Gout is a disease of cartilage. This disease develops, as a rule, due to impaired metabolism, since the formed s alts of uric acid are deposited in the joints. You will learn more about the etiology, pathogenesis, clinic, diagnosis and treatment of gout later in the article.
Reasons
Any human disease arises from something, and gout is no exception. Most of all, men suffer from it, the female part of the population rarely suffers from this disease and only after the onset of menopause. Among the main reasons for its occurrence:
- Obesity (not just overweight). Excess weight is when the body mass index is more than 30. In people with obesity, uric acid in the body is more than normal, this leads to degeneration of joint tissues and the development of gout.
- Hereditary predisposition. The disease is not inherited, but a predisposition develops. This does not mean that it will manifest itself with a 100% probability, but in the presence of provoking factorssuch a risk is great. Often, gout is provoked by fermentopathy, which is inherited more often through the male line. DNA molecules that have been damaged cause the body to not properly absorb the enzymes.
- Purine bases ingested. If the level of uric acid in the body is higher than normal, and the kidneys cannot completely remove the substance, this leads to its stagnation. It often happens that during normal functioning of the kidneys, they still diagnose a disorder in which they cannot clear the blood of purine metabolites even at their normal concentration.
Gout can also be caused by a sedentary lifestyle, malnutrition, hypertension, kidney failure, diabetes of various types, consumption of large doses of coffee or fat, severe surgical treatment of the joints, severe infectious diseases.
Drinking alcohol
At risk are people who like frequent feasts. A small portion of alcohol is enough, and after a short amount of time there will be severe pain in the joints. Ethyl alcohol reduces the properties of drugs that must be taken constantly for gout, and increases the likelihood of side effects. Also, alcohol retains fluid in the periarticular tissues, increases swelling, and provokes intense pain.
Gout symptoms
The course of gout is characterized by severe attacks. There are long periods of rest between them. Symptoms of gout can be observed only during periods of acuteseizures. The main of them is pain around the joint. It all starts with discomfort, but quickly develops into a sharp pain that does not allow you to move the affected limb. Also, with gout, a severe inflammatory process is observed, in which the affected joint increases in size, and the skin turns red. In the inflammatory process, an increase in body temperature often occurs.
An attack of gout usually lasts about a week, after which there is a period of rest, and all symptoms completely disappear. Its duration ranges from several months to 1-2 years. In chronic gout, the frequency of attacks increases with age, and periods of rest decrease. People with gout are advised to avoid alcohol and fatty foods from their diet, as these foods lead to excess uric acid production.
According to the clinical classification, seven forms of the course of the disease are distinguished:
- classic (typical) attack of acute gouty arthritis,
- subacute,
- pseudophlegmonous,
- polyarthritis of the infectious-allergic type,
- rheumatoid-like,
- polysymptomatic,
- periarthritic.
Diagnosis of gout
When a patient complains of pain in the joints, the doctor first interrogates him to determine what kind of disease he has encountered. You can judge gout if:
- the patient had joint pain more than once, the first symptomsbegin with the small joints of the hands and feet;
- there were cases of gout in the family.
In addition, factors such as bad habits, an abundance of meat food in the diet, drinking insufficient water can also provoke this disease. But for a more accurate definition of the clinic and diagnosis of gout, of course, you will need to undergo an examination, which includes:
- Ultrasound of joints.
- CT (computed tomography).
- X-ray.
- Scintigraphy with technetium pyrophosphate.
Characteristic changes in the joints with gout during ultrasound can be seen only during an exacerbation of the disease. Since with acute pain the joints swell, soft tissues thicken, etc. Already in 5 days it will be almost impossible to detect these changes.
CT is good to use in the late stages of the disease, in this case, high-precision images are obtained, allowing you to examine in detail the deformity of the joints, to accurately determine the localization of changes. In the early stages, it is difficult to detect any signs of the disease using CT, it will only be possible to notice tissue thickening during an exacerbation of the disease.
X-ray also provides little information in the early stages of the disease. It is usually prescribed at the initial stage of the disease when there are other disorders or diseases of the joints. X-rays will also be more useful in the chronic course of the disease.
At the initial stage, the most effective method for diagnosing and analyzing gout is scintigraphy. During the procedure, a special substance is injected into the patient's blood, which, with furtherscanning the body allows you to identify all the existing deposits of urate. This method is good at the initial stage of the disease, as it allows you to identify any articular defects even before the deformity process begins.
Additional Research
In addition, if gout is suspected, the doctor will offer to make a differential diagnosis of gout. The method will help to reveal a more accurate picture of the disease, and will also distinguish it from other similar ailments. To diagnose gout, you will need to pass the following tests:
- General analysis of urine and blood.
- Biochemical analysis of blood and urine.
- Examination of fluid in the joints.
- Research of tophi and their contents.
Each of the methods of laboratory diagnosis of gout has different criteria, but together they will help to get a complete picture of the course of the disease, as well as prescribe adequate and timely treatment.
Medicated treatment
The use of pharmaceutical substances during an exacerbation is most effective. During the period of anti-inflammatory therapy for gouty arthritis, Colchicine is often prescribed. This medication is taken orally or administered intravenously, the dose is set by the doctor. "Colchicine" is especially effective if it is started as soon as the initial signs of the disease appear. A significant improvement in the condition of patients is already observed inthe first twelve hours of taking this medication in 75% of cases. But there may be side effects, for example, in the form of disorders of the gastrointestinal tract.
In addition, other anti-inflammatory drugs are prescribed for exacerbation of gout, including Indomethacin, Phenylbutazone, Naproxen, Etoricoxib and others.
In the event that there are contraindications to taking the above substances, then oral administration or intra-articular administration of glucocorticoids, for example, drugs with triamcinolone hexacetonide, can be effective during exacerbation of gouty arthritis.
Another way is the external use of creams and gels, which include non-steroidal anti-inflammatory substances. The most popular drugs in this group are Diclofenac, Ketoprofen, Nimesulide. During the period of remission of the disease, drugs are prescribed that normalize the concentration of uric acid in the body. These are pharmaceuticals based on benzbromarone, allopurinol. For example, "Avisan" and others. Please consult a doctor before use.
Physiotherapy
As a component of complex treatment, physiotherapy for gout is extremely effective. It improves the condition of cartilage tissues and prevents their decay. Let's analyze the most popular types of physiotherapy, which are usually prescribed in the periods between attacks:
- Electrophoresis is a procedure during which stable electrical impulses act on the body. This gives a local therapeutic result. In addition, electrophoresisenhance the penetration of pharmaceuticals through the skin. For gout, Analgin and Novocain are used for the purpose of pain relief, and zinc, sulfur and lithium are used to stimulate cartilage tissues.
- Mud treatment is considered a common way to improve the condition of patients with gout. This procedure is often prescribed during the period of spa treatment.
- Thermal treatments promote the absorption of uric acid deposits. For this purpose, paraffin and ozocerite applications are made to patients.
- Balneotherapy is one of the most enjoyable types of physiotherapy. The impact on the joints is made during the bathing period. In case of gout, as a rule, a cycle of radon, hydrogen sulfide or sodium chloride baths is prescribed.
- Bishofite is a natural mineral. Magnesium s alt is obtained from it, from which a healing solution is prepared. Compresses with bischofite effectively relieve inflammation and anesthetize the affected area.
Among other things, gout is successfully treated with UVT, sound and magnetotherapy, exercise therapy and massage. Which method will be the most effective is difficult to judge. The treatment regimen, including physiotherapy procedures, is prescribed by the doctor, taking into account the characteristics of each specific case. Most physiotherapy treatments are usually readily available during the course of a spa treatment.
Folk treatment
Traditional medicine for gout can be very effective. The main thing is to consult with your specialist and notrefuse traditional methods of treatment on their own. So, the most effective natural remedies for fighting gout:
- Healing decoction of chamomile flowers is perfect for improving the condition of the limbs. In order to prepare this decoction, you will need flowers (100 g) and water (10 l). After that, you need to add ordinary s alt (200 g) and mix thoroughly. Use the solution when preparing baths for hands and feet affected by gout.
- Ordinary spruce cones are an excellent remedy for the treatment of joints. In order to prepare a decoction, it is necessary to pour unopened cones with seeds (5-6 pieces) with hot water (1.5 tablespoons) and leave to brew overnight. The resulting decoction should be divided into three doses, taken half an hour before a meal. The infusion is drunk until complete recovery.
- Bay leaf is a very unusual and effective remedy. It is necessary to pour 5 grams of bay leaf with water (1.5 tablespoons) and cook in a water bath for five minutes, then cover and let stand for three hours. After this, the decoction should be drunk throughout the day in small portions.
- Boiled rice is another great remedy for joint pain. It is necessary to rinse 2 tablespoons of rice with water until clean water, then pour a 1.5-liter jar and pour water into it, leave overnight. In the morning, take out the rice, rinse, add water and bring to a boil. After it boils it is necessary to rinse it again and bring it to a boil again. Complete the procedure four times in total. After that, it should be eaten without s alt and oil.
Food
Gout is a very unpleasant disease, which is why it is very important to follow the right diet during the treatment period. He althy foods and meals to eat during gout:
- Fruit. They are very important, as they contain many useful substances, special attention should be paid to citrus fruits.
- Vegetables. Actively consume beets, potatoes, cucumbers, tomatoes, onions, carrots.
- Various berries should also be present in the patient's diet.
- It is recommended to use freshly squeezed juices from berries and fruits.
- Sour-milk products (cottage cheese, cheese and milk, kefir, etc.) must be in the diet.
- Seafood like shrimp and squid are very good for gout.
- Flour products and cereals should also be present in the diet, but you should not abuse them too much.
- Nuts are very useful for gout. It is recommended to eat a small handful of pine nuts, almonds, hazelnuts, avocados or pistachios.
- Borscht, pickles, vegetarian soups, beetroot - these liquid dishes cannot be refused, they must be on the menu.
- Greens (dill, cilantro, parsley, etc.).
As for harmful products for gout, these include s alt, any sausages, smoked products, mushrooms, pickles. Spinach, sorrel, cauliflower, radish, celery should be used with caution.
It is also recommended to remove offal from the diet (brains, liver, kidneys, lungs). Doctorsit is advised to give up smoked fish, spicy dishes, exclude cocoa, chocolate, strong tea and coffee from the menu. Alcohol during this illness is generally prohibited, especially wine and beer. All hot spices and sauces are also banned, as they cause irritation and have an extremely negative effect on he alth.
Gout Prevention
For the prevention of gout, it is necessary, firstly, to follow a certain diet. Its main rules are:
- less high-calorie meals, more yogurt, cottage cheese, vegetables and fruits, eat one citrus every day;
- wholemeal bread;
- the amount of water consumed should be at least 2.5 liters per day, so the kidneys will be washed better and the amount of uric acid in the blood will decrease;
- alcohol should be eliminated from your life, as it promotes the crystallization of uric acid;
- minimum s alt intake;
- don't forget about fasting days without meat and fish.
Even if there is no pain and associated symptoms, you should not give up the diet. Secondly, gymnastics, cycling, brisk walking, but without heavy loads, will be a good helper in the prevention of gout. If the pain intensifies, then the sport should be abandoned. It is also necessary to minimize heavy physical work. It is worth paying special attention to your shoes and try to choose the most comfortable one. At home, it is best to walk barefoot. It is recommended to visit specialists twice a year (surgeon, therapist, neuropathologist) and take tests.
In the article weconsidered the features of the classification, clinic, diagnosis and treatment of gout. If we turn to the reviews of people suffering from this disease, we can conclude that it is very difficult to cure the disease, especially if it is already at an advanced stage. First of all, like doctors, in the reviews people are advised to start eating right and moving - this is an effective preventive and therapeutic measure. It is not necessary, according to them, to write off traditional medicine, as well as spa treatment, which, in combination with drug therapy, give good results.
