What is gout ? It is one of the types of joint diseases in which there is a deposition of uric acid salts in them. It is called the “disease of kings” because... The disease was previously widespread in high circles, and most often arose as a result of excess in food and alcoholic beverages.
At the moment, the disease occurs in only three people out of a thousand, and in most cases it is observed in men over 40 years of age, less often in women after menopause.
Gout is also called the “disease of kings”, as this joint disease has been caused by poor diet and alcohol consumption for hundreds of years.
Gout occurs due to an increase in uric acid in the blood, which is deposited in the joints, organs and systems of the body. Over time, the accumulation of uric acid leads to partial or complete destruction of the joints.
Uric acid can accumulate in the body due to two main factors:
Important! The main cause of gout is the abuse of fatty, “junk” foods and alcohol.
Risk factors for gout include:
There are more and more people suffering from gout every year, because... Recently, people have begun to more often eat foods rich in purines (fatty fish, meat) and more alcohol.
Manifestation of gout on the foot
Most often, people do not know what kind of disease gout is and how it manifests itself?
Important! The first signs of gout are the appearance of growths (tophi) on the legs or arms and intense pain in the affected areas.
Conventionally, gout can be divided into several stages depending on the development of the disease.
At this stage, the disease does not manifest itself in any way, but uric acid gradually begins to accumulate in the joints. This condition can last for thirty years, but ultimately only in 20% of cases leads to gout.
It develops after the first manifestations of arthritis - pain and swelling in the area of the affected joint.
Clinical picture of the acute phase of gout:
Most often, at first the pain manifests itself in only one joint - usually the big toe is the first to suffer (gout of the big toe), less often - the knee or ankle joint.
Important! Gout should be treated in the first 24-48 hours after symptoms appear, so that the disease does not become chronic.
An attack of gout occurs suddenly and unexpectedly (at night or in the morning), and is characterized by severe pressing pain in the affected joint, redness and swelling in the joint area. During the day, the pain usually subsides, but by night it becomes stronger again - such attacks can last from several days to several weeks.
After a few years, the symptoms of gout begin to manifest themselves more often, the time between attacks gradually decreases, and the disease becomes chronic.
The damaged joints are increasingly destroyed, and the disease begins to affect neighboring joints. With a long course of the disease in the affected areas, tubercles begin to appear under the skin, which are called tophi (or gouty nodes). Gout most often appears on the legs and arms.
Gouty nodes appear due to the fact that too large deposits of salts in the joints cause the body to perceive them as a foreign body, as a result of which the immune system begins to produce white blood cells that cause severe inflammation. Over time, the tophi burst and crystals of uric acid are observed in them (they look like whitish dust).
Where do tophi form:
Tophi are usually painless, but can sometimes cause stiffness and pain in the affected joints. If tophi are not treated, they can develop within 10 years from the moment of the first manifestations of gout.
If gout is not treated in the first days, it can become chronic.
When treating gout, a person will have to seriously change their lifestyle and ensure constant use of medications, since this disease, unfortunately, cannot be completely cured. But if symptoms are identified promptly and treatment is followed in accordance with the doctor’s recommendations, then it is possible to take control of the disease and minimize the painful manifestations of the disease.
Important! The main principle of gout therapy is to control the amount of uric acid in the body.
Drug treatment is prescribed by a rheumatologist, who will prescribe medications aimed at reducing uric acid in the body, its rapid elimination, stopping the inflammatory process and relieving pain.
A large amount and accumulation of uric acid is the root cause of gout, so eliminating this problem can quickly reduce attacks and relieve discomfort.
For high uric acid, the following medications are used:
To treat the symptoms of gout (relieving pain, swelling, stopping attacks), the following drugs are prescribed:
Important! Only a qualified specialist can prescribe medicine for gout, because A number of medications have side effects that can negatively affect the body .
How to treat gout at home during an attack:
If you have gout, you should drink at least two liters of alkaline drink per day.
On the first day of therapy, an increased dosage of drugs is prescribed, after which it is gradually reduced to the usual dose. The medication regimen must be prescribed by the attending physician.
Exacerbation of gout with elevated uric acid can be stopped with indole and pyrazolone drugs - Butadione, Ketazone, Reopirin.
Uric acid is removed with the help of Allopurinol and a specially selected diet.
Therapy for the chronic form of gout is aimed at reducing the amount of uric acid in the body, preventing relapses of attacks, and restoring impaired joint functions.
Important! If the diagnosis is questionable or during mild attacks, you should not use medication treatment at home for a long time.
How to treat gout on the legs and arms:
Adherents of alternative medicine suggest treating the disease with folk remedies, which, when used correctly, can relieve pain and even eliminate the cause of the disease.
Treatment of gout with folk remedies at home can only be carried out with the knowledge of a doctor; in case of acute pain, it is better not to self-medicate, but to consult a specialist.
Typically, for gout, diet 6 is prescribed, which contains the full calorie content, the consumption of salt and animal fats and the amount of protein are reduced. The gout diet recommends increased fluid intake and split meals in small portions.
Important! Nutrition for gout is a major part of treatment. Without changing the diet, there can be no talk of a cure, since food abuse is often the cause of the disease.
What can you eat if you have gout:
If you have gout, you need to eat right and eat fruits.
The menu for gout should be drawn up taking into account the fact that all dishes should be served boiled or steamed. You can eat berries, fruits and vegetables raw.
It is better to replace tea, coffee and cocoa with natural jelly, fruit drinks, compotes or decoctions of rose hips, mint, and yarrow.
It’s a good idea to have fasting days once a week by choosing one of the following options:
Fasting days help reduce the amount of uric acid and improve metabolic processes.
If you have gout, you should not eat:
During an exacerbation of gout, they eat only liquid foods: weak vegetable broths, milk and lactic acid products, vegetable and fruit juices, herbal decoctions, liquid porridges.
During treatment, it is imperative to consume as much still water as possible - alkaline mineral water (Borjomi), weak green tea and herbal decoctions are recommended.
With the development and progression of gout and untimely and incorrectly selected treatment, complications may arise, among which there are very dangerous conditions:
If left untreated, the disease progresses, gradually destroying bones and cartilage, causing joint deformities and resulting loss of movement. This condition can lead to loss of ability to work and disability.
To prevent the occurrence of new attacks and reduce the manifestations of gout to a minimum, you should follow some rules:
The prognosis for gout is favorable and recovery depends on the extent of the disease and compliance with adequate treatment. The sooner the patient goes to the doctor, reconsiders his own lifestyle and begins treatment, the greater the chance of stable remission.
Without proper treatment, gout progresses quite quickly, especially in elderly and mature patients who are prone to it, so treating the disease according to the “grab and drop” principle is absolutely not possible.
Today we will talk about the signs and treatment of gout, the causes of its occurrence, and of course, about diet as an important element in the treatment of the disease.
Gout - what is this disease and why does it occur? Gout is a kidney and joint disease that occurs due to protein imbalance in the body. At the same time, the amount of uric acid in the human blood increases significantly.
Gout (the manifestations of which can be seen in the photo) is often called the “ rich man’s disease ”, since once upon a time this serious disease mainly affected monarchs and rich people who consumed red wine and meat in large quantities.
More often, the disease develops after 40 years of age; men are 4 times more susceptible to the disease than women. If a woman does develop gout, this happens already during menopause, since estrogens produced at a younger childbearing age successfully protect against this.
In addition to damage to the kidneys and joints, nodules with uric acid salts can form in the skin itself, so-called tophi . They are usually yellowish in color, located on the legs, in the ear area, on the elbows, shins, and can appear on the forehead, near the entrance to the nasal passages. At a certain stage of their development, they burst, whitish salt crystals become visible, all this is accompanied by intense pain and inflammatory reactions.
When too much uric acid is produced, it crystallizes and deposits on the walls of joints and internal organs. Later, an infection attaches to these crystals and an inflammatory process occurs.
If it is not detected and stopped in time, the patient’s condition will worsen significantly, and the effectiveness of treatment will be delayed indefinitely.
Doctors distinguish three main types of gout:
If treatment for this dangerous disease is not started in time, it will quickly invade new areas of the joints, which will adversely affect the patient’s health and will also delay the process of his full recovery.
Small joints are most often affected, especially the toes; many even call the disease gout on the legs, but sore hands, elbows, and knees also occur.
This disease can also become chronic. To prevent this, you need to know about the stages of development of gout in order to consult a doctor in time and prevent its progression.
As already mentioned, the main causes of this disease are considered to be an excessive amount of uric acid (urate salts) in the body, as well as its incomplete elimination from the body due to impaired renal function.
People at risk for gout include people who:
Also at risk are those people whose blood relatives have suffered or are currently susceptible to this disease.
The symptoms of gout directly depend on its type. There are two forms - acute and chronic.
Signs of acute gout - an attack - appear immediately after damage to the joints or kidneys. They are quite pronounced, so the patient will pay attention to them in any case:
The first attack of gout lasts an average of a week; regular painkillers may not work.
The chronic form of gout can manifest itself even several years after the first “bell”. Therefore, it is better to start treatment for gout immediately, rather than wait until it affects not only the joints (gouty arthritis), but also the kidneys. Urolithiasis often develops after inflamed joints.
Over time, exacerbations of gout in men become more frequent.
So how to treat gout? This process includes two main steps.
The first is aimed at getting rid of primary symptoms, acute pain and improving metabolism in the body. It involves following a certain diet.
It is impossible to talk about any general methods of treating this disease, since the doctor prescribes a course of therapy based on the collected medical history, tests performed, the stage of development of the disease, the individual characteristics of the patient’s body, concomitant diseases and the severity of the disease.
Among the drugs used for gout are allopurinol (to reduce the level of uric acid), blemarene, colchicine (to relieve acute attacks of the disease), urisan, Celebrex.
Most often, as part of the conservative treatment of gout, blocks of the spine and other painful joints are given, intra-articular injections that relieve inflammation, and non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed for a couple of weeks - diclofenac, nurofen, methindole, indomethacin, ibuprofen.
Physiotherapeutic procedures (magnetic therapy, electrophoresis) and shock wave therapy to break up calcified salt deposits are recommended by a rheumatologist
Sanatorium treatment helps a lot, especially in Caucasian Mineral Waters and Truskavets.
There is an opinion that a complete cure for gout can only be achieved through surgery. It's a delusion. It can be cured with the help of special medications and adherence to a diet - special diet No. 6 .
In case of exacerbation of gout, treatment at home involves bed rest for several days with the foot end of the bed slightly elevated.
For severe joint pain, cold compresses and painkillers are recommended. Then you can smear the affected areas with Vishnevsky ointment and make applications with dimexide.
Be sure to consume a lot of liquids, preferably alkaline ones - mineral water such as Essentuki, Borjomi, Narzan, oat decoction, jelly.
You may also need specially designed gymnastics for the joints and taking diuretics to remove excess fluid containing uric acid from the human body naturally.
Among the folk remedies for removing uric acid and reducing the inflammatory signs of gout, we recommend the grass of knotweed or knotweed and horsetail, lingonberry leaf infusion, and nettle juice.
Apitherapists advise rubbing sore spots with tincture of dead bees (the tincture is prepared at the rate of 1 part dead bees, 4 parts vodka, leave for 2 weeks).
Baths with chamomile, sage leaves, and a decoction of oat straw are quite effective. The bath lasts 20-30 minutes, adding hot water. The course requires 20 baths, but if the process is neglected, after a 2-week break the hot water procedures will need to be repeated.
Nutrition for gout: which foods should be included in the diet first of all, and what should be excluded and limited?
To get rid of the symptoms of the disease, you must adhere to the following dietary rules:
More details about the diet for gout, the so-called diet No. 6 - HERE.
Therapeutic fasting can cause another attack, releasing uric acid into the blood, so traditional doctors do not recommend it. Although, as alternative practices answer them, after this exacerbation there is a general improvement in the condition. So this method is only for those who are persistent and seriously determined to be cured.
To prevent problems with joints and exacerbations of gout from becoming a frequent occurrence in the future, try to stick to a daily routine and perform physical exercise every 2 hours, especially if you have a sedentary job.
It is worth paying attention to the shoes you wear; if they are too tight, the big toe will become increasingly injured, which means repeated attacks of the disease will occur.
Teach this to your children from childhood, because it is very easy to acquire a disease, but sometimes it is very difficult to get rid of it, and sometimes even impossible.
Gout was called a “foot trap” in ancient Greece. Previously, this disease was considered a type of osteoarthritis, and only from the end of the 17th century did doctors come to the conclusion that gout is a separate disease.
Mostly men suffered from the disease, but today this disease has also overtaken the female half of humanity. Gout manifests itself on the arms and legs, more precisely on the joints of the extremities.
Where does gout come from? The disease is a consequence of the fact that a person often overeats and abuses alcoholic beverages. Treatment of gout involves the use of drugs belonging to different pharmacological groups.
These are mainly diuretics (diuretics), as in the photo. Their use is due to the fact that in case of gout, uric acid is practically not removed from the body. The substance crystallizes, turns into sodium salt (sodium monourate) and is deposited on the joints.
Modern doctors classify gout as a systemic disease that affects all organs in the body.
This article is entirely devoted to this disease. After reading it, the reader will learn the signs, symptoms and methods of treating pathology.
You can see what gout looks like on a leg in this photo. And this photo shows gout on the hands.
Depending on the causes of its occurrence, gout is divided into two groups.
The main risk factors include genetic predisposition and gender of the patient. Men suffer from gout much more often than women.
Note! First of all, the lower extremities suffer from gouty pain. Attacks occur after injuries to the legs, long walking, playing football, surgery or prolonged driving.
After injuries or operations, dehydration of damaged tissues occurs, so uric acid salts accumulate in this place. Even with the slightest drop in body temperature, urates located in the joints begin to crystallize.
Often, a gout attack is provoked by overheating in a steam room or sauna. In the bathhouse, increased sweating begins and the body suddenly becomes dehydrated. Exacerbation of gout also threatens those patients who plan to travel to hot countries.
Hypertensive patients often suffer from gout. This occurs due to regular use of diuretics. Uric acid concentrates in the blood, creating ideal conditions for gout.
Other causes of gout include:
The first stage of gout is asymptomatic. Urates gradually accumulate in the body. Ultimately, this inevitably leads to gout. The initial phase can last a very long time, up to 25 years and even more.
The second phase of gout is called acute gouty arthritis. The first signs of gout on the legs at this stage are acute pain and swelling in the area of the affected joint. In addition, body temperature rises.
Symptoms of gout have pronounced clinical manifestations:
If gout has entered the chronic stage, tophi are observed - subcutaneous nodules, which can soften during attacks. This condition often begins with sharp pain. Subsequent attacks become more frequent and can last from several hours to several weeks.
Important! Chronic gout is dangerous because when it appears in the body, a huge number of both small and large joints are affected. At the same time, the development of chronic arthritis in the arms and legs is observed.
You can see what arthritis looks like in the photo. People suffering from gout often have diabetes mellitus, and atherosclerotic plaques form in the blood vessels.
This happens because low-density lipoproteins accumulate in the blood, and cholesterol in the bloodstream also increases.
When diagnosing a disease, the doctor takes into account the frequency of attacks that occur. The final diagnosis is made based on:
Treatment of gout is based on stopping acute attacks. For this purpose, drug therapy and proper diet are used. Much attention is paid to the prevention of new exacerbations.
Treatment for a gout attack on the leg or arm:
Such treatment should begin with a high dose of the drug, after which it is reduced to the average therapeutic dose. The regimen for taking medications against the disease must comply with the doctor’s recommendations and include possible contraindications.
For example, Colchicine should not be used for severe kidney damage, peptic ulcer of the duodenal intestine and stomach.
Treatment of an acute attack is possible with the help of indole and pyrazolone drugs:
In the presence of high drug resistance, therapy involves the addition of Prednisolone. Initially, a dose of 20-30 mg/day is prescribed, which is gradually reduced to “no”. At the same time, Indocid and Butadione are taken in small doses.
Uric acid is removed with a special diet and Allopurinol.
Treatment of the disease during the period when there are no attacks should consist of eliminating hyperuricemia, relapses of attacks, and preventing the occurrence of damage to internal organs. In addition, with the help of complex therapy methods, impaired joint functions should be restored.
Complex therapy includes:
What is not recommended for doubtful gout or its mild attacks is long-term treatment with medications. In the first two days, the patient is shown Colchicine or Indomethacin. Before starting to take anti-gout medications, the type of purine metabolism is determined. It can be renal, metabolic or mixed.
Uricostatics inhibit the formation of uric acid. For example, 100-900 mg of Allopurinol per day is recommended (depending on the degree of damage).
Thus, in two days you can reduce the level of uric acid by 2-3 times. The drug is used constantly because it does not have persistence and long-lasting action. In the summer, due to the appearance of a variety of plant foods in the diet, they take a break for 1-2 months.
Uricosuric drugs increase the production and suppress tubular reabsorption of uric acid compounds. Therefore, they are indicated for renal hyperuricemia:
Usually, for gout, doctors prescribe diet No. 6. Its advantage is that it has a full calorie content.
It contains practically no salt and fats of animal origin, and the amount of protein is reduced.
Diet No. 6 involves high fluid intake.
Foods prohibited for gout:
It is necessary to reduce the consumption of animal saturated fats. They increase the level of uric acid in the blood and reduce its excretion in urine.
Salt should be limited to 5-7 grams, this also includes its content in products. Fasting and overeating are prohibited. As a result, uricemia increases, and a gout attack may recur.
Foods you can eat if you have gout:
The diet should include kefir, milk, curd, kefir and fruit fasting days. On meat and fish days, you can consume 150 grams of the corresponding product. A combination of meat and fish is allowed on the same day, but only if you take vitamin C and B.
During an exacerbation, you can only eat liquid food: lactic acid products, milk, compotes, jelly, vegetable and fruit juices, vegetable soups, rosehip decoction, liquid porridges, weak tea with lemon or milk.
You can only drink alkaline mineral water without gas. If arterial hypertension and poor circulation are present along with gout, the patient is advised to drink a lot of berry compotes, fruit juices and alkaline mineral water.
As a result of gout, the following complications are observed:
If proper treatment is followed, the outcome of gout is very favorable. Prolonged attacks can result in complete recovery. The prognosis of the disease also depends on the level of hyperuricemia.
Patients remain able to work for many years, and their quality of life is not affected. Prevention of the disease comes down to diet; You should not visit places where the air temperature is high (bathhouse, sauna); starvation and overeating are excluded; the use of diuretics and drugs that dissolve uric acid crystals is necessary; Spa treatment is recommended.