Gout: symptoms and treatment, photos, signs of gout
The ancient Greeks called gout "trap for the feet."From the end of the XVII century gout is considered a separate disease.
Gout is mostly male, but now it has overtaken the female half of humanity, and arises in the joints of the hands and feet.
It was a consequence of the fact that people often overeat and abuse alcohol, in the treatment of diseases, many medications, diuretics( diuretics) are used.
Since the withdrawal of uric acid from the body is delayed, it crystallizes and is deposited in the joints, turning into a sodium salt - sodium monourate. Modern physicians consider gout to be a systemic disease that affects the body completely. Signs and treatment of this disease, the first symptoms of gout you will learn from our article.
The disease is divided into two groups, depending on the cause of the onset.
After surgical operations and injuries, the damaged tissue is dehydrated, therefore, salt and uric acid are more localized in this place, they are deposited in the problem joint. With a decrease in body temperature, even by half a degree, the urate begins to turn into crystals in the joints. Gout is often a consequence of overheating in the sauna or steam room, because sweating begins in the bath and the body is drastically dehydrated. Gout is aggravated during trips to hot countries.
Gout is often affected by hypertension because of the frequent use of diuretics. Uric acid accumulates in the blood, creating ideal conditions for the development of gout. Also for reasons include:
The first phase of gout proceeds without symptoms, the level of urates gradually increases in the body, which in the future can lead to gout. This stage lasts a very long time, up to 25 years or more.
The second phase is acute gouty arthritis. The first symptoms of gout in this stage are manifested by pain and swelling near the affected joint, as well as a rise in body temperature.
The clinical picture of gout has pronounced symptoms:
People with gout early onset diabetes mellitus, atherosclerotic plaques are formed in the vessels, since low density lipoproteins are concentrated in the blood. Cholesterol in the blood in patients above the norm( see how to reduce cholesterol).
The diagnosis is based on the frequency of recurrent seizures.
The diagnosis is based on:
Treatment of gout reduces to relief of acute attacks, drug treatment, diet and prevention of repeated exacerbations.
Coping with an acute attack:
Coping with an acute attack is possible with pyrazolone and indole preparations: Reopyrin, Butadion, Phenylbutazone, Ketazone. With increased resistance to drugs, Prednisolone is added to treatment. Take at first 20-30 mg / day, then the dose decreases. At the same time, Butadion and Indocid are taken in small doses. Uric acid is excreted from the body by Allopurinol and a specially selected diet.
For the treatment of gout in the period between attacks at home eliminate hyperuricemia, recurrences of gout attacks, prevent damage to internal organs, restore impaired joint function with the help of complex therapy, including drugs, diet, physical effects and sanatorium-spa treatment.
It is important not to use long-term medication for gout at home under light attacks, and with a dubious diagnosis. The first two days should be used Colchicine( 1 mg / day) or Indomethacin( 75 mg / day.).
Uricostatics inhibit the formation of uric acid, for example, Allopurinol: a daily dose of 100-900 mg, which depends on the degree of hyperuricemia. At a mild degree - 200-300 mg, at an average - 300-400 mg, at a heavy - 600-900 mg / day. For two days you can reduce the level of uric acid by 2-3 times. The drug is used constantly, because it does not have the durability and duration of action. The break is made in the summer for 1-2 months due to the appearance of a variety of plant products in the menu.
With uricosuric agents tubular reabsorption of uric acid compounds is inhibited and production is increased, therefore they are prescribed for renal hyperuricemia. Treat: Etamide, Benzbromarone, Probenecid( BENEMID) and salicylates - 4 g / day. Most often treated with Allamaron, it is convenient in the reception - 1 time per day for 1 table.and has a small number of adverse symptoms.
Dissolve uric acid stones and prevent the formation of new ones - with the drug Uralit( Magurlit, Blemaren).
Usually prescribed for gout diet number 6, which has a full calorie, it limits animal fat and salt, reduced the amount of protein. The diet has many alkaline valences and it provides for increased fluid intake. The energy value of the diet is 3000 kcal. Suitable and diet number 5.
It is forbidden to eat:
It is allowed to eat:
Gout is indicated by the following complications:
Prolonged seizures can result in complete recovery. The prognosis is favorable and depends on the level of hyperuricemia and adequate treatment. People can keep working capacity for many years and the quality of their lives does not suffer.
Prevention is reduced to diet, exclusion of fasting, the use of diuretics, long-term intake of drugs, dissolving urate salts( Uralit), the use of spa treatment.
You can apply compresses to the joints of a mixture of valerian( 3 bottles) and cologne( or vodka) - 200 ml. Compress warmed with a woolen scarf. After an exacerbation the status will improve.
Gout is mostly male, but now it has overtaken the female half of humanity, and arises in the joints of the hands and feet.
It was a consequence of the fact that people often overeat and abuse alcohol, in the treatment of diseases, many medications, diuretics( diuretics) are used.
Since the withdrawal of uric acid from the body is delayed, it crystallizes and is deposited in the joints, turning into a sodium salt - sodium monourate. Modern physicians consider gout to be a systemic disease that affects the body completely. Signs and treatment of this disease, the first symptoms of gout you will learn from our article.
Causes of gout
The disease is divided into two groups, depending on the cause of the onset.
- 1) Primary gout in the vast majority of cases occurs as a consequence of the violation of hormonal and genetic factors, to which improper nutrition and consumption of alcoholic beverages is added.
- 2) The secondary form is a consequence of metabolic disorders, as well as excessive intake of medications. To such medicines carry: Pyrazinamide, Aspirin, Nicotinic acid and various diuretics.
- genetic predisposition of
- men have a higher chance of getting sick, unlike women.
- as a rule, the disease is diagnosed up to 40 years.
- taking medications, especially diuretics
- , alcohol abuse increases the risk of gout, especially for beer.
- excess weight also contributes to hyperuricemia.
After surgical operations and injuries, the damaged tissue is dehydrated, therefore, salt and uric acid are more localized in this place, they are deposited in the problem joint. With a decrease in body temperature, even by half a degree, the urate begins to turn into crystals in the joints. Gout is often a consequence of overheating in the sauna or steam room, because sweating begins in the bath and the body is drastically dehydrated. Gout is aggravated during trips to hot countries.
Gout is often affected by hypertension because of the frequent use of diuretics. Uric acid accumulates in the blood, creating ideal conditions for the development of gout. Also for reasons include:
- metabolic disorders, obesity;
- is a metabolic disorder;
- consumes high-calorie meat, fish food in fried form, abuse of vegetable and animal fats and alcohol;
- hypothermia or overheating of joints and a lot of physical stress on them;
- is a heredity factor.
Signs and symptoms of gout
The first phase of gout proceeds without symptoms, the level of urates gradually increases in the body, which in the future can lead to gout. This stage lasts a very long time, up to 25 years or more.
The second phase is acute gouty arthritis. The first symptoms of gout in this stage are manifested by pain and swelling near the affected joint, as well as a rise in body temperature.
The clinical picture of gout has pronounced symptoms:
- usually exacerbation begins early in the morning, or late at night;
- there is a sharp pain in the joint affected by acid-uric crystals, usually a thumb on the leg;
- there is redness and shine of the skin, together with swelling in the joint and periarticular tissues;
- the temperature rises, touching the joint is very painful;
- general weakness and malaise of the body is also present.
When the chronic stage of gout occurs, many small and large joints are affected with simultaneous development of chronic arthritis.
People with gout early onset diabetes mellitus, atherosclerotic plaques are formed in the vessels, since low density lipoproteins are concentrated in the blood. Cholesterol in the blood in patients above the norm( see how to reduce cholesterol).
Diagnosis of gout
The diagnosis is based on the frequency of recurrent seizures.
The diagnosis is based on:
- 1) Urate monosodium crystals found in the synovial fluid and the absence of microorganisms;
- 2) Confirmed tofus with chemical or polarization microscopy;
- 3) 6-12 signs of gout: X-ray, laboratory, clinical;
- 4) Hyperuricemia, asymmetric inflammation of the joints;
- 5) On the roentgenogram - subcortical cysts without erosion.
Treatment of gout
Treatment of gout reduces to relief of acute attacks, drug treatment, diet and prevention of repeated exacerbations.
Coping with an acute attack:
- prescribe a copious alkaline drink of 2-2.5 liters / day.) And complete rest;
- apply compresses, applying Dimexide in solution - 50% for analgesia and against inflammation;
- arrest the attack with non-steroidal anti-inflammatory drugs: Indomethacin, sodium diclofenac, Naproxen, Pyroxicam;
- relieve pain and inflammation of Nimesil and Colchicine;
Coping with an acute attack is possible with pyrazolone and indole preparations: Reopyrin, Butadion, Phenylbutazone, Ketazone. With increased resistance to drugs, Prednisolone is added to treatment. Take at first 20-30 mg / day, then the dose decreases. At the same time, Butadion and Indocid are taken in small doses. Uric acid is excreted from the body by Allopurinol and a specially selected diet.
Treatment of gout between attacks at home
For the treatment of gout in the period between attacks at home eliminate hyperuricemia, recurrences of gout attacks, prevent damage to internal organs, restore impaired joint function with the help of complex therapy, including drugs, diet, physical effects and sanatorium-spa treatment.
It is important not to use long-term medication for gout at home under light attacks, and with a dubious diagnosis. The first two days should be used Colchicine( 1 mg / day) or Indomethacin( 75 mg / day.).
Before receiving antidotal drugs, establish the type of impaired purine metabolism. It can be metabolic, renal and mixed.
Uricostatics inhibit the formation of uric acid, for example, Allopurinol: a daily dose of 100-900 mg, which depends on the degree of hyperuricemia. At a mild degree - 200-300 mg, at an average - 300-400 mg, at a heavy - 600-900 mg / day. For two days you can reduce the level of uric acid by 2-3 times. The drug is used constantly, because it does not have the durability and duration of action. The break is made in the summer for 1-2 months due to the appearance of a variety of plant products in the menu.
With uricosuric agents tubular reabsorption of uric acid compounds is inhibited and production is increased, therefore they are prescribed for renal hyperuricemia. Treat: Etamide, Benzbromarone, Probenecid( BENEMID) and salicylates - 4 g / day. Most often treated with Allamaron, it is convenient in the reception - 1 time per day for 1 table.and has a small number of adverse symptoms.
Dissolve uric acid stones and prevent the formation of new ones - with the drug Uralit( Magurlit, Blemaren).
Menu for gout: what can you eat?
Usually prescribed for gout diet number 6, which has a full calorie, it limits animal fat and salt, reduced the amount of protein. The diet has many alkaline valences and it provides for increased fluid intake. The energy value of the diet is 3000 kcal. Suitable and diet number 5.
It is forbidden to eat:
- by-products: liver, kidneys, tongue, brains.
- meat of young animals and poultry: veal and chicken.
- with fat varieties of meat and fish, soups and broths from them.
- beans, rich purines: peas, beans, beans, lentils, sorrel and spinach.
It is allowed to eat:
- with meat and fish in boiled form - 2-3 times a week.
- with milk and dairy products.
- with eggs and walnuts.
- with flour and cereal products, white bread( in small quantities).
- vegetables: potatoes, cabbage, zucchini, pumpkin, melons, watermelons.
- fruits: apples, apricots, plums, pears, peaches, oranges.
- berries: grapes, cherries, cherries, strawberries and blueberries.
- before going to bed you need to drink a cup of soft tea, coffee, tea with milk or lemon, juice.
- includes curd, kefir, dairy and fruit-free days.
- on meat days - boiled beef - 150 g or boiled fish - 150 g. You can combine meat and fish and enter that day with vitamin C and B¹.
- during the exacerbation - only liquid food: milk, lactic acid products, kissels, compotes. And also: vegetable and fruit juices, weak tea with milk or lemon, broth of wild rose, vegetable soups, liquid porridges.
Complications of gout
Gout is indicated by the following complications:
- 1) Gouty glomerulosclerosis and urate stones in the kidneys. Nephropathy, gouty nephritis, pyelonephritis develops.
- 2) Violation of kidney function in violation of purine metabolism( gouty kidney).In the presence of arterial hypertension and diabetes mellitus, acute kidney failure develops.
- 3) Gouty arthritis and destructive polyarthritis with joint deformities.
- 4) Osteoporosis( thinning of bone tissue).
- 5) The formation of tophi on the joints or soft tissues: on the wings of the nose, in the auricle, fingers, feet, in the internal organs - the heart, kidneys, etc.
Prophylaxis and prognosis of
Prolonged seizures can result in complete recovery. The prognosis is favorable and depends on the level of hyperuricemia and adequate treatment. People can keep working capacity for many years and the quality of their lives does not suffer.
Prevention is reduced to diet, exclusion of fasting, the use of diuretics, long-term intake of drugs, dissolving urate salts( Uralit), the use of spa treatment.
You can apply compresses to the joints of a mixture of valerian( 3 bottles) and cologne( or vodka) - 200 ml. Compress warmed with a woolen scarf. After an exacerbation the status will improve.