The joint is destroyed by uric acid crystals
A disease such as gout has been known to mankind since ancient times. The cause of its occurrence is an increase in the level of uric acid in the blood. Excess uric acid leads to the fact that the kidneys do not have time to remove it from the body. As a result, salts are deposited in the joints, which causes severe inflammatory processes.
Successful treatment of the disease largely depends on nutrition. All foods that contribute to the formation of uric acid should be excluded from the diet. Drug treatment for gout is prescribed to the patient when following a diet does not bring relief and the level of uric acid in the blood remains high.
In the old days, gout was considered a disease of aristocrats, since it developed as a result of excessive consumption of meat and alcohol, which the poor could not afford. Today, when meat products and alcohol have become available to almost everyone, the disease has spread to almost all segments of the population. The prevalence of gout is low: on average, there are only 3 cases of the disease per 1 thousand people, and men suffer from it much more often than women.
The peculiarity of the disease is that it is chronic and cannot be completely cured. If a person has been diagnosed with gout, in order to avoid exacerbations, he will need to adhere to a special diet for the rest of his life, excluding meat dishes and alcohol from his diet. A normal drinking regime is also very important. To remove uric acid from the body, the patient should drink 2-2.5 liters of liquid per day. But only if he does not suffer from kidney disease.
Gout is characterized by paroxysmal progression. Its symptoms are difficult to confuse with the manifestation of any other disease. A gout attack always begins suddenly and is accompanied by unbearable pain and increased sensitivity of the area around the joint, inside which uric acid salts have accumulated. At the initial stage of the disease, the pain is localized in the joint of the big toe. It becomes hot and red.
Manifestation of an acute attack of illness
The attack occurs most often at night, when the person is at rest. If the patient does not pay attention to the alarming symptoms, does not go to the doctor and does not begin treatment, the disease will progress and spread to other joints. A distinctive feature of gout is tophi (gouty bumps), formed at the site of accumulation of uric acid crystals. If the disease is neglected, it will lead to serious problems in the functioning of the kidneys.
Many people suffering from gout attacks have a question: how to treat this disease? Having noticed symptoms of the disease, the patient should go to a medical facility and undergo an examination. If the result turns out that the level of uric acid in the patient’s blood is elevated, he will be prescribed medication.
There are not so many medications for the treatment of gouty arthritis in modern medicine. They are divided into 2 groups:
In the treatment of gout, the anti-inflammatory and analgesic drug colchicine is widely used, the action of which is aimed at normalizing the metabolism of uric acid in the body. Colchicine tablets are intended to relieve acute attacks and be taken as a prophylactic agent. It has a complex effect on the body:
Treatment of gout with colchicine should be carried out at the initial stage of the attack, in this case the drug has the maximum therapeutic effect on the patient’s body. If gout pills are taken in the midst of an attack, they will not quickly relieve its symptoms. To treat acute gout on the legs and other inflamed areas, colchicine should be taken only as prescribed by a doctor. The duration of anti-gout therapy is determined by a specialist.
Before drinking colchicine, you should familiarize yourself with the contraindications for its use. These include:
The most common side effects during treatment with the drug are allergic reactions, abdominal pain, vomiting, diarrhea, and anemia. Long-term use may cause thrombocytopenia. 90% of patients say that treatment of gouty arthritis with colchicine gives a positive therapeutic effect. Its analogues are drugs such as colchicine and colchimine.
Today, gout attacks are successfully treated with nonsteroidal anti-inflammatory drugs (NSAIDs). These include phenylbutazone, methindole, indomethacin, ketazol, butadione and other drugs. Medicines from the NSAID group effectively relieve pain during a gouty attack, reduce temperature and help reduce the inflammatory process in the affected joints. They are more effective than colchicine and are better tolerated by the patient. The question of which non-steroidal drug is best to choose should be decided by the doctor. He will also prescribe the dosage of the medication and the duration of its use.
Since gout always reminds itself unexpectedly, it is advisable for the patient to constantly carry the pills prescribed by the doctor with him and, in the event of an attack, take them immediately.
If a person has chronic gout, it is treated with preventive medications intended for long-term use. Such a drug is allopurinol, a medicine whose main effect is aimed at reducing the amount of uric acid in the body. Tablets are available in dosages of 100 and 300 mg. This medication is not used to relieve attacks; it is prescribed during the period of remission, when the diseased joint is not inflamed.
The doctor selects the dose of allopurinol individually for each patient, based on the results of his tests. The minimum dosage of the drug is 100 mg, the maximum is 800 mg per day. To avoid negative consequences, treatment of gout with allopurinol begins with a minimal dose. It is recommended to take the medicine after meals. To achieve a positive therapeutic effect, allopurinol should be taken for several months. Contraindications for treatment with this medication:
Patients usually tolerate allopurinol well if it is necessary to take it. In rare cases, they may experience side effects such as insomnia, depression, nausea, vomiting, diarrhea, and blood diseases. At the initial stage of taking the drug, an exacerbation of the disease is possible due to the release of uric acid from gouty tophi and other places of its concentration. If your health worsens while taking the medicine, the patient should consult a doctor.
In addition to allopurinol, anti-gout drugs that reduce uric acid levels are thiopurinol, probenecid, benzobromarone, and anturan. They are also intended to prevent gout flare-ups and are prescribed for a long period.
How is treatment for gout selected? Its goal is to quickly eliminate pain, prevent recurrence of attacks, and long-term complications. a cure for gout is not found in time , kidney destruction and joint damage will occur. It is built on the basis of taking medications, as well as measures that must be followed. In the best case, it is possible not only to overcome the pain, but also to ensure that it will not arise in the future.
What causes the disease? Knowing this, it is easier to identify a treatment method, as well as find a cure. You can take medications for gout in the legs , including diet, which is discussed in more detail here.
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For treatment you need to choose a combination of drugs. For the short term, you need those that will relieve pain. This includes non-steroidal anti-inflammatory drugs, with the exception of aspirin. For example, fullflex is a gout medicine to combat such attacks. It is worth mentioning colchicine here, as well as corticosteroids (for example, warfarin).
A daily dose of 300 mg or more should be divided equally into 3 doses. The drug is taken after meals with plenty of liquid, preferably water. When taking this drug, uric acid levels begin to decrease after 2-3 days. It should not be prescribed for an acute attack of gout. It happens that when treating with allopurinol, an attack of gout develops, then you need to urgently reduce the dosage, but under no circumstances discontinue the drug. To prevent this effect, at the very beginning of taking the drug, colchicine or diclofenac is prescribed in low doses.
It remains to be reminded: if you take medications in a timely manner, relief will come within 24 hours. You cannot delay taking what your doctor prescribes.
When the attack has already begun, you need to immediately take something that will help reduce the acid content in the blood cells. They are also taken after pain appears.
Allopurinol is prescribed to prevent acute attacks of arthritis. Therapy should be started with small portions, 100-300 mg/day. The daily volume of medication is divided into 3 doses. The drug can be taken after meals with water. It is not taken for acute attacks of gout. It is necessary to take the gout medicine allopurinol on time, otherwise the likelihood of recurrence of pain will increase. While completing the course, you need to constantly check the level of lactic acid in the patient’s body.
It is important to take what the doctor prescribed on time. Naproxen will help overcome and eliminate pain and lower body temperature. It should be taken twice a day, the tablets should not be chewed, washed down with liquid. In case of exacerbation, a dose of 0.5 - 0.75 g is needed in the morning and evening hours. During the first use, take 825 mg, every subsequent 8 hours - 275 mg.
It reduces the amount of harmful substances, and during complications it is not taken. There are drugs that help accelerate the movement of deposits through the bloodstream, and to prevent the symptoms from becoming more complicated, the drugs are not taken when pain occurs.
Everyone wants the product to work immediately. The medical approach is treated in two stages:
Until the attack is over, you cannot include a drug that lowers the volume of uric acid the treatment of gout with medications Its movement through the organs must not be hampered.
The course can be long-term. When figuring out how to treat gout with medications , you need to find out how much uric acid is in the body. The more it is, the more difficult it will be. Often, in a complicated course, the gout medicine colchicine - it also works well against recurrence of attacks.
Gout or gouty arthritis - this disease is mentioned in ancient medical tomes.
To effectively combat the disease, doctors use both long-proven and completely new anti-inflammatory drugs.
Treatment of gouty arthritis occurs in two stages:
Medicines for gout should be taken for a long time - up to several weeks after the next attack. The duration of the therapeutic course directly depends on the concentration of uric acid in the body.
In complicated cases, medications (diuretics, activated carbon, colchicine) will have to be taken even for several years.
Like the best remedy, medications for gout should be prescribed in combination. If a short-term therapeutic course is expected, the doctor prescribes the patient anti-inflammatory medications that act directly on the source of inflammation and pain. Most often these are non-steroidal drugs.
The use of regular aspirin can only increase the symptoms of the disease. In this case, the best pills for gout are Colchicine. In addition, diuretics and activated charcoal are prescribed. Corticosteroids are injected directly into the affected joint.
Tablets for gout containing hormones are indicated in situations where treatment with non-hormonal drugs has not brought results or the patient has certain contraindications to NSAIDs.
Anti-inflammatory non-steroidal ointments, drugs and some diuretics are contraindicated if the patient's medical history includes chronic kidney failure or various diseases of the gastrointestinal tract accompanied by bleeding.
For long-term treatment of gout on the legs, not only drugs that inhibit the synthesis of uric acid are prescribed, but also those drugs for gout that promote its rapid elimination from the body (diuretics).
Allopurinol is used to reduce the production of purines. And Colchicine is necessary to reduce the frequency of gout attacks. This is a relatively new and effective medicine that is also used for preventive purposes.
If treatment is started in a timely manner, the patient may feel relief within 24 hours. The doctor prescribes the patient a single dose of the maximum dose of the drug. After the acute pain is relieved, the dosage of the medication is gradually reduced.
Any diuretics have certain contraindications. Therefore, when prescribing them, the doctor should not doubt that the diagnosis is correct.
The patient should not take Aspirin; this remedy for gout can worsen the situation, as evidenced by reviews from doctors.
To combat the attacks of gouty arthritis, pharmaceutical companies around the world are constantly working on new effective drugs, trying to create the perfect cure for gout. Today there are many such drugs.
Doctors recommend the following medications to their patients:
These medications are prescribed if the doctor cannot prescribe Allopurinol to the patient.
It is worth telling about them in more detail.
Fullflex for gout is a drug that quickly removes uric acid from the blood. At least this is what the reviews of most doctors indicate. Fullflex, as a medicine for gout, is also used to treat other diseases:
This is due to the fact that the product has anti-inflammatory and anesthetic effects. The release form of the drug is capsules or tablets for oral use, cream for topical use.
The course of treatment with Fullflex tablets lasts one month (1 tablet per day). The cream should be rubbed in twice a day. The drug is contraindicated during pregnancy and breastfeeding.
Allopurinol effectively reduces uric acid levels in the blood. The medicine is available in tablet form. Daily dosage – 1-2 tablets. If gout is in a state of moderate severity, the dose can be increased (3-4 tablets per day). Allopurinol does not have an analgesic effect, but directly affects the cause of pain.
Unfortunately, Allopurinol has contraindications and side effects:
The medicine should not be taken by pregnant women and people suffering from liver pathologies.
If there is an individual intolerance to the components of the drug, the patient should consult a doctor who will replace the medicine with another.
Another effective treatment for gout is Colchicine. The medication has a powerful analgesic effect and is prescribed to eliminate the acute symptoms of a gout attack.
Colchicine is absolutely safe for the body because it is of plant origin. Release form: 1 mg tablets. After taking the first tablet, the patient should take the second one two hours later. This regimen will eliminate intense pain in the legs during a gout attack.
Complete pain relief will occur three hours after taking the first tablet. The effect of the drug lasts approximately 12 hours. Colchicine can be used not only to treat attacks, but also to prevent them.
Side effects of colchicine:
During pregnancy, the use of the drug should be strictly controlled by a gynecologist. When treated with Colchicine, men may experience a decrease in sperm count and motility. The occurrence of such a phenomenon requires refusal to take the drug.
A treatment regimen for gout, especially during an exacerbation, should be drawn up by a doctor. Self-medication in such a situation is very dangerous, as it can provoke serious complications and significantly delay the onset of remission.
Gout is a disease caused by a violation of purine metabolism , resulting in the deposition of urates (uric acid salts) in the joints, ear cartilages, and epiphyses of bones, with the subsequent development of aseptic inflammation.
Treatment of gout with medications requires an individual approach aimed not only at combating this disease, but also its accompanying diseases. The treatment is based on pain relief, prevention of new attacks, as well as chronic complications, which include kidney damage and joint destruction.
Therapy includes medication and dietary nutrition. Treatment is carried out in 2 stages :
During the period of exacerbation, the patient must arrive as an inpatient in special hospital departments.
The goal of this stage of treatment is to relieve pain, reduce the inflammatory process in the joints, which affects the metabolism of uric acid and restore normal joint mobility.
For this purpose, the following groups of drugs are prescribed.
NSAIDs - the more effective drugs in this group are:
Steroid hormones - drugs in this group are very powerful, but contain many side effects. They are prescribed in a short course or once in the form of injections, which are given directly into the damaged joint, as a result of which the attack can be stopped, and the inflammatory process subsides. Mainly prescribed:
Colchicine , a gout medicine derived from the crocus plant, is a powerful gout-relieving medicine. Available in tablets - 0.5 mg for oral administration and in ampoules for injection. Intravenous administration is indicated for severe attacks.
The mechanism of action is to suspend the process of lysosome degranulation , inhibit leukocytes, and impede phagocytosis of urates. In addition, the drug has a mild anti-inflammatory, antinin, and antihistamine effect.
Colchicine therapy should be started during the prodromal period. After the first dose, improvement is observed after 12 hours. The drug shows its effectiveness in 90% of cases, with timely treatment. The inflammatory process disappears within 48 hours. Lack of effect is observed when it is used late.
This treatment is started after the inflammation has been relieved. The goal of therapy is to improve the health of the body as a whole. Treatment is carried out using medications that are part of 2 large groups:
Medicines for gout from this group act on the main link in the pathogenesis - they reduce the level of uric acid in the blood , as well as its salts.
The most common uricodepressants are:
The most popular uricosuric drugs include:
tophi can form , which are mostly painless, but sometimes increase in size and cause complications. If you treat them promptly, which requires an integrated approach, they will decrease on their own. Sometimes their opening can occur on their own, without any treatment.
Opened granulomas are treated with an antiseptic; for these purposes, iodine-containing agents and antibacterial ointments are used.
The most severe complication of gout is chronic renal failure . To avoid this, abundant fluid intake and periodic intravenous infusions (infusions) of alkalizing solutions are recommended.
This measure prevents the deposition of urate stones in the pelvis of the liver. For alkalization, sodium infusions, electrolyte solutions, and soda bicarbonate are used. All these agents should be used under close laboratory supervision.
In the process of laboratory tests, urine and blood tests evaluate the presence of acid, as well as the amount of urate excreted in the urine. In this regard, at the time of exacerbation, patients should arrive in an inpatient setting under the supervision of a rheumatologist.
Drug treatment of gout will be ineffective if you do not resort to additional measures, which include :
The entire range of procedures can be completed in special sanatoriums, where all additional treatment methods are carried out in a complex.
Nutrition plays a big role in therapy, since certain foods can trigger relapses of gout. from the diet :
Use with restrictions:
The main menu should include:
Of the fats, it is preferable to consume butter and vegetable oil.
The effectiveness of treatment can only be achieved by completely abstaining from alcohol-containing drinks and limiting the consumption of coffee and strong black tea. Outside of exacerbation, do daily warm-up and therapeutic exercises.
Gout was already treated as a separate disease in the 17th century. It was called the "men's leg trap." Today, in both men and women, it affects the joints of the legs and arms due to overeating and abuse of alcohol and diuretics (diuretics). Let's look at the most effective medications for gout.
With gout, uric acid salts are deposited in the joints. The most common joints affected are the joints of the feet.
Gout is a systemic disease that can affect the entire body. Joint pain is especially painful with gout.
But before you self-medicate and take pills for gout, you need to make sure that the cause of rare and acute pain is the uric acid salt. To do this, you must undergo a full medical examination.
Gout develops due to a violation of uric acid metabolism. Patients themselves create conditions that contribute to the progression of the disease:
Gouty joints of the big toe
The primary signs of gout are rare attacks. When it enters the chronic stage, the sharp pain does not subside for hours or weeks. Wherein:
X-ray demonstrates bone changes in gout
Acute attacks are treated with effective painkillers for gout : Naproxen, Sodium Diclofenac, Indomethacin and Piroxicam, Ibuprofen, Meloxicam, Nimesil and Nise - non-steroidal anti-inflammatory drugs (NSAIDs).
These types of drugs are produced in the form of tablets, injection solutions, as well as gels and ointments for external use.
In short courses during gout attacks, steroid hormones are prescribed in the form of injections, tablets or ointments:
Pain and inflammation are effectively relieved after using a gout medicine such as Colchicine.
Important! The product is toxic; it is used at the very beginning of the attack, and when the patient’s condition improves, it is canceled. Side effects of using Colchicine are nausea, vomiting and diarrhea.
Acute attacks are stopped with increased doses of drugs, then the doses are reduced to average therapeutic levels, following the regimen, the doctor’s recommendations and taking into account contraindications. For example, Colchicine cannot be included in therapy if the patient has severe liver and kidney damage, gastric ulcer and duodenal ulcer.
Relief also occurs if you use indole and pyrazolone drugs for gout: Ketazone, Phenylbutazone, Reopirin and Butadione.
We previously wrote about the treatment of gout with ointments and recommended bookmarking this article.
To reduce the synthesis of uric acid, uricodepressants are prescribed:
Uricosuric agents are used to remove salts from joints and cleanse the blood.:
The most popular compress for gout is Dimexide. Using a 50% solution in the form of a compress for half an hour helps relieve pain in the joint and relieve inflammation. However, during an exacerbation of gout, Dimexide is not used . But during the period of remission it is used in a course of 10 to 90 days.
Compress with Dimexide
Aspirin and iodine are used to treat and prevent the disease. They relieve inflammation and pain. How to use aspirin and iodine for gout?
You can add freshly squeezed juice from 1 lemon to a solution of 10 ml of iodine and 2 aspirin tablets.
Supplements for gout can be used as part of complex treatment. Dietary supplements based on medicinal plants are used:
Diet No. 6 for gout provides a complete calorie diet with limited animal fats and salt, and reduced protein intake . The diet has an alkalizing effect, so you need to consume liquid in large quantities.
Note. Diet No. 5 is also suitable.
The diet should not contain:
It is important to know. Overeating and fasting are prohibited, so as not to cause an increase in uricemia and not provoke a gout attack. Salt needs to be limited.
You can supplement your diet with dishes from:
Cereal porridges and white bread are allowed in small quantities.
During exacerbations, they eat liquid food: juices, decoctions of vegetables, rose hips, jelly, liquid porridges.
There is no one, most effective medicine for gout that will immediately relieve pain and eliminate changes in the joints. Treatment must be comprehensive, individually selected, and carried out under the strict supervision of a physician. In addition to medications, you must follow a diet. Then the periods of remission will lengthen, and the frequency and intensity of attacks will decrease.
Co-author of the material: Dmitry Ulyanov is an orthopedist-rheumatologist with 22 years of experience, a doctor of the first category. Engaged in the diagnosis, treatment and prevention of all diseases of the joints and connective tissue. He has a diploma in Rheumatology and studied at the Peoples' Friendship University of Russia.
The disease gout has been known to mankind since ancient times. All the main signs of the disease were described by Hippocrates. Previously, this disease was called the disease of kings. After all, problems with joints most often occurred among representatives of the upper class. The reasons are quite obvious: lack of exercise, excessive addiction to alcohol and meat foods. The disease continues to be insidious today. However, various techniques that provide treatment for gout during exacerbation give many patients a chance to improve their condition.
Some people are familiar with the disease from literary works. Others, unfortunately, have experienced it themselves. Gout is a type of arthritis. It has a very specific reason.
The pathology is provoked by excess uric acid, which accumulates in the body as a result of impaired metabolism. This substance forms into microcrystals and settles in the joints. Most often they are deposited in the joints of the foot, big toe, and knee. A distinctive feature of the crystals is their needle-like shape. That is why they dig into the tissues of the joints, causing unbearable pain.
The attack most often begins at night. Severe pain occurs, which in a short time becomes simply unbearable. The joint swells and turns red. Only adequate and timely treatment of gout during exacerbation can reduce the severity of symptoms.
The disease can appear in any person. But according to statistics, most often the pathology is observed in men 40-50 years old. Quite often, gout, which is not treated with adequate methods, leads to the development of kidney stones. Other, no less serious ailments may also arise. That is why it is so important to start the fight against this insidious disease in a timely manner.
Of course, if pain occurs for the first time, be sure to consult a doctor. After all, only with the help of tests can a disease be correctly diagnosed.
If you are sure of the disease, then treatment of gout during an exacerbation at home will be as follows:
Following these recommendations allows you to stop an attack in literally 2-3 days.
The medicinal methods that doctors recommend resorting to in the fight against pathology do not exclude the use of home recipes. Treatment of gout during exacerbation with folk remedies has fully confirmed its effectiveness. After all, over the millennia of the existence of the disease, many excellent methods have been accumulated that can alleviate the patient’s suffering.
Doctors often recommend that patients include various traditional methods in therapy. Their advantage is accessibility, thorough time-testing and the absence of contraindications.
So, what methods can you resort to if you suddenly have an attack?
Doctors and healers recommend the following treatment of gout during exacerbation using traditional methods:
However, you should not rely solely on folk remedies. After all, the disease of kings can only recede with complex therapy. Therefore, treatment of gout during exacerbation must necessarily include medications. But remember that only a specialist should prescribe them.
Most often, therapy in the acute period is based on the following medications:
It should be understood that even without an exacerbation, gout continues to have a destructive effect on the joints. Therefore, you should not abandon therapy as soon as the attack has been stopped. Otherwise, you will soon need treatment for gout again if it worsens.
Medicinal herbs are very popular. They are a powerful tool in the treatment of gout.
The following baths will provide an excellent therapeutic effect:
A course of bath therapy involves 25-30 procedures. If we talk about the duration of one manipulation, then it lasts 30-40 minutes. However, it should be remembered that when the liquid cools, it must be reheated.
This therapy is very popular. Its main goal is to combat the main cause of the disease - an increase in the concentration of uric acid.
However, treatment of gout during an exacerbation in a sanatorium should be prescribed by a doctor. Since such therapy has contraindications. In addition, not all procedures can be prescribed during an attack.
Sanatorium-resort treatment is strictly prohibited for persons diagnosed with:
Most often, therapy is based on two directions:
Certain resorts are recommended for patients. As a rule, these are sanatoriums in which the patient is offered baths containing radon, sodium chloride, sulfides, and nitrogen. Iodine bromide is also useful.
Alkaline mineral waters are recommended for consumption. They help speed up metabolism. Alkali ensures the breakdown of uric acid. Thus, the painful crystals do not increase in size, and new tophi do not form.
The surgical method is used extremely rarely. Surgical treatment of gout during exacerbation may involve joint puncture. During surgery, corticosteroids are injected into the joint.
As a rule, the need for surgical intervention arises if the deposits have grown greatly and have a negative effect on the tissue. In this case, the nodes are removed surgically. If there is significant destruction of cartilage, then the patient is indicated for reconstructive surgery - arthroplasty.
Proper nutrition plays one of the most important roles in the fight against disease. By following a diet, you ensure effective treatment of gout during an exacerbation.
What foods should you avoid first? Doctors advise avoiding the use of:
These foods increase the production of uric acid.
In addition, you should exclude foods that can provoke an exacerbation of the disease:
What foods should people who are prescribed treatment for gout eat during an exacerbation?
The diet is based on the following foods:
People suffering from gout should remember that dietary nutrition is the basis of treatment. The right diet can gradually relieve the patient from painful symptoms. However, be aware that deviating from the diet will lead to new attacks. Therefore, following the diet described above should become the norm for gout.
Gout is a disease caused by metabolic disorders. It develops due to the deposition of uric acid salts in the joints.
This pathology was described by ancient physicians. It was once called the “disease of kings.” This is explained by the fact that gout mostly affected very wealthy people, whose daily diet included large amounts of animal protein (“red meat”), as well as alcoholic beverages.
Currently, gout is diagnosed relatively rarely; it is detected in only 3% of the population. It affects men over 40 years of age to a greater extent.
Representatives of the fair sex usually develop gout during menopause (more often after 55 years), when the synthesis of female sex hormones - estrogens - sharply decreases in their body.
Children and young people almost never get gout. In the rarest cases, the disease can affect a young body if there are congenital disorders of uric acid metabolism.
As a rule, gout is characterized by a chronic, paroxysmal course. During an attack, the patient suffers from pain and limited mobility in the problem joints.
The main factor predisposing to the development of the disease is a persistently high level of uric acid in the patient’s blood. Its derivatives (urates) are deposited in the form of crystals in the joints, as well as in some other organs (in particular, the kidneys), which causes the development of gout. A compound such as sodium urate tends to be deposited in joint tissue, leading to its destruction over time.
A high level of uric acid in gout may be due to its large intake into the body, when even completely healthy kidneys cannot cope with excretion. Another situation is possible when the body receives a normal amount of this compound through nutritional means, but the functional activity of the kidneys is reduced for one reason or another.
Important: the main source of uric acid is food rich in purines, mainly animal meat and fatty fish.
Purine compounds enter the body not only through the diet (with protein foods), but are also synthesized endogenously. During metabolism, they are broken down into uric acid, which is then excreted by the kidneys, i.e., excreted in the urine. When there is an excess of acid, it and its derivatives are deposited in the form of crystals in tissues that are minimally penetrated by blood vessels, such as cartilage and tendons, which leads to the appearance of gout symptoms.
Please note: uric acid is required by the human body in normal quantities. It protects blood vessels by acting as a powerful antioxidant.
Factors predisposing to the development of the disease include:
As a rule, the disease begins with an attack of the so-called. gouty arthritis. Initially, the inflammatory process affects only one joint. Usually the big toe (less often the ankle or knee joint) is affected first. The attack most often begins at night or in the morning. The pain appears suddenly; it has a pressing character and is characterized by high intensity. The affected joint quickly swells, and its projection shows hyperemia of the skin and a local increase in temperature.
Important: in some cases (during severe attacks), a general increase in body temperature (up to 39°) is possible.
The skin often takes on a “glossy” appearance. During the day, the intensity of the pain decreases somewhat, but increases again at night. The total duration of an attack of gouty arthritis can range from 2-3 days to 1-1.5 weeks. As the process progresses, other joints are also affected, the tissue of which undergoes partial destruction over time.
Characteristic clinical signs of gout:
Please note: when the characteristic gouty growths break through, white crystals can be seen. These are deposits of conglomerates of uric acid salts.
The most common complications of the disease develop:
Gouty arthritis results from the body's immune response recognizing crystalline deposits as a foreign object. Inflammation develops as a result of the migration of a large number of leukocytes to the pathological focus.
Urolithiasis is another of the most serious complications of gout. Its outcome is often kidney failure, which in turn can cause death.
It is almost impossible to completely get rid of this chronic pathology. After the first attack, the disease may not make itself felt for up to a year or more, but this does not mean that the disease went away on its own. As it progresses, the intervals between attacks will inevitably become shorter.
Important: if you follow a strict diet and other instructions from your doctor, you can ensure that gout goes into a “dormant state” and attacks will occur relatively rarely.
For gout, treatment is carried out at home. An acute attack is an indication for strict bed rest. It is advisable to keep the limb, the joints of which are affected by the inflammatory process, in an elevated position, placing something soft under them (a rolled up blanket or pillow).
The disease primarily affects small joints, and therefore, increased attention should be paid to improving their mobility. It is recommended to make it a rule to do exercises for your joints every day, while avoiding excessive stress. Patients should take walks in the fresh air more often, preferably outside the city limits, where the air is less polluted. If the joints of the foot are affected, you should stop wearing tight, uncomfortable shoes.
A patient in the acute phase of the disease needs to drink as much as possible (at least 3 liters per day). Drinks with an alkaline reaction - mineral water or milk - are best suited. Water with lemon juice helps. It has been experimentally proven that citric acid dissolves urate deposits.
Important: while consuming a lot of fluid, you need to control daily diuresis (volume of urine output).
It is better to slightly reduce food consumption before the attack stops. Preference should be given to semi-liquid products - porridges and pureed soups.
You can reduce pain by applying an ice pack to the sore joint. Compresses with Dimexide or Vishnevsky's liniment can achieve a good effect.
Of the pharmacological agents, the most effective for stopping an attack or reducing the intensity of pain in gout are NSAIDs - non-steroidal anti-inflammatory drugs. Most often doctors recommend Diclofenac. The solution should be administered intramuscularly, 1 ampoule (3 ml) per day. A course of treatment for gout for 5 days is indicated. It is imperative to maintain a time interval of at least 12 hours between injections.
Other drugs in this pharmacological group include Naproxen, Butadione, Indomethacin and Methindol - they can also be prescribed for gout.
Colchicine is very effective for emergency use. An alkaloid of plant origin prevents the crystallization of urates; it must be administered within the first 12 hours after the onset of a gout attack.
Important: conventional painkillers (Analgin, etc.) are practically ineffective during a gout attack.
In order to quickly reduce the level of uric acid and its metabolites, Febuxostat, Thiopurinol, Allopurinol, Milurit and Hepatocatazal are used. During gout remission, Probenecid may be indicated for treatment. Medications that reduce the level of uric acid in the blood should only be prescribed by an experienced rheumatologist. Self-medication often leads to worsening of the condition!
Important: patients with severe forms of the disease may be given intravenous injections of the enzymatic drug Pegloticase, which is capable of dissolving urate crystals. The drug is administered 2 times a month in a hospital setting, due to the real danger of developing anaphylactic shock. The disadvantage of this drug is its high cost.
To quickly reduce inflammation, in some cases hormonal drugs from the glucocorticoid group are used - Prednisolone, Cortisone, Hydrocortisone. These drugs suppress the immune system, so their use is justified when the expected benefit outweighs the possible risk to the patient.
In order to reduce the frequency of attacks, you need to reconsider your taste preferences and make your diet more balanced. Patients are shown therapeutic diet No. 6, which involves reducing the consumption of meat products, fatty fish, mushrooms, marinades, smoked meats, sorrel, cauliflower, legumes and chocolate and introducing large amounts of milk, cheeses, vegetables, fruits, whole grains and cereals into the diet.
Important: patients with gout can consume no more than 120 grams of animal protein per day!
The elimination of excess uric acid in the urine in people suffering from nicotine addiction and consuming alcoholic beverages proceeds much more slowly, so cigarettes and alcohol (especially beer) will have to be abandoned.
It is also advisable to reduce or completely eliminate the consumption of drinks such as “powdered” (reconstituted) juices with fructose, strong tea, coffee, cocoa and soda with sodium benzoate.
At least once a week you need to arrange “fasting days”, during which you need to adhere to a “mono-diet” with the consumption of one product. Completely hungry days are strictly excluded!
For external use, traditional medicine recommends an ointment based on homemade unsalted butter. Melt the butter over low heat until foam appears and pour the same amount of ethanol into it. The resulting mixture must be set on fire and wait until all the alcohol burns out. The finished product is poured into a clean container and stored in the refrigerator. When the next attack begins, the ointment should be rubbed into the affected joint while being in front of a heat source.
Onion decoction is also considered an effective folk remedy for the treatment of gout. For 3 onions you need to take 1 liter of water and cook over low heat until the onion is completely boiled. The broth should be cooled, strained and taken orally 200 ml 3 times a day before meals. The duration of the course is 2 weeks.
Foot baths with iodine are also useful for gout. Add 3 tsp to 3 liters of warm water. sodium bicarbonate (baking soda) and 9 drops of iodine. Regular procedures with this type of treatment help reduce the volume of salt deposits.
Another recipe for a folk remedy for the treatment of gout: for 5 tablets of acetylsalicylic acid (Aspirin), take 10 ml of a 5% alcohol solution of iodine. After mixing, you should get an absolutely clear liquid, which should be rubbed into sore joints in the evening before bed. After rubbing, you need to put warm mittens or socks on your hands or feet.
Other folk remedies for gout include tincture of lilac flowers, infusion of lingonberry leaves and compresses based on a decoction of fresh spruce or pine needles.
Plisov Vladimir, medical observer
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