attack of gout can appear only after a month or two.
In case of an acute attack of gout, not only the joints but also the tendons of the patient can become inflamed. Such a disease is dangerous because with repeated manifestation of the ligament can be so damaged that a person will partially lose the ability to move independently. A gout attack also affects the functioning of the kidneys, since excess urinary salt is excreted through this organ. In some cases, a person can detect small nodules under the skin, which causes not only discomfort, but also the need for surgical intervention.
First aid for attacks of
Acute attack of gout is treated mainly with the help of medications. First of all, anti-inflammatory drugs are prescribed, for example, diclofenac. Tablets of diclofenac should be taken three times a day, and rubbing ointment is carried out twice a day. With an acute attack of gout, only one anti-inflammatory agent is prescribed, since several of them can significantly reduce the effect.
Treatment of gout. Complications of gout
How to treat gout
The main goal of treating gout is to get rid of the pain( attack of gout) and decrease the content of uric acid in the blood. Treatment of gout also includes taking medications and taking measures that can further prevent the onset of gout attacks.
Treatment of gout is selected individually and depends on the degree of the disease, on whether you have a gout attack right now or try to prevent it.
In addition to taking drugs that reduce the content of uric acid, other diseases that cause gout should be treated in parallel. The doctor should study the patient's medical record, find out his chronic illness, examine the patient completely and find the reasons for the high concentration of uric acid.
There are also new methods of treating gout. These are procedures for the purification of blood with the help of devices plasmaphoresogemosorption.
How to relieve gout
To relieve pain with gout, the doctor injects corticosteroids. And also he can write out a large dose of medications, the dosage of which decreases in parallel with the reduction of pain. If the treatment is started immediately after the onset of an attack, the pain will begin to subside within 24 hours.
What you can do at home right at the beginning of an attack :
- to provide a leg rest( damaged joint)
- elevated position for a sick limb
- bed rest
- take ibuprofen, it has an anti-inflammatory property
- it is not recommended to take aspirin, as itincreases the content of uric acid in the blood, which can cause an exacerbation of the attack.
- a copious alkaline drink
- the diet should contain dairy and plant products.
What to do if you have a gout attack, your doctor should tell you and these medications should be in your home medicine cabinet.
As a prophylaxis for repeated attacks, the doctor prescribes medications that excrete uric acid from the blood by the kidneys. And these drugs are taken strictly according to the schedule set by the doctor. Most often they have to be taken for life.
Surgical treatment of gout
Operations are performed with severe gout, when tofu that have caused infection and joint deformity has already been formed. In this case, medicines do not help.
Prevention of subsequent attacks of gout
In addition to medications, the patient himself must monitor himself. What does it mean:
- to control your weight. But here you also need to be careful, fat and roast certainly should be excluded, switch to less caloric foods, but at the same time it is impossible to have a diet with a very low calorie content, which can also increase the level of uric acid. Nutrition should be discussed with your doctor;
- to control blood pressure
- do not take diuretics. At your increased pressure, the doctor may ascribe diuretics, so you must warn him that you are inclined to gout
- to exclude alcohol, especially beer( beer contains purines).If you can not completely exclude, then limit its consumption. Since alcohol prevents the excretion of uric acid from the body;
- to limit the consumption of meat and seafood
- tell your doctor how you take the drugs with concomitant chronic diseases, becausethey too can cause an increased content of uric acid;
- regular exercise at a moderate pace
- regularly take a blood test for uric acid
- do not wear tight narrow shoes. Now it's fashionable that the sock be sharp, but the shoes that squeeze your fingers, worsen the state of gout
Physiotherapy. Spa treatment
When treating gout, the patient is prescribed physical therapy, mud therapy, paraffin baths, radon or hydrogen sulfide baths, which are performed in the remission stage. Electrophoresis helps to reduce pain and increases the mobility of the joint. Also, ultrasound and ultraphonophoresis procedures can be prescribed, which relieve pain and have an anti-inflammatory effect.
Between attacks, patients with gout should undergo comprehensive treatment and, in addition to the above treatment, should perform therapeutic gymnastics. It promotes the preservation of motor activity.
Complications of gout
If after the discontinuation of an attack of gout , the patient quickly forgot about his illness and stopped treatment, the level of uric acid will again rise, which will lead to the appearance of gouty nodes. They can occur in different places - in the cartilaginous tissue, subcutaneous fatty tissue, in the muscles, which will cause inflammation.
Also salts of uric acid adversely affect the kidneys. It promotes the formation of stones, which leads to urolithiasis.
The presence of gout significantly increases the risk of heart failure, as well as the risk of systolic cardiac dysfunction. On this subject there is the scientific work of Dr. Esvar Krishnan from the School of Medicine of Stanford University, who examined the patients with gout for 16 years. Increased uric acid in the blood leads to narrowing of the lumen of the vessels and hypoxia of the tissues( lack of oxygen).
The House of Councils reminds everyone that the best treatment for the disease is its prevention. With gout, you have a lifetime. And if you do not want to experience this painful pain, then watch your way of life.
How to treat gout at home - Onwomen.ru
One of the substances that is produced in the human body is uric acid. As a rule, it is easily removed by natural means. However, with a metabolic disorder, uric acid crystallizes, turning into urate salts, and deposited in the tissues of the body, hitting the muscles and joints. This disease, known since the Roman Empire, is called gout and is accompanied by swelling, fever and severe pain. It is quite difficult to completely get rid of gout, and it will take more than one month to cleanse the body of the accumulated uric acid .Nevertheless, with an attack of gout at home, you can significantly alleviate the suffering of the patient and restore his health, saving him from the acute symptoms of the disease.
Factors affecting the development of gout
As a rule, gout is a consequence of impaired renal function, which is unable to effectively purify the body of uric acid. However, in some cases, doctors state that this body functions quite satisfactorily, and the problem lies in the fact that due to improper metabolism the body produces an increased amount of urate. Plus, the doctors were able to identify the relationship between gout and overweight. Therefore, people who are obese, belong to the first risk group .It is also worth noting that those who lead a sedentary lifestyle, abuse alcohol, meat dishes and seafood are often affected by gout.
Symptoms and clinical course of gout
Many people mistakenly believe that gout is one of the varieties of arthritis, since at the initial stage the symptoms of these two diseases are identical. The thing is that salts of urate, deposited in muscles and joints, are perceived by the body as a foreign body, which must be removed in any way. Therefore, in places where the urate accumulates, inflammatory processes begin that are accompanied by severe pain in the joint region. As a rule, gout affects the fingers and toes, elbows and knees. However, it is not uncommon for the site of a dislocation of urate salts to become the spine, hip bones and even ribs. Against the background of painful symptoms, often there are uncaused attacks of fear or melancholy, nausea and diarrhea, palpitations. All this indicates a strong intoxication of the body, which is not observed with arthritis.
Zones affected by gout are swollen during the day, and the tissues acquire a bluish tinge. In addition, the body can appear so-called tofusy - dense neoplasms in the form of balls in which salts of uric acid accumulate. To additional symptoms that are characteristic of gout, also include renal colic, chills or fever.
How to stop a gout attack at home?
To begin with, remember that people suffering from gout, during an attack, need to ensure complete rest .First of all, this concerns affected joints, which under no circumstances can not be subjected to physical exertion. Therefore, the attack of gout is best to wait in bed, where it will be necessary to spend from several days to 10-12 days depending on the course of the disease. In this case, swollen limbs should be kept in a slightly elevated position, placing a pillow under the arms and legs, and periodically lubricate the tumor with dimexide, which helps to remove swelling, and Vishnevsky ointment. Plus to everything. To alleviate the attack of gout is possible with the help of non-steroidal anti-inflammatory drugs, which include movalis, diclofenac and nimesulide. Choosing anesthetic drugs, it is worth paying attention to their composition. So, to use aspirin in this case is strictly prohibited, since it contains salicylic acid, which can only aggravate the situation. In addition, to cleanse the body of urates, you can resort to activated charcoal, which should be taken 3-4 tablets after each meal.
Special attention should be paid to the nutrition of the patient , whose daily diet should include fresh vegetables and fruits, as well as dairy products. In turn, it is best to refuse meat, fish, salty, smoked and sour dishes. Also, any animal fats that are to be replaced with vegetable oil are contraindicated. Help to cope with the attack of gout can fresh tomatoes, dried rye bread and a plentiful warm drink.
Traditional methods of treating gout
Since time immemorial, pain with gout in Russia was removed with fresh fish, which should be separated from the bones, and put the fillet at bedtime to the damaged joints, wrap the wrap with cellophane and a dense warm cloth. In the morning, a fish that perfectly removes inflammation and draws uric acid out of the joints should be discarded, and the damaged areas of the body should be rinsed with warm running water. It is believed that if you use this method for several days in a row, you can easily get rid of gout without medications.
Derivation of urate from the body during an attack of gout is also helped by the decoctions of such plants as , such as chamomile, elder, lilac leaves and birch buds. Take such decoctions should be after a meal in a warm form, replacing them with coffee and tea. If desired, a little honey can be added to the broth, which has excellent anti-inflammatory properties.
In order to relieve acute pain symptoms, it is also necessary to prepare an ointment at home for which you will need butter and medical alcohol. Ingredients should be taken in equal parts, and the oil must be pre-melted and mixed with alcohol, and then ignite the resulting mass. When the alcohol is completely burned, the ointment should be cooled and used to treat the affected joints twice a day, in the morning and in the evening, rubbing the product with light massaging movements. Before bedtime, sweaty areas of the body are also well lubricated with iodine, after which you should wrap them with a warm scarf or woolen shawl.
Gout is a chronic, severe systemic joint disease. It is dangerous, therefore leads to a significant decrease in the standard of living. Most often, this disease affects men who have crossed the 40-year mark and women older than 55-60 years. But even 30-year-old people may have symptoms of this terrible disease. Every year the number of sick people suffering from gouty pain and having an attack of gout grows rapidly.
The causes of the development of the disease
There are several factors of its development: heredity, unbalanced diet, overeating, mainly a meat ration rich in purines, abuse of wine and low quality beer, sedentary lifestyle.
In the patient's body, an excessive amount of uric acid is formed. This can lead to hyperuricemia, glut of urate. In this condition, they are not properly excreted from the circulatory system. This occurs as a result of the excess volume of these salts, or because of the pathology of the kidneys responsible for removing this substance from the body.
These salts crystallize, as they are unable to dissolve, and then deposited in the joints and tendons.
The body is trying to get rid of these pathological deposits, which leads to inflammation of the affected tissues. The process of crystallization with gout occurs in the joints of the limbs, if there is a zone of poor blood circulation.
Symptoms of the disease
The most typical manifestation of gout development is gouty arthritis, which begins first in one joint. In 50% of cases, the first joints of the big toes are affected. Gout can also develop in the ankle, knee joint, in the bone tissues of the wrists, elbows, fingers.
The patient first learns of his illness, suddenly feeling an acute unbearable sharp pain in the swollen joint, revealing reddening of the skin on this site. The peculiarity of this pain is that pain medications can not remove it. The temperature rises sharply to 39-40 C, and the joint becomes hot and immobilized. Such manifestations usually in the dark time of the day suddenly begins an acute attack of gout, which can cause suffering for 2-7 or more days. In the daytime, a sick person can feel temporary relief of pain. But at night the deterioration of his condition will follow again.
Later, a painful painful attack is repeated many times. But if the proper treatment is carried out, it can be prevented. First of all, it is necessary to eliminate the factors that cause exacerbation of gout. Sometimes, in order to reduce the incidence of frequent outbreaks, it is enough to change the way of life. But many people also need special medicines, which can reduce the level of uric acid and prevent an attack of the disease.
In the remission phase, the patient is normally disturbed by aching pains. But at the beginning of the disease, the symptoms of the disease may not always bother the patient or not manifest at all.
As the gout flows, a normal joint structure may occur. This usually becomes noticeable after a four-year period of development of the disease. There are painless dense growths of yellowish color in the region of joints. This tofusi, gouty nodes, covered with dark rough skin. They consist of salt crystals. Such dense subcutaneous formations can grow to large sizes and cause inflammation of surrounding tissues.
The development of the disease can be effectively managed
How to ease the attack of the disease and relieve the pain
The patient is able to take a number of effective measures on his own to help himself.
The best remedy for gout is the right lifestyle and physical activity.
A clear plan should be drawn up: what to do during an exacerbation of gout.
- With the acute onset of the disease, the first priority is to reduce pain.
- The affected joint should be protected, allow it to rest for a day.
- To reduce the tumor, ice can be applied.
- The use of anti-inflammatory non-steroid drugs( NSAIDs) will help stop the development of the inflammatory process and prevent a new attack of the disease.
- But patients with this disease are contraindicated taking aspirin. It can worsen the patient's condition, since it dramatically changes the level of uric acid.
Lifestyle of the patient with gout affects the course of the pathological process
Rational power system
To ensure that the patient is not disturbed by an acute attack of gout, a proper nutrition system has been developed to treat the disease by specialists.
- It is necessary to exclude a diet low in carbohydrates and high in fat, protein. Because with such food the patient can get a large number of purines. This contributes to the deterioration of the course of the disease.
- It is necessary to moisturize the body well, taking a lot of liquid.
- The patient needs to eat a lot of sweet fruits, which supply the body with the necessary nutrients. Vitamin C, contained in mandarins, oranges, lemons, can prevent a gout attack.
- Skim milk, dairy products, cottage cheese are allowed.
- Salads with olive oil, potatoes, beans, oats are useful.
- The liver, fatty meat and seafoods increase the amount of uric acid. In the diet, you need to have some lean beef, pork and chicken.
- Fresh green leaves contain a lot of oxalic acid, so it should be avoided.
- Simple carbohydrates in foods made from white flour are harmful, as their use leads to weight gain.
- Sweetened drinks, especially with fructose, are harmful for gout.
- Alcohol contains many purines. Therefore, excessive consumption of alcoholic beverages, especially beer, leads to an increase in the body level of uric acid.
Maintaining the optimal body weight is necessary
- Extra kilograms create additional loads on the joints and quickly increase the risk of developing this ailment.
- You need to constantly strive to maintain a normal weight, lose weight, if necessary. But it should be remembered that an excessively low-calorie diet will enhance the process of crystallization of urinary salts. This will negatively affect the development of the disease.
Folk medicine can also help
- Decoction of parsley roots has a diuretic effect.
- Apitherapy has long been used in the treatment of gout to restore the normal functioning of the affected joints. Bee venom contains active substances that can quickly remove severe pain and reduce the inflammatory process.
Drugs for gout are prescribed by a doctor depending on the degree of severity of the pathology of
- . These can be medications to relieve pain and inflammation: NSAIDs( nonsteroidal anti-inflammatory drugs), indomethacin, naproxen. But they can not be used for a long time.
- Effective preparation Fullflex facilitates excruciating painful articular attacks.
physiotherapy helps the patient well. If the joints are constantly on the move, they will be healthy. Active physical training and breaks during activities associated with a static posture will have a beneficial effect.
The best remedy for gout is swimming, biking, walking, exercises with light dumbbells. But you need to exclude the risk of injury. Contraindicated repetitive tedious sharp movements of affected joints. You need to get a doctor's consultation, choosing the forms of physical activity.
Gout is an extremely complex disease. It can change the whole life of the patient. But to control its development and maintain its health with the support of a doctor is real. Only the right way of life and fulfilling the doctor's prescriptions can provide effective treatment for gout.
To cure this ailment is completely impossible, but for a person's life, the prognosis for gout is always favorable. However, the question is the quality of this life, since this ailment can lead a person to disability. Only strict self-discipline and self-restraint, adherence to all the rules of treatment of this disease will help a person with gout feel good.
Manifestations of gout should be known to all people so as not to miss the appearance of the first symptoms at an early stage. If there is an attack of gout, in case of a feeling of characteristic pain, you need to contact a rheumatologist, do a diagnosis and begin treatment.
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