Gout (gout, podagra) is an acutely inflammatory disease, which is related to the nature of the disease, especially with the use of alcohol, seafood and alcohol. In case of provoking factors, physical attack, stress, overcooling or overheating in the place (sauna).
Healthy and inflamed
For treatment of gout and prevention of attacks, drug therapy was established, early on they were forced to use restrictions on the diet , for which reason it became difficult to manage an anti-gout diet. Moderni preporki for a diet for gout are decent, the system is sanely stored, with a functional choir. An anti-gout diet helps control production and separates it from the body.
The presence of this for gout and iskva is rare, control nivoto on picochnata kiselina in kravta , observation with a rheumatologist for yes, get punishment for drug treatment and correction for diet, exchange starting with the stomach, namely:
On the background on visokoto nivo on picochna kiselina in krivta, in the place of se natrupvat and the formation of crystals of urate on sodium, which leads to the development of acute inflammation, accompanying edema and worms on the stave with izrazen pain syndrome. Pikochna kiselina and the edge of the product are washed with purini - a natural substance that will keep all the cells on the body and almost all the storage products.
Nai-many “loshi” purini (adenine, guanine, xanthine and hipoxantine) se sudarzha in tykanite from Zhivotinsky origin with high metabolic activity (for example, mesni under products) and in sharing it with golyama speed cells (for example, May).
Other purini, cato caffeine, theobromine and theophylline, which are all consumed in cafes, tea, cocoa and chocolate cannot and are dangerous. Store plants (for example, beans) that contain a lot of purini, but as a rule, they are not very dangerous, since they are delivered to organic kiselini, which will be added for separating the excess into pico kiselin.
Vitamin C and cafe namalyavat nivata na picochnata kiselin and the risk of gout
Diet for gout is possible:
Spazvane na preporkite for storage with gout is not the basis for the treatment of gout, but it can help in preventing or treating the pain and scabies in the case of pain. Broy on stored tryabva and reach up to 5-6 five per day in small portions and with plenty of drink in the intervals between storage.
Provide information in a general way and not be able to discern the individual characteristics of the organism. It is important to keep an eye on the reaction of the body to the consumption of products and also to the individual and the doctor, constantly and to the core of an individual diet . Do not take away without the medicine supplied, it is not enough to achieve remission.
Important! During the period of acute gout, tryabva and se premine on a strict diet excluding different types of mesni and ribni products, decoctions, eggs, alcohol.
Yes, you will avoid or significantly limit the use for storage with high-quality food for purini, a mixture from young animals and poultry , mash for products, broths and sauces; sea darove, daubed varieties of fish (heringa, mackerel and others like that) and canned fish; shellfish
Storage with high maintenance on daubing of the ability to paint on the body and everything will be separated from picochnaya jelly and added to the smoldering area. You will direct the selection to the greenery of all kinds of culinary processing, including rich in purini (asperzhi, carfiol, legume plants). Drawing on the amount of milk in the diet will also help milk products with low tolerance to milk.
Alcohol drinks (bira, port and the like, with stronger wine, vodka, rakia, whiskey) are one of the main risk factors for the development of gout - alkoholt blocker funktsiyat na bbrettsit for premahvane na picocnate kiselina from the body. During the attack, it is important to be completely off alcohol. Because of exacerbation on the disease, up to 250 ml of dry wine per day is allowed, but not more than 3-4 times a week.
Fructose has an authentic effect on the production of picochna kiselina, and the concentration of neinata in blood. Tya sedarzha in sweetening non-alcohol and juice drinks, sweet products, ketchup, fruit and mountain fruit, zakhar, prince syrup and other products.
Yashte more carefully store, fruit, greens and little by little refined vegetables , cream cakes, sweets, bonbons, sandwich products and biscuit dough, bread.
Some studies have shown that dairy products with a low diet may reduce the risk of developing gout . For example, daily consumption of sour milk or 2 bowls of mlyak.
In the process of metabolism, substances containing oxalic acid form oxalates, which are responsible for the development of urolithiasis. There is a lot of oxalic acid in the takiva products, carambola, black piper, magdanoz, poppy seeds, amaranth, spanak, tsveklo, sugary tsveklo, cocoa, chocolate, povecheto poisons and fruits, beans.
With the whole purpose, it is separated from the body of picochnata kiselina and prevention of stone formation in bubretsite se preporchva piene for a sufficient amount of fluid (not a little from 2 liters per day) with lipsa on contraindications from the country on sartseto and bbrecite.
Gout is an insidious pain. The reason for gout is the increased amount of picochnaya kiselina in the blood. And this is a consequence of systemically pre-treatment and treatment.
The problem is, why did se vednzh not iska and si trgva appear? It calmed down and then reappeared again, but the trace of time became constant and the sleep was constant and for the sake of not taking the situation to the extreme, shaking and taking measurements. Dori, when admitting gout, it is necessary to understand the basis of the storage regime and apply or avoid it in every possible way, which can lead to hair loss.
Diet for gout is often treated with or without it, but it has no effect. For yes, that's why we've got rid of picochna jelly from the body, tryabva and that's the spray that's taken on the new one, and that's what helped us release it from the starata.
It is very important to frequently eat from the diet and keep it in storage, get rich in protein and increase the amount of food you take, drink mineral water and fresh juice.
The diet is limited to Zhivotinsky products, especially to distinguish between drebolium and black shot, raw materials, etc., salt and alcoholic beverages. With gout, the imam has three types of products: permission to store, store, koito mogat and se consumirat, but in small quantities and neatly and store, koito sa naply zabreni.
The diet is strict and allow you to store it in small amounts, but it is more limited. Maybe yes, consume the fish, not tryabva, yes, no mazna, prepared with a lot of little mash, whether you cook or bake. Zelenchucite with tryabva and sa jam, liver or steamed. Some ghee is harsh, especially on salad, avoid dressing, maybe a little juice from the lemon, and a little zechtin. Solta is taken away and without tova nyama as yes I will avoid in full, protection in the vvecheto product I am, but kindly yes not I crawl additionally. Mozhe da se consumirat without limiting potatoes and oriz. From plodoveta sa permission with the exception of sinita plum and raspberry. Particularly suitable for citrus fruits, which will help the body and remove toxins. Milk products sa permission, but ako sa with a little oil and a little salt.
Storage at the basin diet tryabva yes sa nachesto and little by little. Between separate sittings on masata e goodness and se accept more than the flow. Vedenzh seven-weekly si pravete merchandising den, more fruit and greens, but not full of gladness. Don’t overeat and take softening medications or diuretics, as they will harm your body and make you ill with acidic acid.
Keep theses, don’t harm them, but don’t see them and help them, and deal with the pain. But they are good, they are present in the menu and then in limited quantities. Takiva store and distinguish dough products, including bread, pizza, banitsi, sweets, biscuits. Tryabva yes se izbyagvat sosovete, especially domateniyat and theses, koito sa with poveche corrections. Little by little, keep the consumption of lyutiv and jelly, preserve it and send it at home, sweet and winter. Eggs can be consumed seven days a week.
As you can see, the diet is strict. It’s also easier, because the storage type is stored, continue between three and five years, and then they will cleanse the purinite from the body and the amount of acidic acid and normalize it. If you approve, you can and se mine na po-lek option na dietata, kato se they will add nyakoi from store from the second group. Don’t be afraid to refuse and break your diet, protect your comrade vis dokara novi start on gout.
Gout is the most common type of inflammatory arthritis when over 40 years of age. Gout is characterized by a sudden, painful attack on the sore throat, worms and pain in the area, based on the finger. Unhealthy conditions start on the stomach and the main cause of the disease is gout .
More on the topic ZhelturcheValcha appleNovete medicines for heart disease and cancer diseasesRibenoto oil pressed, caused by arthritisHomeopathy cato assistant on psychosomatic medicinePikochnata kiselina is formed in the body as a result of metabolism on nucleinitis kiselina. Synthesisra se in cherniya fraction and vv view on sodium salt se namir in krivta. Izlachva se prez bbretsite i nivoto na picochna kiselina in krivta se determining the balance between the two processes - synthesis and izlachvane. Cogato concentration on picochna kiselina in kravta premina granitat from 540 mmol/l, these salts are soiled and crystallized (receiving a presiten solution on picochna kiselina) and yes everything will be deposited uratni crystals in mekite fabrics on tyalo - usually put capsules around, but so is in surceto and other organi. Tova is sick with gout , and the condition is high - hyperuricemia . Crystalite predisvikvat inflammatory reaction - blow, pain, worms, floods, and disrupt the function on the stage. Ignoring what is deposited on the crystal, putting the forest in place on the leather, exposing it to the studio. About 1% of the chorate with gout will develop uratni stones in bbrecite. In the bbretzite they can and do form uratni stones and something e nay-losho, these stones cannot and se visualize on x-ray, the protection is transparent. The presence of this on the stone can lead to acute insufficiency and lead to death.
For a lot of chorus, gout initially reflected everything on the golem prst. What can you do and influence and glaze, petite, kneel, bow, forgive and lactate.
Gout is exactly the same thing, it’s increased control over picochna kiselina in the blood , otherwise it can lead to other acute illnesses, for example, arthritis , stones in brutitis , and in some cases, two illnesses at the same time. Arthritis is obtained, protected picochnata kiselina osven in bbretzite , deposits and in the deposits and there, forming crystals, which lead to unbearable pain and blowing. Osven from kristalite bolkata idva and from vazpalenat near stavat takana, from kadeto se getting blown. In the future, cases of pain should be taken into account and the organs and water up to abdominal insufficiency , angina pectoris, myocardial infarction .
Gout can be divided into two main types: primary and secondary . Primary origin is from factories, due to the beginning on the stomach, inheritance of defects in metabolism on substances, taking medications. Secondary gout is a result of other diseases: congestion, diabetes , increased blood load , metabolic syndrome, abdominal insufficiency , leukemia , etc. Some of the main risk factors that can and will provoke the development of gout.
If you get sick, you can do this beforehand in four stages:
Some risk factors are associated with the development of hyperuricemia and gout :
The development of gout is associated with the use of medications, medium diuretics, medications used in organ transplantation, such as low doses of aspirin. Between 45 and 60% of the age, those suffering from heart disease take low doses of aspirin daily for preventive purposes. Aspirin, and then taken in a low dose, will increase the risk of development of gout . Simultaneous use of diuretics can be even more effective and the situation with lice can be worse.
The sign of the disease appears on the protein in the urinate. The swelling will appear in the area, increasing the amount of diuresate. At about 30% of the disease arterialnoto nalyagane se pokachva. The content of picochnata kiselina in the blood is constantly and significantly increased. Honestly, in the abbreviation, they are formed by stones, which are caused by lessons. In some cases, abdominal insufficiency gradually develops.
When diagnosing gout, pay attention to the symptoms: sudden onset of acute and long-lasting pain in the stomach, pain or swelling, worms and swelling, difficulty moving. It is very important to check everything for picochnata kiselina in the blood or the presence of inflammation and stones.
Diagnosis of gout e lesna. Parvo se izsledva kravta za picochna kiselina. During the evening there is an attack - approximately on the kolyanovo, the fluidity from the kolyannat stav is “dissolved” (under a microscope they look at the crystallite, in which there are deposits of acidity). In order to make a diagnosis, we also need to do a lot of research on catalytic echography (to recognize crystalline arthritis among other types of arthritis ), x-rays, etc. Treatment is medication.
For the painting, it was formed on the picochnata of kiselina and in a bright way and eliminated the soil of the trace:
No inflammatory joint disease is as closely tied to our lifestyle as gout. Moreover, this disease has the simplest and at the same time complex treatment. If it weren’t for the huge number of medical errors, the reason for which is ignoring some important components of a biochemical blood test, then treating gouty arthritis would not be difficult . In past centuries, gout was considered a sign of being chosen, since only noble nobles could eat well then.
Who is at risk of getting sick?
Today, gout is called a disease of obese people and lovers of good food. Mostly men suffer from it, and this is not without reason:
It is men who prefer red meat, smoked fish, alcohol, especially beer, which contains xanthine and guanosine in their diet - the breakdown products of these compounds are those same ill-fated purines, as a result of which uric acid is formed.
Elevated levels of uric acid in the blood are hyperuricemia
However, this does not mean that women do not suffer from gout: a woman’s advanced age is usually accompanied by hormonal disorders that can provoke gouty arthritis.
Added to this is physical inactivity, which sharply slows down metabolism - and uric acid accumulates in the blood
Provoking factors for gout can also be :
The presence of ancestors in the direct line of people with gout does not mean the inevitability of the disease - all you need to do is monitor your lifestyle:
The bad thing is that uric acid is insoluble in water, alcohol, or ether. It is susceptible to dissolution in alkaline solutions, hot sulfuric acid and glycerin
What is constantly in the blood inevitably crystallizes, and then the process proceeds in stages:
The first manifestation of the disease manifests itself in the form of an attack - acute gouty arthritis begins
The photo shows an example of gout of the toes:
The alternation of sudden attacks with temporary relief, the prolongation of each subsequent attack and the reduction of intervals between exacerbation phases are all signs of the development of gout.
In the final stage, the pain practically does not recede - chronic gouty arthritis is diagnosed.
Symptoms of chronic gout appear:
In the photo - gouty tophi:
Tophi nodules form not only under the skin over the diseased joint, but also on the ears.
The development of urolithiasis and pyelonephritis are signs that gout is already severely advanced
Symptoms of female gout are milder:
Symptoms of gout are often mistaken for arthrosis, especially when diagnosing the disease in women.:
It’s not so bad if incorrect conservative treatment is carried out followed by incorrect recommendations for “collagen” nutrition - a diet with jellies and rich meat broths, which are killer for gout.
It is much worse when, having stated the complete destruction of the joint, would-be doctors offer expensive and absolutely useless endoprosthetics: uric acid urates after this operation are gladly taken for the remaining healthy joints.
Surgeons can, without hesitation, mistake gout for gangrene and, having opened the toe, later click their tongues in surprise: Eka, the process is progressing quickly! - so it went to the other finger...
All that was needed was to check the level of uric acid in the blood.
The most surprising thing is that even the existing analysis with an indicator of uric acid content that is twice as high does not really burden the minds of some “specialists”.
Another difficulty in diagnosing gouty disease is taking a biochemical analysis during an acute attack:
If treated correctly, gout can be completely cured.
Drug treatment is carried out using the following drugs:
There are serious contraindications for probenecid and uricozyme group drugs:
Therefore, these drugs are not considered essential in the treatment of gout.
Any drug treatment will not bear fruit if the patient does not show will and does not moderate (literally) his appetite
Unfortunately, there are slaves of the stomach who, even on pain of death, are unable to give up their addictions. For such people, treating gout is very difficult: they are constantly (from attack to attack) forced to take allopurinol, which they manage to eat with juicy steaks and wash down with beer.
For other ascetics, in terms of nutrition, one course of medication is enough to cure the disease.
This is why treating gout is both easy and difficult - it all depends on your connection to a specific person.
The figure below shows a table with allowed and not recommended products:
Special diets for gout are at the end of the article.
Gout can be cured by removing uric acid from the body and always using a diet. If you don’t do this, no folk remedies will help.
Local treatment in the form of all kinds of lotions and compresses may relieve inflammation and pain, but will not exclude the possibility of further attacks, so we will not even consider it.
The exception is decoctions and tinctures taken orally to remove salts.
The following folk remedies may be of interest::
Bay leaf has always been considered an excellent folk remedy for cleansing joints of salts.
Video: How to treat gouty arthritis:
You've probably wondered more than once what kind of disease gout is and where it comes from? Gouty arthritis, or “gout” for short, was found in the medical treatises of Hippocrates; even then they knew that the cause of this disease was uncontrolled consumption of food and drink.
Increased levels of uric acid in the blood (Hyperuricemia) are detected in 4-12% of the country's population, so 1 out of 1000 people suffer from gout in the Russian Federation, in Europe and America 2 out of 100 people, in Australia and Africa the figures are close to Russian ones. It is known that Newton and Darwin, Da Vinci, Alexander the Great, Sultan Suleiman and others suffered from gout.
A metabolic disorder in which the content of uric acid and urate in a person’s blood increases, causes the appearance of gout. Substances crystallize and are deposited in joints and tissues, destroying them. More often than others, fingers, elbows and knees, joints of the hands and feet are affected.
4 stages of gout:
Gout disease photo
There are two types of gout - acute and chronic .
Deposition of sodium urate crystals is also possible under the skin on the ears or near the joints. Tophi are formed - hard nodules with a white porridge-like mass inside. When the tophi breaks through the resulting hole, uric acid crystals spill out. The wound heals quickly without consequences.
Shocking statistics! According to recent studies, more than 80% of Russians have severe joint damage. However, most people are not even aware of the danger they are exposed to.
Many who already have characteristic symptoms of joint damage simply do not pay attention to it, thinking that there is nothing special about it. However, according to doctors, any pain and discomfort in the joints is a sign that the joint has begun to deteriorate.
The main symptoms of joint destruction include: swelling, numbness, crunching and pain in the joint (first with stress and bad weather, and then constant), lumbago in the lower back, frequent headaches, impaired motor activity of the toes and hands, and many others. At least one of the listed symptoms indicates the presence of joint problems.
Many doctors call the innovative drug “Artropant” a real salvation for joints. After all, it allows you to completely restore the joint and eliminate the risk of further development of dangerous pathologies in just a few weeks.
Therefore, it is not surprising that this particular cream was chosen as the main product during the Federal Healthy Joints program, which started 1.5 months ago.
During this program, any resident of the country will be able to purchase Arthropant at a discounted price!
We asked the country's leading orthopedist and rheumatologist, a doctor of the highest category, Professor Mikhail Vladimirovich Zavyalov, to tell us more about the federal Healthy Joints program. Read more "
The above symptoms and their manifestation occur only in men; in women, even the chronic form is milder. The ankle and knee joints are most often affected, and damage to the joints of the hands is possible.
Before starting treatment, it is necessary to confirm the diagnosis. If the doctor suspects the presence of gout, he will first prescribe the patient a biochemical blood test , which will show that the level of uric acid and its salts is increased.
A diagnosis of elevated urate content alone is not made.
There are a sufficient number of other diseases in which this indicator increases, but only 10% of people have gouty arthritis. Another problem in correctly diagnosing gout is that at the time of exacerbation, the level of uric acid is within the normal range, because it is all concentrated in the inflamed joint. And this is precisely the period when the patient consults a doctor. The pain has gone and the patient stops thinking about his health, hoping “that everything will resolve itself.”
The combination of symptoms of gouty arthrosis, the detection of “punches” on the bones and increased uric acid in a biochemical blood test - these are sufficient reasons to make a diagnosis of gout. Only after a final diagnosis is the correct treatment selected so that the person can start living pain-free again.
Gout, X-ray view
A Nijmegen account has also recently been proposed (table). In patients with a total score <4, the probability of gout is 2%, between 4–8 points - 31%, more than 8 points - 80%.
What to do first:
Only an experienced rheumatologist can prescribe the correct treatment, because the course depends on the stage of the disease, age and gender of the patient. To stop an attack of gout, non-steroidal anti-inflammatory drugs are prescribed, the list of which is quite wide today, mainly voltaren or ibuprofen, or short-acting anti-gout drugs (colchicine or another drug with the same property). To reduce pain, you can make a compress of dimexide and novocaine, the proportions of which can be obtained from your doctor and only under his supervision.
Treatment lasts from 7 to 14 days, but then comes the second stage - preventive. For several months and even years, patients take special medications to reduce the formation of uric acid - purinol and allopurinol (which are basically the same thing).
In addition to medications, the doctor prescribes a special diet for the patient, which is an integral part of the treatment.
Simultaneous use of the drug and following a diet leads to rapid normalization of the condition and a return to life without pain. Sometimes, in the first 2 weeks after starting allopurinol therapy, an exacerbation occurs, but you should not stop taking the drug. See treatment of gout with folk remedies at home.
To avoid new exacerbations, it is recommended to do the following for prevention:
If you are diagnosed with gout, overeating is contraindicated for you, but fasting is also prohibited. You need to eat at least 4 times a day. Drink enough liquid, about 0.5 liters per day, and in case of exacerbation, increase drinking to 3 liters per day (if there are no kidney diseases).
Rheumatologist, 8 years of experience
Publication date December 6, 2017
Gout is a systemic disease that develops in connection with an inflammatory process that occurs at the site of deposition of monosodium urate crystals in people with elevated serum uric acid levels (more than 360 µmol/l). Hyperuricemia occurs under the influence of both environmental and genetic factors.
The disease usually affects men, but recently it has also been detected in the weaker sex. The prevalence of gout is increasing, and this can be attributed to the rising standard of living of the population. Asymptomatic hyperuricemia is common, but gout does not always develop.
The development of gout is influenced by:
Features of the modern course of gout:
Gout affects the musculoskeletal system and the urinary system. Acute monoarthritis occurs, accompanied by unbearable, rapidly growing and rapidly passing joint pain over several hours or days, the skin over the joint turns red, and the joint itself increases in volume.
Other symptoms include fever, weakness, and sweating. When the disease becomes chronic, tophi form around the affected joints and the joints become deformed.
Urate stones form in the kidneys, causing nagging pain in the lower back and the periodic appearance of blood in the urine, nocturia (more urine is excreted at night). [2] [3]
As the formation of urates increases and their excretion by the kidneys is impaired, excess uric acid is formed in the blood, and urates accumulate in the tissues of the body. When monourate crystals are deposited in the joint cavity, an inflammatory process occurs due to the activation of various proinflammatory cytokines. In addition, these crystals are deposited in the renal tissue, leading to the development of nephropathy and urate nephrolithiasis. [7]
3 stages of gout development:
For the first time, a gouty attack occurs without warning, usually between the ages of 40 and 50, although cases of the disease are known at a much younger age. Acute joint pain, most often in the metatarsophalangeal joint of the big toe (classic onset), finds a person in the second half of the night or in the early morning hours. Any movement or touch in the joint causes severe pain. Violation of the diet, drinking alcohol (alcohol blocks the kidney from releasing uric acid), surgical interventions, infectious diseases, increased stress and joint trauma precede the onset of an attack. Patients complain of redness of the affected area, swelling, severe pain, general weakness and malaise, increased body temperature, sweating, fatigue, and depression. Acute bursitis (prepatellar or ulnar bursa) is also characteristic. [6]
Within a few days (about a week), the attack goes away on its own. It is because of this that gout often creates the appearance of being benign: everything goes away (especially at the beginning) on its own, and the problem is forgotten until the next exacerbation. In fact, gout with this approach can lead to destruction and deformation of joints and chronic kidney disease. Further, in the absence of adequate control over the disease, attacks become more frequent, cease to go away on their own, and disappear over a longer period of time. Later, the person no longer feels healthy at all, but is in a state of prolonged attack. As a result, painless subcutaneous nodules with crumbly, cheesy contents – tophi (whitish or yellowish uric acid salts) – form over the area of the affected joints. The favorite location of tophi is the area of the joints of the hands and feet, the Achilles tendon, the ears, ankle and elbow joints. With chronic tophi gout, cartilage is destroyed, which threatens deformation, complete destruction of the joint and its ankylosis (complete fusion and lack of movement). Sometimes tophi can open on their own, and thick contents are released from them. [9] [17]
Diagnostic criteria for Wallace gout (proposed by AAP in 1975, approved by WHO in 2002):
During puncture, the doctor obtains synovial fluid, in which crystals of monosodium urate are detected under a microscope. They can also be found in tophi. The diagnosis can be established with one hundred percent probability. Urates appear as needle-shaped crystals with one thin end. In the absence of a polarizing microscope, diagnosis is based primarily on the typical clinical manifestations of gout. Acute arthritis, in which pain increases like an avalanche, swelling and redness of the affected joint appears, is a good reason to think about gout. X-ray examination of joints at an early stage of the disease is not very informative. Changes are detected at a late stage. In particular, the “puncture” sign (subcortical cysts), a typical radiological sign of gout, is useful in diagnosing its tophi forms. Also, with radiography in gout, there is no periarticular osteoporosis, we rarely see a narrowing of the joint space, and osteolysis is often detected. [eleven]
It is worth paying attention to the fact that during an attack the level of uric acid in the blood may be normal, since at this moment it is intensively excreted by the kidneys. Its level in the blood should not be relied upon when making a diagnosis.
The gout diet is quite strict, but following dietary recommendations is the key to successful treatment. Foods that are rich in purines should be eliminated or minimized. Drinking plenty of alkaline fluids helps the kidneys get rid of excess uric acid in the blood (the kidneys are the only organ that removes uric acid).
Let's start with the main source of purines - poultry and meat. Chicken is one of the most harmful types of poultry. Duck and goose are slightly inferior to chicken (contain less purines). Turkey lasts on the list, having the lowest purine content of any poultry. Beef is the leader among meat products in terms of purine content, followed by veal and pork, and lamb.
As for fish, the most harmful are salmon species, followed by sprats, sprat, sardines, and cod. Sea creatures living in shells (oysters) are the richest in purines. Offal is also very harmful (brains, liver, lungs, kidneys), as well as jellied meat, meat broths and sauces. Sausage (any kind) should be completely excluded from the diet. Also not recommended: mushrooms and mushroom broths, legumes, sorrel, eggs, chocolate, yeast, polished rice, figs, rolled oats, cauliflower, yeast. Alcoholic drinks are prohibited (especially beer, wine, champagne).
The volume of liquid consumed per day is 2-2.5 liters. Alkaline drinks are recommended: alkaline mineral water, water with lemon, juices.
Now about purine-poor foods - exactly those that need to be eaten. They are: milk and dairy, lactic acid products, many vegetables (white cabbage, potatoes, cucumbers, tomatoes, carrots, onions), nuts, fruits, flour products, cereals, honey, butter. It is recommended to eat boiled meat and fish 2-3 times a week. You can eat lard, since fat contains almost no purines. Some studies suggest that 1.5 liters of coffee per day is equivalent to 100 mg of allopurinol, and cherries are also known to have hypouricemic effects. [4] [15]
Treatment of chronic gouty arthritis
To successfully treat chronic gout, it is necessary to prevent the formation and dissolve existing crystals of monosodium urate, and for this it is necessary to maintain uric acid levels below 360 µmol/L.
Patients are subject to clinical observation by a rheumatologist. The doctor determines the frequency of monitoring tests, changes (increases or decreases) the doses of medications received, and treats the attack. Anti-gout medications are taken for a long time. Also, related specialists (cardiologist, endocrinologist, urologist, nephrologist) can be involved in the treatment of concomitant pathology. The patient may be hospitalized in the rheumatology department in case of a prolonged attack, ineffective treatment at the outpatient stage, as well as for the selection of permanent therapy.
The prognosis depends on the timeliness and success of the treatment started, the patient’s adherence to treatment, and compliance with dietary recommendations. For the most part, the prognosis is favorable, but it worsens with the development of kidney damage, which can even cause the death of the patient.
Strict adherence to diet is the main point in preventing gout attacks. It is necessary to limit alcohol consumption and not take certain medications (thiazide and loop diuretics, non-selective beta blockers, aspirin, nicotinic acid, levodopa). If the patient is losing weight, then one should be wary of rapid weight loss. You should try to avoid dehydration, heavy physical activity, and exposure to low temperatures. For preventive purposes, allopurinol can be prescribed only to patients suffering from cancer and receiving chemotherapy. [14]