Gout is a disease in which metabolism is disrupted, and uric acid salts (urates) begin to be deposited most often in the joints and kidneys. Previously, rich people suffered from this disease, so gout was called “the disease of kings.” This was due to the fact that people of this particular class ate more animal products and moved less.
Gout mainly affects men over the age of 40, and in women this disease can occur during menopause. Doctors attribute this to the fact that the female hormone estrogen influences and maintains hormonal balance in the body.
Urates are essentially hard crystals that, when deposited in a joint, can cause deformation and partial or complete destruction.
Causes that can cause gout:
Gout can become a primary disease, as well as a secondary one that occurs against the background of prolonged intoxication of the body. In the first case, the kidneys do not have time to remove the amount of urate that is formed in the blood, and in the second, the diseased kidneys do not perform their functions well.
The most common symptom is gouty arthritis, which often occurs in the metatarsophalangeal joint of the foot, but gout can affect any joint. In this case, a characteristic symptom of gout is a sudden, severe shooting pain that appears in the morning or at night.
The appearance of uric acid crystals in the joints is recognized by the immune system as a foreign body and begins to fight it. With an exacerbation of the disease and severe pain, the affected joint may swell, all signs of inflammation develop - swelling, redness develops, the temperature rises, the skin on the joint becomes shiny.
During the day, pain and symptoms of inflammation subside, and at night they return again, sometimes not going away for weeks or months. If treatment is not started and the process is not stopped, complete destruction of the joint may occur.
Complications of gout include destruction of the joint with its deformation, as well as urolithiasis of the kidneys. In this case, so-called “tophi” appear in the area of the affected joints - swelling of a solid consistency, which is an accumulation of uric acid crystals.
In addition to local manifestations, gout may be accompanied by nausea, decreased appetite, and increased blood pressure.
Treatment for gout cannot be started without following a strict diet. The following products are not allowed for consumption:
The goal of the entire diet is to limit protein intake (to 1g per 1 kg of weight) in order to reduce the formation of uric acid in the body. Fats, especially animal fats, should also be excluded from the diet.
The consumption of fresh vegetables and fruits, dietary meat, dairy products, nuts, eggs, low-fat cottage cheese or sour cream is recommended.
In addition to diet, dry heat, rest, and a warm bath are indicated during an exacerbation. During the period of remission, you need to move more, do physical exercises, and engage in physical labor.
Most people, not knowing the difference between arthritis and gout, treat only their manifestations without getting rid of the cause. Both diseases are characterized by joint damage due to metabolic disorders. Such pathologies often become chronic and can lead to disability. Gout is only a type of arthritis that has distinctive signs, causes, development mechanisms and methods of treatment.
It is important to understand the difference between gout and arthritis, because by eliminating only the symptoms of joint damage, it is impossible to achieve a complete cure. This will only lead to an advanced stage of the disease and loss of joint function. Differential analysis with comparison of significant aspects of the disease: etiology, symptoms and treatment will help to distinguish these pathologies and identify inconsistencies.
Arthritis is an inflammatory disease of the joints and occurs due to the following factors:
Gout occurs due to metabolic disorders that cause a sustained increase in uric acid levels in the body, which contributes to the deposition of crystals in the joint tissues. The breakdown product of purines accumulates when kidney function is impaired, when they are unable to remove it from the body. One of the main causes of gout is the consumption of food with purines, which provoke the deposition of urate.
Sometimes metabolic disorders are identified as the cause of arthritis, but the main root cause of the development of such a disease is infection.
The table shows the symptoms of arthritis and gout and their differences:
Treatment of diseases must be comprehensive. To reduce symptoms and relieve inflammation in arthritis, drug therapy is prescribed. To get rid of pain, NSAIDs are prescribed. Physical therapy will also be useful in the initial stages. A rheumatologist selects an individual course of physiotherapy and massage for each patient. If the disease is advanced, a surgical operation is performed - replacing the joint with a prosthesis.
The basis of gout treatment is a balanced diet and constant use of medications to remove uric acid from the body and normalize metabolism. It is difficult to completely recover from gout. The diet should be designed so as not to increase the level of uric acid in the body and not provoke a new attack. Physiotherapy and alternative medicine - acupuncture - help alleviate the condition. Therapy with folk remedies is effective.
Treatment for arthritis includes taking the following medications:
Drug treatment of gout includes the use of the following drugs:
Alternative medicine is used as an alternative treatment. The following remedies will help improve the patient’s condition with arthritis:
The following can help reduce the amount of salts in the body during gout:
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Gout and arthritis are not completely different diseases. They have a similar mechanism of development and manifestation. Arthritis is a collective name for inflammatory joint diseases, and gout is a type of it that occurs when purine metabolism is disrupted. Gout mainly affects the joint of the big toe, and arthritis affects the knee, elbow and other joints.
Gout is a joint disease, the etiology of which is a metabolic disorder, an imbalance in the metabolism of purine compounds and the accumulation of uric acid in the body.
The first scientific description of the symptoms of chronic gout dates back to 1865. Thomas Syndegam, who suffered from this disease for 30 years, wrote a Treatise on Gout, which included descriptions of what gout is, the clinical signs of the chronic stage of the disease and acute attacks of gout.
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Gout affects mostly adults. According to statistics, gout affects 0.1% of the adult population of the planet on average, and in developed countries (Western European region, USA) the number of people suffering from gout is close to 2%. At the same time, experts suggest that the actual morbidity picture differs from the study data, since a full study of statistics is complicated by late diagnosis of patients.
Medical researchers also point out that gout, which until the 20th century was considered a predominantly male disease with rare exceptions, now affects both sexes, although the ratio of male to female patients is still far from uniform: for every 20 cases of this diagnosis in males, one disease is detected in women. The reason for the increase in the diagnosis of female gout is considered to be an improvement in the quality of life of the population, an abundance of food rich in purines, and an increase in alcohol consumption by the population as a whole.
A trend of “rejuvenating” the diagnosis of gout has also been revealed: if previously the disease manifested itself as an acute attack of gout in men 35-45 years old, now the lower limit is 30 years.
The incidence of gout in the male population compared to the female population is explained by two factors: the hereditary nature of some diseases, the predisposition to which is transmitted through the X chromosome, which means the absence of options in men who have only one chromosome of this type; and the development of gout due to unhealthy diet and alcohol consumption, which is more common in men.
A feature of male gout is considered to be late diagnosis due to the tendency of this part of the population to seek medical help at the stage of a developed disease with acute gouty attacks or at the stage of external manifestations of gout in the form of joint deformation and the formation of tophi.
In women, a process accompanied by an increase in uric acid levels and the deposition of urates, salt crystals, in soft tissues is characteristic of the menopause period. During this period, the risk of gout increases significantly, especially in the presence of a hereditary predisposition, so most often female gout is diagnosed between the ages of 50-55 years.
However, the genetic inheritance of gout for women only suggests the likelihood of developing the disease, unlike for men. The gene responsible for the production of enzymes necessary for the metabolism of purine compounds is located on the X chromosome, and women have two such chromosomes. Therefore, when a gene on one chromosome is damaged, its dysfunction is compensated by the intensive work of the intact gene on the other.
If there are two damaged genes in the genome, the likelihood of developing gout in women is the same as in men (almost one hundred percent), and the age of onset of the disease is also significantly reduced.
An increase in the level of uric acid in the body, or hyperuricemia in childhood, is a secondary dysfunction against the background of a primary disease or condition and is not due to a hereditary predisposition.
The causes of gout in children include active cell death, which provokes increased production of purines and is observed with dehydration, starvation, renal failure and other pathologies of kidney function, the presence of malignant tumors, etc.
Also, the etiology of the development of gout in childhood may include a complete or partial absence of hypoxanthine guanine phosphoribosyltransferase, as well as increased activity of phosphoribosyl pyrophosphate synthetase.
A steady increase in the concentration of uric acid in the blood, leading to the formation of salt crystals and their deposition in the soft tissues of the body, is the only cause of the development of gout. The initial stage of hyperuricemia, the accumulation of uric acid, does not lead to the formation and deposition of crystals, but signals metabolic disorders, the first manifestations of the disease.
Several factors can contribute to the increase in uric acid concentration. The main factors are hereditary predisposition, excessive intake of purine compounds into the body with food and liquid, increased catabolism of purines, as well as age-related or dysfunctional slowdown in the process of removing uric acid from the body during urination.
In the process of processing purine bases that enter the body with food or are formed as a result of the breakdown of one’s own cells, uric acid is produced. This compound is filtered by the glomeruli and is normally excreted from the body in urine. If at any stage disturbances occur (increased production of uric acid, insufficient concentration, output), conditions are created for the development of hyperuricemia. It is worth remembering that a diagnosis of “hyperuricemia” does not equate to the presence of gout, since an increased concentration of uric acid can be a sign of other diseases. But hyperuricemia itself can provoke the development of gouty processes.
In case of gout, uric acid, which enters into chemical reactions with calcium, sodium, potassium and other elements, is converted into crystalline compounds or urates. Urates accumulate in tissues of mainly two types of localization: organs of the urinary system (urate stones in the kidneys, in the bladder) and soft tissues of joints, periarticular tissues - urates enter and settle there due to the characteristics of blood flow in these parts of the body.
The breakdown of purine bases, leading to the formation of uric acid, normally has a stable rate determined by the number of enzymes. With an increased amount of purines in the body due to their increased intake from food, significant breakdown of one’s own cells or other pathological processes and interventions, the rate of synthesis increases, forming excess uric acid in the blood, which creates conditions for the development of gout.
This process can be temporary, easily reversible, or it can be long-term due to chronic diseases or constant disruption of a balanced diet. Enhanced synthesis of nucleic acid bases is also provoked by long courses of taking cytostatic drugs, radiotherapy and chemotherapy, hemolysis, and some types of surgical interventions.
Gout as a secondary disease develops against the background of impaired renal function. After being processed and filtered by the kidneys, uric acid normally leaves the body in urine. In chronic kidney disease, the process of removing purine base breakdown products may be disrupted, which leads to an increase in the concentration of uric acid in the blood.
The main factors that prevent the excretion of uric acid are partial blocking of the lumen of the ducts due to inflammatory processes or proliferation of connective tissue.
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Although the excess consumption of foods rich in purines in itself is not the cause of the development of gout, it creates optimal conditions in the presence of a dysfunction in their processing or removal of their breakdown products. And a specific diet is both part of therapy for gout and a method of preventing the occurrence or exacerbation of this disease, especially in the presence of a hereditary predisposition or other provocative conditions for the development of gouty inflammation.
A group of enzymes and proteins that ensure the processing of purines is determined by the presence of certain genes in the human genome. With enzymopathy, the body is not able to produce enzymes in sufficient quantities to support the process of synthesis and processing of various compounds. If there is a deficiency of specific proteins that regulate the processing of purines and the excretion of uric acid, the concentration of toxic compounds in the blood plasma increases, which causes the development of gout. This pathology is hereditary and is transmitted from parents to children.
Often, enzyme deficiency, which is a provocative factor for gout, is part of the general genetic metabolic syndrome, which also causes a tendency to excess weight, diabetes, hypertension, and hyperlipidemia.
As a rule, this disease is characterized by a clear clinical picture, pronounced symptoms and a sequence of changing stages of disease development. However, in some cases, symptomatic manifestations may not be sufficiently pronounced or hidden behind the manifestations of other diseases.
Only a specialist can establish the correct diagnosis, and the first characteristic signs of gout should be the first sign of gout. In the absence of therapy, limited diet, untimely diagnosis, pain attacks become more frequent, inflammation and joint deformation increase, conditions for urolithiasis, systemic damage to the body, significant impairment of health, and disability of the patient develop.
The stages of gout are distinguished according to the following indicators:
Based on these signs, one of three stages of gout is determined:
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The intermittent and chronic stages are accompanied by acute pain attacks. Most often, the pain begins in the evening and at night, and localization can spread from the affected joint to the entire limb. Solid urates and crystals accumulating in soft tissues injure joints and cartilaginous joints, causing acute pain, to which is added pain from the inflammatory process in the periarticular bursa.
Painkillers are usually ineffective during an attack. The pain intensifies even with slight pressure on the joint area.
Most often, the joints at the base of the big toes and the first metatarsophalangeal joint are affected, which is due to the peculiarities of the blood supply to this area. This localization of urate is observed in more than 50% of patients suffering from gout. The joints of the phalanges of the fingers, wrists, elbows, ankles, knees, hips and others may also be affected.
From 60 to 80% of gout patients suffer from classic acute attacks with severe clinical symptoms. Against the background of remission of a chronic disease, severe pain begins, after the attack ends, a period of remission begins again.
The duration of attacks depends on the general condition of the patient, types of therapy and stage of the disease. In addition to acute pain in the area of the affected joint, there may be a general deterioration in health, weakness, headache, low-grade hyperthermia, swelling, redness, and then cyanosis of the skin around the joint/joints.
The following forms of gout are also distinguished:
The above forms are characteristic of the initial stages of gout development,
Gouty arthritis, or gout of the joints in its more common name, is manifested by various external symptoms. In an acute attack of the disease, there is hyperemia, redness of the skin around the inflamed joint, which intensifies as the pain increases due to the peculiarities of the blood circulation of the inflamed joint.
There are other symptoms of gouty arthritis:
A specific articular manifestation of gout in the later stages of the disease is the formation of tophi, subcutaneous and intradermal formations consisting of solid crystalline compounds of uric acid. The average time for the formation of tophi is from 3 to 5 years after the onset of gout progression, however, in some cases, accelerated formation of solid inclusions is observed.
The development of the disease leads to an increase in tophi in size, up to several centimeters in diameter. Circulatory disorders caused by crystalline neoplasms can provoke the appearance of fistulas with the release of a thick white mass or powder from the hole.
The most common localization of tophi is the ankle, elbow, knee, phalangeal and metatarsophalangeal joints, as well as the ears and brow ridges. With gout of the fingers and other joints that are not among the most common sites of injury, the formation of tophi can progress faster and the onset of the process starts earlier than the average period of deposition of salt crystals.
Since the main symptom noted by patients suffering from gout is the occurrence of painful sensations in joints of various locations, this fact can significantly complicate diagnostic measures due to the need to differentiate gout from a variety of rheumatological diseases, consequences of injuries and other joint pathologies.
To accurately diagnose the disease, the specialist relies on the data collected from the anamnesis, as well as on paraclinical studies and tests carried out in this case (biochemical, general blood and urine tests). The timing and accuracy of diagnosis also depend on the severity of symptoms, the degree of development of the disease, general well-being, health of the patient, and the presence of concomitant dysfunctions and abnormalities. Urinalysis alone by any method is ineffective, since its indicators largely correlate with the presence or absence of diseases of the urinary system.
Using additional tests to diagnose gout, the presence of the following manifestations is checked:
As the disease progresses, renal dysfunction and the occurrence of urolithiasis are noted with high frequency, therefore, when diagnosing gout, regular checks of the condition and functioning of this organ are necessary.
The etiology of painful manifestations in articular and periarticular tissues is subject to examination using diagnostic equipment. The affected joints are examined using ultrasound, computed tomography, radiography, as well as scintigraphic examination using intravenously administered technetium pyrophosphate. The latter method is effective both in late and early stages of the disease.
At the initial stage of gout, other, most common instrumental examination techniques are not entirely informative, since in case of gout in the primary stage of the disease, destructive signs of damage to the articular and periarticular tissues are still insignificant and cannot be detected by most instrumental diagnostic methods. However, their use makes it possible to accurately differentiate the development of gouty arthritis from other types of rheumatic diseases.
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The process of breakdown of purine bases supplied or produced by the body is quite complex and has several stages. Violations of each of the stages lead to the accumulation of uric acid; depending on the type of violation, rapid or gradual development of gout is observed. Severe symptoms appear only during an acute attack of the disease, so until the onset of the disease, the patient may not be aware of dysfunctions, disorders and the onset of the disease.
The etiology of gout determines the principles of therapy. Gout of secondary etiology, caused by the presence of other diseases and abnormalities, can be treated only if the original source of the disorder is eliminated. In hereditary gout with fermentopathy, a deficiency of enzymes for processing purine bases, drug therapy is aimed at symptomatic treatment.
The specialist selects medications for gout based on information about the form, stage and cause of the disease. Independent attempts to treat gout can lead to a significant deterioration in health, rapid progression of the disease, and other health problems.
The first choice medications for gout are anti-gout and anti-inflammatory drugs.
Antigout drugs (uricodepressants and uricosurics) are aimed at accelerating specific metabolism, the processing of purines, as well as the production and removal of breakdown products of purine bases. In some cases, as prescribed by a specialist, mixed-action medications are also used, for example, colchicine injections at the onset of an acute gouty attack.
Both in acute periods and during remission, it is advisable to use anti-inflammatory drugs, systemically or locally in the form of compresses and applications. Among the most commonly used anti-inflammatory medications for gout are the group of non-steroidal drugs (Indamethacin, Butadione and others) and glucocorticoids (mainly Prednisolone). The use of these drugs can reduce inflammatory manifestations, pain, and swelling of tissues at the site of the lesion.
Depending on the form and stage of gout, physiotherapeutic agents may be prescribed: UV irradiation, electrophoresis, heating with paraffin, ozokerite, and so on.
Dietary principles of nutrition for gout are so effective in the case of the primary etiology of the disease that they also serve as a method for diagnosing gout. A biochemical blood test to determine the concentration of uric acid is carried out initially when the patient consults a specialist and after a week of strictly following nutritional rules. With gout of primary etiology, the level of uric acid in such cases decreases, which makes it possible to more accurately diagnose the cause of the disease and develop tactics for effective treatment of gout.
Dietary nutrition according to Pivsner, with minor variations depending on individual characteristics, is prescribed to everyone suffering from gout. By adhering to this diet, you can effectively influence the metabolism of purines and reduce the level of uric acid, thereby preventing the formation of salt deposits in the periarticular and other tissues. With a properly formulated diet, patients with gout of primary etiology experience long periods of remission up to clinical recovery in the early stages of the disease. Frequent exacerbations of primary gout are usually a sign of a diet violation, consumption of foods from the non-recommended list, non-compliance with drinking rules, caloric intake, and the inclusion of alcoholic beverages.
The presence of frequent exacerbations when following diet No. 6 and the doctor’s recommendations indicates the addition of other factors that provoke gout attacks, or an incorrect diagnosis of the cause of gouty changes.
The basic rules of diet No. 6 include:
In case of exacerbations of gout, they switch to diet No. 6e, which excludes all products of animal origin, with the exception of the fermented milk group. The diet includes vegetable soups, porridges, compotes, fruit drinks, jelly, and juices. This diet must be maintained until remission occurs.
To facilitate the choice of food products for patients suffering from gout, the specialist will recommend using a list that divides the main foods into groups with high, medium and low content of purine bases.
The first group with a high purine content, which is categorically not recommended during any period of illness, includes beef liver, legumes of all types, sardines, mackerel, and shrimp.
The second group with an average level of purines includes all types of meat, poultry, fish, and crustaceans (with the exception of shrimp). When choosing meat, it is recommended to give preference to adult animals, since the concentration of purine bases in young meat is much higher.
The group of products suitable for consumption during gout at any time due to the low content of purine nucleotides includes milk and dairy products, grains, vegetables, fruits, eggs, nuts, honey, and caviar.
Prevention of gout is especially important for people who have a hereditary or individual predisposition to the occurrence and development of this disease. Primary gout occurs against the background of an increase in the concentration of purine bases, so compliance with restrictions on the consumption of certain foods not only serves as a basis for preventing frequent exacerbations, but is also recommended for people predisposed to gout who do not have signs of the disease.
A healthy lifestyle and regular preventive visits to specialists are also measures to prevent and combat gout. Risk factors for the development of gout include regular fasting, including for health purposes, rapid weight loss, leading to an increase in the breakdown of one’s own tissues, taking certain groups of drugs (cytostatics, diuretics, both in tablet form and in the form of teas, herbal remedies etc.), abuse of alcohol, foods and liquids with a diuretic effect, causing dehydration, non-compliance with the drinking regime, injuries, stress, acute infectious diseases, etc.
If you have a diagnosis of gout, all preventive measures will help reduce the frequency of exacerbations, slow down or stop the development of the disease, and restore health.
Gout is one of those diseases that is not life-threatening, but at the same time causes a lot of inconvenience to a person. Ancient Greek healers called this disease “imperial disease.” This is explained by the fact that gout most often manifested itself in representatives of high society who did not observe the limit in food and alcohol-containing drinks.
Nowadays, this metabolic disorder, due to which salts are deposited in the movable joints of the bones, is not very common.
According to data provided by WHO, three out of a thousand people suffer from this disease. That is, arthritis can be classified as a rare disease, which most often manifests itself in men after forty or forty-five years. Women after menopause are also susceptible to it.
Gout harms all joints. However, it quite often develops into a chronic disease. Therefore, you need to avoid this disease, which can cause a lot of inconvenience to a person. Well, in order to protect yourself from gout, you need to know about the causes of this disease.
The main culprit in the occurrence of this disease is the high level of trioxypurine, which is contained in the blood. It is because of the increased concentration of this acid in the blood that salts are deposited in the joints. These urate crystals cause irreparable damage to human joints. Moreover, salt can completely destroy the junction of the ends of the bones, which leads to serious consequences.
There are several reasons for the development of the disease.
As you can see, in both cases the amount of this acid in the body is related to the functioning of the kidneys. Therefore, people who have kidney problems should not delay treatment of these organs in order to avoid the occurrence of gout.
Representatives of the World Health Organization claim that in recent years the number of patients with arthritis has increased rapidly. This is explained by the fact that people now abuse meat, fatty foods and alcohol. Therefore, the risk of this unpleasant disease is one of the negative consequences of increasing the standard of living of people in developed countries.
Arthritis, or the tendency to develop arthritis, is one of those diseases that has fairly obvious symptoms. During this disease, inflammation occurs in the joints of the big toes or knees. The ankle joints may also become inflamed.
Most often, attacks that cause inflammation occur in the morning or in the middle of the night. A person’s joints suddenly begin to ache, and the affected area quickly becomes swollen and red. All this can cause an increase in temperature, so the patient can take an antipyretic or pain reliever.
After an overnight attack, the pain decreases. During the day, the joints may not bother the patient at all. However, closer to night the pain noticeably intensifies. Typically, such attacks occur over several days. Sometimes the duration of an attack can be more than a week, which causes a lot of inconvenience to a person.
Symptoms of this disease can be not only internal, but also external. Typically, patients develop growths on the fingers of the extremities. This means that the level of uric acid in the cells has increased. Such growths can hurt and even burst. That is, the disease prevents you from leading a normal lifestyle.
Like many other diseases, gout has flare-ups. The main complication of the disease is the development of gouty arthritis. There is also a possibility of kidney stones.
It is worth noting that urolithiasis in this disorder can cause the development of renal failure, which, in turn, can lead to the death of the patient. Therefore, if you have gout and feel pain in your kidneys, then immediately go to the doctor.
People who suffer from this disease need to understand that attacks of this disease almost never go away instantly. And even if you follow all the doctors’ recommendations, you will not be able to instantly get rid of acute pain. However, this will significantly reduce the duration of the attack.
To reduce the time you suffer from gout, stay in bed. This is especially true if you have inflamed joints in your legs. It is advisable to place a pillow under the sore limbs so that they are on a hill.
In order to reduce unbearable pain in the joints, ice can be applied to the affected area. You can also use compresses with the well-known Vishnevsky ointment. Such compresses will reduce the duration of acute attacks of gout. Therefore, you should not neglect them.
Many doctors recommend following a diet. This can help the body overcome gout. It is recommended to limit your diet to liquid cereals and vegetable broths without meat.
As for the drinking regime, here doctors agree that it is necessary to increase the amount of consumption of alkaline drinks. First of all, we are talking about milk, jelly, oat broth and ordinary water with lemon juice. At the same time, you need to drink quite a lot. All this will reduce the exacerbation of the disease.
The main treatment is prescribed by the doctor, who will also tell you what diet the patient should follow. In parallel with traditional treatment, you can also consult about the use of traditional medicine.
In order to rid the body of excess uric acid, you can use healing infusions and decoctions. It is also good to include eggplants in your diet.
If joint pain occurs, you can use various rubs, apply poultices and lotions to them
In order to protect your body from the appearance of such an unpleasant disease as gout, a person needs to reconsider his lifestyle. This is especially true for those people who have had injuries to their extremities, since gout primarily appears in such places.
Therefore, if you have broken your arms or legs, then pay close attention to the places where there were fractures. This will reduce the risk of developing the disease.
You should not wear uncomfortable shoes that restrict your feet. The fact is that such shoes can harm the big toe, which is so susceptible to gout. You also need to watch your diet and not abuse alcohol. A lot depends on this moment, so you need to pay special attention to it and gout will not be scary. And earlier there was an article about worms and prevention.
A dental fistula on the gum, also called a gingival fistula, is the result of a focus of inflammation affecting the upper part of the tooth root. Visually it is noticeable, it looks like an inflammatory-purulent formation in the form of a hole or a dark sac on the gum.
In fact, a fistula in the mouth is a canal passing through the gum cavity, which connects the infected lesion with the surface of the muscle tissue covering the tooth roots. With the help of this tubular cavity, purulent exudate and fluid accumulated in the area of inflammation are removed. A fistula opening cannot appear on its own - it is a complication of other diseases of the oral cavity, one of which is often chronic periodontitis.
A fistula on the gum appears for a single reason - the development of an inflammatory process in the root zone of the tooth, which led to an abscess. The accumulated pus and blood in the infected area form a channel through which the masses are brought to the surface of the gums through the outlet.
An inflammatory-purulent condition in the gums can be caused by the following reasons:
The impetus for the appearance of a fistula can be a number of reasons:
An example of a fistula on the upper gum.
It is worth noting that not only a single fistula, but also multiple holes may appear on the gum.
A carious tooth lesion in an advanced form, which was not treated in a timely manner, is the most common and primary cause of a fistula on the gum. When caries occurs, rotting of hard dental tissues occurs, as a result of which the tooth is destroyed by carious bacteria from the inside, forming a cavity.
In turn, advanced caries provokes a complication - the development of pulpitis with the formation of an infectious focus directly in the pulp. The abscess affects the core of the tooth with blood vessels and nerve processes, which gradually die. An infected pulp is a source of infection. As the lesion grows, the jaw bone tissue and gums suffer.
If therapeutic measures are not taken at this stage, progressive pulpitis affects the apex of the tooth root and leads to the formation of a purulent abscess in this part - periodontitis. Next, a channel is formed for the removal of purulent exudate and a fistula opening on the gum.
The chain of processes is interconnected, develops sequentially and is associated with characteristic symptoms, which increase as the disease progresses:
Then a fistula forms on the gum, the above symptoms disappear. This is due to the release of purulent masses through the fistula opening onto the surface of the gums. The pain syndrome renews upon palpation and during eating.
Considering the consequences that caries leads to, it is very important to start treatment in a timely manner. The dentist will tell you what to do.
According to statistics, the causal relationship between poor quality dental treatment and the appearance of a fistula on the gums accounts for about 65%. As a rule, root canals are filled in case of pulpitis, periodontitis and before putting on a crown.
The main mistake of the procedure is filling at an insufficient depth, which leaves voids in the area of the apex of the tooth root. Such unfilled space is a favorable place for the life of bacteria and the formation of an infectious focus. The affected area tends to grow, affecting areas outside the tooth, and the suppuration is eventually localized at the apex of the tooth root. The fistula opening with suppuration is located on the gum, next to the projection of the root of the diseased tooth.
In this case, touching or biting the causative tooth may not cause pain in a person, or the syndrome may not be pronounced.
The cyst visually resembles a bubble with purulent contents, which is located at the top of the tooth root. As a rule, the appearance of this formation is not associated with specific symptoms, so a person does not feel pain or discomfort. Therefore, it often goes unnoticed, and only when favorable conditions occur (low immunity) does it become inflamed. The process is accompanied by an abscess, the formation of a channel for the removal of purulent masses and a fistula on the gum.
At this stage, the main symptoms are characterized by the following:
The formation of granuloma is associated with periodontitis, visually resembles a cyst, but has a different morphological structure. With granuloma, pus and fluid accumulate in the soft tissue surrounding the tooth.
In the absence of treatment, granulation tissues grow, granulating periodontitis forms, and, accordingly, nearby healthy cells are destroyed. The result of this condition is a formed fistula on the gum.
A perforation is a non-physiological hole formed due to a mistake made by a dentist during manipulations related to root canal cleaning. If you do not immediately apply a special filling to the perforation area, then suppuration begins in it, and the situation can end in extensive inflammation. Such circumstances lead to the occurrence of a fistula.
A fistula can appear as a result of delayed, complicated eruption of wisdom teeth. The condition is accompanied by inflammation, swelling, and an increase in the size of the gums. Because of this, nearby tissues are subject to constant injury, which provokes an inflammatory process, infection, accumulation of pus, and the formation of a canal and fistula.
Upper and lower wisdom teeth can present many surprises.
If, upon examination of the oral cavity, an open fistulous tract from the gums was discovered, this indicates a formed fistula. This canal is the connecting link between the abscess and the oral cavity.
The appearance of a fistula is accompanied by characteristic symptoms:
All symptoms are aggravated while the fistula is in the maturation stage. As soon as the suppuration begins to come to the surface, there is a tendency for the throbbing pain to decrease.
A fistula on a tooth is detected by visual examination. To assess the state of the process, understand to what depth the lesion has reached, and determine the intensity of the disease, the doctor prescribes an x-ray examination.
To cure a fistula, it is necessary to begin treatment of the specific cause that gave rise to its appearance.
The strategy for treating a fistula on the gum depends on the severity of the condition and follows the following plan:
A fistula on the gum has simple treatment at the very beginning of its development. The more advanced the case, the more difficult it will be to heal.
The rehabilitation course includes:
For preventive purposes, it is recommended to use professional pastes and gels. In addition, they speed up the healing process of the fistula.
Folk remedies are aimed at alleviating the condition and accelerating the healing of the fistula. These methods are not a replacement for traditional treatment, they can be used after proper medical care has been provided.
Recipes prevent the spread of infection and help remove inflammation:
To avoid serious complications, and especially surgical intervention, you need to consult a dentist as soon as possible when you identify the first signs of a fistula. Only he will tell you exactly how to cure the problem in your case. Self-medication and delaying a visit to the doctor can cause tooth loss.