What are gout symptoms? Gout: types, causes, symptoms, diagnosis, treatment

Gout is a complex disease associated with metabolic disorders that affects internal organs urogenital area, kidneys and leg joints. Pathogenesis: the development of gout is accompanied by the deposition of salts in the joints of the feet uric acid. The accumulation of salts under the skin provokes the formation. In the absence of adequate therapy, gout provokes pathological lesions of internal organs.

Today, gout is rarely diagnosed. In the Russian Federation, approximately 0.1% of citizens make this diagnosis, in Europe – 2%. Men suffer from the disease 4 times more often. This is due to high levels of the hormone estrogen, which protects the female body. Therefore, gout is diagnosed in women after menopause (50-55 years), while in men at 40-45 years. But the disease can also occur at a young age; cases of gout being diagnosed in children have been recorded. What is gout and how it manifests itself and how it looks in the photo, we will consider in the article.

Gout: what kind of disease is it?

What kind of disease is gout and where does it come from? Gout code according to ICD 10 (International Classification of Diseases, 10th revision) M10. Gout is provoked by an increase in the quantitative indicators of uric acid in the blood. Crystallizing, uric acid is deposited in the joints, which provokes a pathological change in their structure and mechanical trauma to the cartilage tissue. And ultimately to partial or complete destruction of the joint.

Interesting!

The disease is characterized by damage to the joints of the knees, hands, feet and elbows. Most often, manifestations of gout are noticeable in the joints of the lower extremities, which is associated with their increased load.

If gout therapy is not carried out, the disease spreads to other joints, and inflammation of the bladder and kidneys occurs. The disease becomes chronic.

There are four stages of gout:

• Initial or asymptomatic;
• Acute gout;
• Intercritical stage or idiopathic gout;
• Chronic stage of the disease.

Provoking factors

There are two causes of gout:

• The body synthesizes an increased amount of uric acid, which is not completely excreted by the kidneys and its salts (urates) settle on the joints;
• Impaired kidney function. In this case, the amount of acid is normal, but it is not excreted from the body.

Gout most often develops in patients:

• Hypertensive patients who are overweight;
• Having genetic determination;
• Those diagnosed with renal failure, diabetes mellitus, chronic diseases Gastrointestinal tract;
• Leading a sedentary lifestyle;
• With metabolic disorders;
• Are undergoing treatment for cancer;
• They abuse alcohol, especially beer.

The relationship between uric acid and gout

The first signs of gout are a violation of metabolic processes in the body. Purines are synthesized by the body and enter it with food. They are subsequently converted into uric acid and excreted by the kidneys. But in a person with gout, hyperuricemia is observed - an excess of quantitative indicators of uric acid. Uric acid crystals accumulate in tissues where there is no blood flow - this makes it easier for them to take hold.

Note!

The cartilage tissue of the joint and tendons are most often affected. In addition to the joints, the disease affects the kidneys. Against the background of the disease appears urolithiasis or renal colic.

However, the etiology of the disease is not only associated with an increase in uric acid levels. Gout occurs due to factors such as Not proper nutrition, obesity, genetic predisposition.

Classification and symptoms

The generally accepted classification of gout in medicine divides the disease into acute and chronic forms. Vivid symptoms of gout of the joints appear during an exacerbation. An acute attack of gout occurs due to consumption of alcohol or fatty foods and is accompanied by:

• Severe gouty joint pain at night or early in the morning. During the day, the joint hurts less with gout, but in the evening the pain intensifies;
• Inflammatory process in the affected joint;
• Hyperemia (redness) of the skin. Possible swelling of the joint and low-grade fever with gout.

Note!

Accompanying symptoms of gout are dyspeptic disorders (nausea, heartburn, lack of appetite), and a possible jump in blood pressure.

The chronic type occurs two to three years after the first exacerbation. If you do not pay attention to the signs and do not treat gout, chronic illness provokes kidney dysfunction, urolithiasis and gouty nephritis.

The following types of disease are distinguished:

• Endemic or molybdenum. This type is found in areas with a high molybdenum content and a lack of copper. These include the Krasnoyarsk Territory, Altai, Siberia and Taimyr;
• Limestone. It occurs against the background of a violation of local blood flow in the distal joints of the hands, as a result of which calcium deposition in the joints begins;
• Rheumatoid. The name is due to the similarity of the causes and treatment of this type of gout with rheumatoid arthritis. A feature of the rheumatoid form is that it affects the joints of the hands, and not the lower extremities, as in the classic form.

It is also customary to divide the disease into primary and secondary. The first variety is hereditary. Secondary gout occurs due to pathologies such as:

• Increased cholesterol levels;
• Metabolic disorders;
• Diabetes;
• Thyroid diseases;
• Kidney dysfunction.

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A secondary form of pathology can develop due to the abuse of strong alcohol or diuretics.

Possible complications

The lack of adequate therapy leads to the formation of gouty nodules, which the doctor uses to diagnose the disease. Tophi are beige nodules that appear on the feet, behind the ears, on the elbows, fingers and toes, on the forehead and nasal septum. They are clearly visible in the photo of gout. If the tophi bursts, milky crystals are visible - these are deposits of uric acid.

Joint pain due to gout and the inflammatory process are caused by the fact that the patient’s body perceives the nodule as a foreign element and begins to fight it. A general blood test reveals an increase in the number of leukocytes.

Interesting!

The disease often occurs in conjunction with diabetes mellitus and urolithiasis.

Diagnostic techniques

After the initial examination, a rheumatologist or arthrologist who knows everything about gout writes out a referral for an X-ray examination of the affected joints, a general and biochemical blood test.

An X-ray image shows the clinical picture of the disease: characteristic “holes” are noticeable around the joints of the feet. A blood biochemistry test shows increased level uric acid. After diagnosing gout, the doctor will select a treatment method.

Sometimes, when donating blood for biochemistry directly at the time of an attack, when the patient goes to the hospital, the analysis does not record an increase in the quantitative indicators of uric acid. This is due to the fact that most of the uric acid enters the affected joint during an attack.

Therefore, to make an accurate diagnosis, uric acid levels should be checked several times, including between attacks. An incorrect diagnosis and lack of adequate treatment can cause complications, both in the joints and in the kidneys.

Therapy

The symptoms and treatment of gout are interrelated. Diagnosing a disease means that the patient should change his diet, lifestyle, and give up bad habits and get used to constantly taking medications. Since it will not be possible to completely get rid of the disease. But with timely detection and treatment, the prognosis is favorable. Attacks can be minimized and complications can be avoided.

The main goal of treatment is monitoring lactic acid levels.

A rheumatologist or arthrologist will tell you how to treat gout. Taking medications is aimed at reducing the amount of uric acid and accelerating its elimination from the body, as well as relieving inflammation and relieving pain. You should not self-medicate. This may lead to the development of complications.

Drug treatment

Drug treatment is aimed at reducing uric acid levels. By normalizing its parameters, it is possible to stop attacks and get rid of pain. For this, the following drugs are prescribed:

• . The tablets reduce the concentration of uric acid, as well as its salts in the blood, lymph, urine, and also stimulate the rapid dissolution of existing urate deposits in the kidneys and joints. The medication is contraindicated in patients with renal failure;
• Uloric (Adenuric, Febuxostat). Within 1 course (three months) of use, it promotes the dissolution of salts in the joints and prevents their re-accumulation. Approved for use by patients with renal impairment;
• Pegloticase. Promotes the breakdown of salt crystals. Used twice a month by those patients for whom traditional medications are ineffective;
• Santuril (Probenecid, Benemid). Stops the entry of uric acid into the kidneys and stimulates its excretion through the ureter. Since the drug does not suppress the synthesis of salts, but only promotes their elimination, it is advisable to use it during the period of remission.

Symptomatic therapy is aimed at stopping attacks, reducing swelling, and reducing pain. For this purpose they prescribe:

• Colchicine (Colchimin, Colchicum). Stops the inflammatory process in joint tissues, prevents crystallization of salts. Indicated as a medicine emergency assistance;
• Glucocogritoids (cortisone, Prednisone, Hydrocartisone). Synthetic steroids. They quickly relieve inflammation, but suppress the immune system, so they are used as a last resort;
• Nonsteroidal anti-inflammatory drugs (Diclofenac, Analgin, Ibuprofen). They stop the inflammatory process, relieve pain, and do not have a depressing effect on the immune system.

Note!

Local ointments will help relieve pain. Butadione ointment relieves pain, reduces swelling, and facilitates joint movement.

Diet

Treatment of the disease is impossible without changing the diet. A diet for gout of the joints involves proper nutrition without fasting. It is beneficial to eat food cooked in a steamer. Prohibited:

• Concentrated broths;
• Caviar;
• Legumes;
• Black tea and coffee;
• Canned food;
• Cabbage;
• Asparagus;
• Spinach and sorrel.

Note!

If you have gout in your joints, you will have to give up spices and sauces.

It is useful to drink more water. This promotes the dissolution and removal of salts. Alkaline mineral water is recommended - Borjomi or Essentuki. It is good to diversify the menu with fruits and vegetables. Watermelons are especially useful.

Sport

Physiotherapy, exercise therapy or home gymnastics will have a positive effect on strengthening the body. The patient is recommended to spend more time outside, walking, cycling, and working out in the pool.

Traditional treatment

Treatment of gout at home is possible as an additional technique as part of complex therapy. Traditional medicine cannot completely eliminate the cause of the disease, but it can completely alleviate the symptoms. To relieve inflammation and reduce pain, the following methods of treating gout using folk remedies are recommended:

• Compresses from chamomile infusion or cabbage leaf decoction;
• Oral intake of tincture of fir cones. They are poured with boiling water and left for 12 hours. Take three times a day half an hour before meals.

Surgical treatment

If conservative treatment methods are ineffective, joint disease continues to progress, it is shown surgery, which involves surgical excision of nodules (tophi) that cause compression of the joint, its deformation and pain.

In most cases, the operation is successful; in rare cases, a secondary infection may occur.

It should be understood that gout is a chronic disease that requires lifestyle changes. Prevention of gout consists of following a diet, moderate exercise, and giving up bad habits.

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.

Gout in different age periods

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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 identified: 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.

Gout in men

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 that there are no 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 treatment. medical assistance 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.

Features of gout in women

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.

Gout: signs and treatment in children 10 years old

Increased levels 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 hereditary predisposition.
The causes of gout in children 10 years of age 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.

Causes of gout development

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.

Relationship between the development of gout and increased uric acid concentrations

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 gout, uric acid enters chemical reactions with calcium, sodium, potassium and other elements, it 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, 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 rate of purine nucleotide synthesis as a factor in the development of gout

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.

Rate of removal of uric acid from the body

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 preventing the excretion of uric acid are partial blocking of the lumen of the ducts due to inflammatory processes or proliferation of connective tissue.

Excessive intake of purines

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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 violation of the functions of their processing or the removal of their breakdown products. And a specific diet is both part of therapy for gout and a method of preventing the occurrence or exacerbations of this disease, especially in the presence of a hereditary predisposition or other provocative conditions for the development of gouty inflammation.

Genetic predisposition as a cause of gout

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 fermentopathy, the body is unable to produce enzymes in sufficient quantity to support the synthesis process 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 included in the general genetic metabolic syndrome, which also causes a tendency to the formation of excess weight, diabetes mellitus, hypertension, hyperlipidemia.

Symptoms of gout, stages of development and forms of the disease

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 he should be the first to contact characteristic features 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.

Stages of gout

The stages of gout are distinguished according to the following indicators:

• clinical picture diseases with manifestations characteristic of individual stages;
• level of uric acid concentration in the blood;
• the presence of solid urates, crystalline formations.

Based on these signs, one of three stages of gout is determined:

• the initial premorbid stage is characterized by hyperuricemia, which is determined by a blood test using a biochemical method. There are no signs of damage to joint tissues and the urinary system, but a general picture of nonspecific symptoms may be observed: a tendency to be overweight, disturbances in the digestive system (frequent constipation, difficulty defecating), itchy skin, etc.;
• intermittent or interval stage, the beginning of the formation of salt crystals in the periarticular tissues, and occasionally in the kidney tissues. This stage is characterized by the onset of pain symptoms, acute inflammation joints, gouty attacks. Acute pain, attacks last from 3 to 7 days, ending with independent remission. The duration and frequency of occurrence depends on several factors. A gout attack can be triggered by poor diet, consumption of alcoholic beverages, dehydration, fasting, hypothermia, acute infectious diseases, surgical interventions and so on;
• The chronic stage of gout is accompanied by alternating attacks and periods of remission. It differs from interval salt in the formation of tophi, compounds of small salt crystals. Depending on the advanced stage of the disease, tophi can be quite significant in size and cause severe pain. This stage is also accompanied by redness of the skin in the area of ​​the affected joint, limitation of its mobility, hyperthermia and inflammation in local tissues. At the stage of chronic gout, urolithiasis often also develops.

Localization and characteristics of pain in gout

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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 medicines, as a rule, are 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.

Forms of gout

From 60 to 80% of patients with gout 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 general condition 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.
Also distinguished following forms gout:

• the subacute form is characterized by less severe symptoms, affecting the area of ​​only one joint, without severe pain, swelling, or nonspecific manifestations of the disease;
• the pseudophlegmonous form differs from the typical clinical picture of a gout attack: there is acute inflammation of the periarticular tissues, high temperature body (39°C and above), significant deterioration in health, chills, general symptoms of intoxication of the body;
• In the rheumatoid-like form of gout, the clinical picture is similar to the symptoms of rheumatological diseases, for example, chronic arthritis. As a rule, with this form, symptoms appear most often in the joints of the fingers and wrists. Gout of this form is characterized by the duration of attacks of exacerbations lasting from several weeks to months;
• a separate form of gout is accompanied by symptoms similar to those of infectious-allergic polyarthritis. In 5% of patients, a clinical picture of migratory polyarthritis is observed, which, when differentiating the diagnosis, is defined as specific gout;
• with asymptomatic gout, a blurred clinical picture of the manifestations of the disease is observed with mild symptoms during exacerbations, moderate pain, slight swelling, and redness of the skin of the tissues of the affected joint.

The above forms are characteristic of the initial stages of gout development,

Articular manifestations of gout

Gouty arthritis, or gout of the joints in its more common name, is manifested by various external symptoms. During 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 gouty arthritis:

• bursitis, tendinitis, tendovaginitis secondary etiology due to the inflammatory process in the soft tissues around the joint;
• limited mobility of the affected joint, mainly manifested during acute attacks, although some patients note this symptom during remission;
• local hyperthermia of the inflamed area, an increase in local temperature by 1-2°C.

Specific articular manifestation of gout late stages The development of the disease is considered to be 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.

Diagnostic methods for gout

Since the main symptom noted by patients suffering from gout is the occurrence of pain 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 analysis blood and urine). 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:

• hyperuricemia, a persistently increased concentration of uric acid in venous blood, determined by biochemical research;
• presence in the body and stage of the process of urate accumulation;
• deposits of these crystals in the area of ​​periarticular tissues;
• the presence of periods of acute inflammatory processes, the degree of joint mobility.

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.

Instrumental methods for diagnosing the disease

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.

Methods of treatment and prevention of gout

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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 stage 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. For hereditary gout with fermentopathy, a deficiency of enzymes for processing purine bases, drug therapy is aimed at symptomatic treatment.

Medicines used for gout

Choice medications in case of gout, the specialist carries out treatment based on data about the form, stage and cause of the disease. Independent attempts to treat gout can lead to a significant deterioration in well-being, rapid progression of the disease, and other health problems.
The first choice medications for gout are anti-gout and anti-inflammatory drugs.
Antigout medicines(uricodepressive and uricosuric) 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 allows to 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.

Nutrition for gout

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 effective treatment gout

Diet No. 6 for 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:

• splitting the total daily diet into 4-6 meals;
• meat, fish, and poultry must be boiled before further processing or serving in order to release the maximum amount of purines. Patients with gout, especially its strong variations, should not eat broth;
• medium portion of meat or fish dish is no more than 150 g with a frequency of use 2-3 times a week;
• should be organized weekly fasting days on fermented milk products, fresh fruit and vegetables;
• It is necessary to maintain a drinking regime, drinking at least 2.5 liters of liquid daily, optimally clean water.

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.

Choosing foods for gout

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 the disease, includes beef liver, legumes of all kinds, sardines, mackerel, 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.
In the group of products suitable for consumption for gout at any time due to low content purine nucleotides are found in milk and dairy products, grains, vegetables, fruits, eggs, nuts, honey, caviar.

Prevention of gout

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 in 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.

In this article we will talk about the “disease of kings,” which was described by the ancient scientist Hippocrates in his scientific medical treatises. Today doctors call this disease gout. We invite you to understand in detail, what kind of disease is this? gout who is at risk of encountering it, and what to do to cure it.

Gout is a joint pathology that occurs due to excessive deposition of urea salts on them. According to medical statistics Few people suffer from gout. Most often these are men and women who have reached 40 years of age.

The main reason why gout appears is a high level of urine acid in the blood. It can accumulate in two cases:

• If completely healthy kidneys stop completely removing uric acid because it is producing too much
• If the kidneys cannot excrete uric acid because an inflammatory process develops in them

Where do high levels of uric acid in the blood come from? The answer is on the surface - from food, which most people consume in unlimited quantities. It's about about unhealthy fatty and salty foods, as well as alcoholic drinks. Due to poor nutrition and a sedentary lifestyle, obesity occurs, which also leads to the destruction of joints or their modification.

People who have undergone cancer chemotherapy may also develop gout. However, it should be noted that the disease develops in cancer patients extremely rarely. Most often, their joints simply collapse, but uric acid has nothing to do with this.

Gout: signs

Gout symptoms very easy to recognize. We list the main ones:

1. A lump appears on the big toe, at its base, which turns red and begins to hurt very much. This is the most important sign that a person has begun to develop gout on legs.

In some people, other joints become inflamed. Those who have ever had an injury may experience gout in the exact area where there was a fracture, bruise or other problem.

1. In places of inflammation on the joints, a person feels very strong gout pain. Moreover, it becomes acute at night and early in the morning, and subsides during the day.
2. In addition to pain, during gout attack the person feels weak, chills and heartburn. He loses his appetite and his blood pressure rises sharply.

If gout is not treated, although doctors are sure that the disease cannot be completely controlled, then it will become chronic, and then every year it makes itself felt, causing a lot of discomfort in a person’s life.

Types of gout

There are four types of gout:

1. Asymptomatic: When external signs A person does not yet have gout, but uric acid accumulates in his blood. This happens during the first 30 years of life.
2. Spicy: when the first symptoms appear, but they are paroxysmal in nature and can be treated:

• If pain occurs in only one joint, this indicates development monoarticular acute gout;
• If the pain has spread to more than one part, it means the person is developing polyarticular acute gout.

1. Intercritical: when a person experiences gout attacks every few years, but they go away and most of the time do not make themselves felt.
2. Chronic: Severe gout in which tophi form on the joints - hard deposits of uric acid crystals on the joints that can even break through the skin and appear as white or yellow nodules.

Diagnosis of gout

If you discover a tumor on your joint, you should immediately contact a rheumatologist to undergo an examination, which includes the following procedures:

• Taking biochemical blood and urine tests to determine uric acid levels
• Puncture of the affected joint to examine synovial fluid
• X-ray of the affected joint

It should be noted that there are many diseases that have symptoms similar to gout. These include:

• Infectious arthritis
• Reactive arthritis
• Rheumatism
• Bursitis
• Arthrosis

Therefore, it is very important to identify gout immediately, so as not to waste time and cure the disease as quickly and effectively as possible.

Gout: treatment

If a person has been diagnosed with gout, this means that he will not only have to take various antibiotics and antispasmodics, but also completely change his usual life and adjust his diet. Doctors warn that to completely get rid of unpleasant symptoms this disease is almost impossible, but thanks to proper treatment, it is quite possible to keep the disease under control.

About How treat gout on legs or on any other part of the body where inflammation of the joint occurred, we will tell you in more detail below.

Drug treatment for gout at home

All pharmaceutical medicines for gout can be divided into two groups:

1. Medicines prescribed for treatment gout in women and men in order to reduce the level of uric acid in the blood:

• Allopurinol(the medicine has many side effects, therefore it should not be taken by people with kidney pathologies).
• Febuxostat – an effective medicine that is produced only in Western countries, so its cost is quite high.
• Pegloticase – is prescribed if gout has become chronic. The drug is available in the form of injections and is administered to the patient intravenously. It dissolves urates that are deposited on the joint.
• Probenecid – prescribed at the stage of remission of the disease. The drug effectively removes uric acid from the blood.

1. Medications that are prescribed for treatment of gout in men and women, to relieve inflammation from the affected joint and relieve pain:

• Colchicine- comes in the form of tablets that need to be taken immediately as soon as a painful gout attack occurs.
• Hydrocortisone or Prednisolone– these are hormones that perfectly relieve the inflammatory process, but have a negative effect on the immune system.
• Analgin, Aspirin or Ibuprofen– excellent painkillers that will quickly alleviate the condition of a person suffering from gout.

Gout: treatment with folk remedies

You can treat gout at home using recipes alternative medicine. Here are a few good recipes that can be used:

• You need to make baths with tincture of chamomile and iodine
• Drink a decoction of fir cones or bay leaves
• Steam rice and eat it without spices or adding oil
• Drink black radish juice or raspberry root tincture
• Apply compresses to the affected area using salt or lard
• Apply self-prepared ointment made from butter and vodka to the affected joints

Gout is very dangerous disease, so treat it exclusively traditional methods not worth it. Trust the professionals who will prescribe comprehensive treatment specifically for you.

Diet for gout

Nutrition for gout must be dietary. The patient should eat at least 4 times a day, but in small portions. In addition, you must drink at least 2 liters of clean water. Doctors recommend excluding these from your regular diet. foods for gout:

• Canned food
• Smoked meats
• Salty food
• Fried foods
• Legumes
• Alcoholic drinks
• Rich broths
• Spices
• Sweets
• Malina
• Figs
• Grape

IN menu for gout should include:

• Steamed dishes
• Stewed and baked foods
• Poultry or rabbit meat
• Seafood
• Cereals
• Vegetables
• Nuts
• Berries
• Compotes
• Fruit drinks
• Fruits
• Low-fat fermented milk products

Gout: photo

Complications of gout

Because of gout, a person can develop diseases that he has never encountered before in his life:

• Gout can destroy a joint, leaving the sufferer permanently disabled.
• Urolithiasis, pyelonephritis and renal failure will develop. This will happen in the background constantly high level uric acid in the blood.
• Problems will arise with the heart muscle and blood vessels, because gout attacks affect blood pressure, breathing and the rhythm of heart contractions.
• Chronic pneumonia. The fact is that uric acid in advanced cases can penetrate into the lungs.

Prevention of gout

If you have already had a gout attack once, then you need to do everything in your power to prevent it from happening again. Here are some simple recommendations on this matter:

• Do not put any weight on the joint affected by tophi.
• Use ice compresses more often
• Don't take aspirin because it may increase uric acid levels in your blood.
• Swim and do morning exercises
• Measure your uric acid levels in your blood daily using a meter
• Watch your weight
• Give up coffee, cigarettes and alcohol forever

To overcome the disease, you need to have patience and will. Coping with gout is not easy, but with this diagnosis, people can live long and happily by following simple recommendations described by us in this article.

Video: “Gout. Disease of Kings"

Content

Three out of a thousand people are susceptible to a disease such as gout. In most cases, pathology begins to develop after the age of 40, and the majority of patients are representatives of the stronger sex. What does this term mean, and how to treat gout at home?

What is gouty arthritis

Gout is chronic disease joints, in which the patient experiences deposition of uric acid salts. This happens due to improper breakdown of proteins during metabolism. Any joints can be affected: feet, knees, fingers, elbows, hands. At risk are people over 40, people with diabetes, hypertension, and poor diet. First you need to understand what gout is and how to treat it correctly, and a rheumatologist is responsible for consulting and prescribing specific types of therapy.

This disease is not only associated with painful sensations joints, but is characterized by many more signs. To understand what gout is and how to treat it, you need to find out what symptoms the pathology manifests. This:

• sharp, intense pain in the joint;
• heat, inflammation, redness of affected areas;
• attacks of pain occur at night;
• joint tingling;
• a noticeable sign showing what gout is in men - a growing bone on the foot next to the big toe;
• the appearance of tophi (nodular seals);
• gradual increase in intensity, frequency and duration of previous signs of the disease;
• over time, pain in the kidneys additionally appears;
• often observed cutting pain in the urinary tract.

To treat gout at home, you need to understand what forms of pathology development exist:

1. Acute form. Actively manifests itself at night. What is typical: headache, severe weakness and elevated temperature bodies. The big toe hurts a lot, redness appears on the skin, the joint is not capable of mobility, its functions are impaired.
2. Subacute. Painful sensations in the big toe, sometimes fluid leaks from the inflamed tissues.
3. Monoarthritis. The inflammatory process can appear on any joint; the patient's condition is similar to fever. Red blood cells settle quickly in tests.
4. Rheumatoid gout (idiopathic). Occurs on the hands and small joints.
5. Gouty arthritis. The disease is chronic, the affected areas of the leg joints become inflamed. Consultation, prescriptions on how to treat gout on the legs at home, and a referral for tests must be obtained from a specialist.

Treatment of gout during exacerbation at home

The acute period often manifests its symptoms at night. Pain, redness, swelling develops very quickly, and the temperature rises. The person feels exhausted, there is severe weakness of the body and limited movements. What causes the symptom to appear:

1. Injuries, excessive stress on the joint (running, long walking, exercise in the gym).
2. Surgical interventions.
3. Taking medications.
4. Drinking alcoholic beverages.

Which therapeutic measures carried out when an acute form of the disease appears:

1. Be sure to prescribe bed rest.
2. The affected limb should be completely at rest and slightly elevated (place a pillow under it).
3. An anti-inflammatory agent is used.
4. Be sure to follow a diet and drink plenty of fluids ( mineral water, decoctions, uzvar).

How to treat gout

The disease, despite the acute symptoms, can be cured. Do you know what gout is and how to treat it depends on the form of the disease. Directions in therapy:

1. Diet and anti-gout therapy. If you like to eat not too much healthy products, that is, there is a high risk of impaired protein breakdown. A special diet No. 6 is prescribed to normalize uric acid compounds.
2. Treatment of acute attacks.
3. Treatment of chronic polyarthritis.
4. Identification and treatment of concomitant diseases.

Having found out what gout is and how to treat it correctly, they use such methods of therapy at home as:

• herbal baths;
• compresses;
• diet No. 6 for the treatment of gout;
• rubbing inflamed areas;
• medications for oral administration - as prescribed by a doctor;
• physical therapy;
• hardware treatment;
• traditional methods.

Medicines

You can treat gout with medications, but only if they were prescribed by a specialist after observing the characteristics of your disease and test results. The dosage required by the patient is prescribed by a rheumatologist. Medicines that can treat gout include:

1. Aspirin, Anturan, Ketazone - to reduce nodules and accelerate the release of uric acid. The latter is administered intravenously or taken orally.
2. Benemid – with long-term treatment, tophi disappear. Prescribed for use throughout the patient's life.
3. Flexin - the use of the drug is limited due to the possible occurrence of side effects.
4. Atofan - for relief when an attack of gout occurs. Reception is recommended in limited doses due to a number of side effects.

Ointment

Local treatment of gout is required to reduce pain. The patient can purchase a finished product or use traditional recipes. What ointments are appropriate to use to treat gout:

1. Butadione is an ointment that provides relief from painful spasms. Additionally, the ointment has a positive effect on joint mobility and relieves swelling. You should immediately test for sensitivity to the drug. Apply a little ointment, then watch for any rash, redness, or other allergy symptoms. It is not recommended to rub the ointment in; it should be applied in a thin layer. Avoid exposure to the sun's rays on the treated areas, but do not cover with a bandage.
2. Ointment with oil. To create the product you need to take butter and alcohol (proportions 1:1). Place the oil on low heat, boil, and skim off any foam that has formed. Pour in alcohol and stir well. Set the mixture on fire so that the alcohol evaporates and after this stage the ointment is ready for use. Apply to the skin to treat gout only after it has cooled.
3. Ointment with laundry soap. Take equal parts of kerosene, grated laundry soap, vegetable oil, water. Stir well and leave for three days. Use the ointment after taking a warm bath.

Folk remedies

To get rid of knee pain forever, plus for prevention purposes, you can use recipes traditional medicine. Whether you are in Moscow or a small town, you should definitely see a good doctor. It is the patient's responsibility to ensure that the signs that have been detected indicate that his gout needs to be treated. Then, in addition to taking pills, using purchased products and creams, as an addition to the main treatment, traditional methods therapy:

1. Grind the calendula flowers into a paste, add 3.5 tablespoons of iodine, a tablespoon of vinegar and stir. The mixture is used to rub painful areas, which must first be smeared with chicken bile.
2. Nettle is a versatile herb and is also suitable for oral use. Nettle juice should be drunk three times a day, a small spoon.
3. It will be useful for women and men to take foot baths, to which decoctions are added: chamomile, lingonberry, oat straw.

Video

What does gout look like - photo