In the article, we will consider the causes and treatment of gout.
This pathology is also called the disease of kings and is associated with the appearance of bumps in the area of the thumb on the lower extremities. Unfortunately, the lesion tends to gradually spread to other joints, and even internal organs.
To avoid its development, you should study the causes of gout and the risk factors that can lead to it, as well as knowledge of what preventive measures can be taken to minimize the likelihood of future disability.
Reasons
Gout occurs as a result of the deposition of uric acid in the form of crystals in the cartilaginous articular tissues. The accumulation of these formations provokes an inflammatory process, which is characterized by a pronounced pain syndrome. Sodium urate is converted into crystals and deposited in the joint tissues, eventually leading to the destruction of the joint.
This is the main cause of gout.
Risk factors
There are also a number of factors that can trigger gout:
- Uncontrolled use of certain medications such as diuretics, acetylsalicylic acid, cyclosporins, etc.
- The cause of gout on the legs in men is the presence of a history of pathologies such as coronary heart disease, diabetes mellitus, overweight, etc.
- Wrong diet with a predominance of fatty meat, alcohol and carbonated drinks, seafood. Such a diet can lead to the accumulation of uric acid in the body.
Pathology affects mainly males aged 30-50.
The causes of gout in men should be identified by a doctor.
Pathology is characterized by seizures that can occur against the background of a stressful situation, alcohol abuse, citrus fruits, as well as as a result of viral infections, psycho-emotional or physical overload and long-term use of certain drugs.
We have considered the causes of gout, then we will move on to the symptoms.
Symptoms
Gout manifests itself in a specific way, inherent only in this pathology. The first signs of the disease appear on the big toes and can be either unilateral or bilateral. It is this joint that becomes the first harbinger of the beginning pathological process. This type of gout, like gouty arthritis, occurs latently until it is provoked.attack. It can be triggered by wearing tight shoes, overeating, or drinking too much alcohol.
There are a number of characteristic symptoms of foot disease or gout during an exacerbation:
- Pain syndrome. It occurs suddenly at night and is localized in a specific joint. The pain is of a very intense nature, when even patients with increased endurance emphasize the abnormal severity of this symptom. The foot is practically immobilized, while painkillers do not produce the desired effect.
- Inflammatory process. The joint affected by gout swells, hyperemia occurs. Quite often there is an increase in temperature to an indicator of 39-40 degrees. The aggravated period can last up to four days. Further, the symptoms go away on their own, even in the absence of treatment. This is due to the fact that phagocytes come into opposition to the inflammatory process. Relief of the condition will not mark recovery and the attack will recur, perhaps even after a few years. From the joints of the big toes, the pathology spreads to the phalanges of the fingers, ankle, knee, wrist joint, etc. When the exacerbation passes, inflammation and limited mobility of the affected joints remain.
Signs at an advanced stage
When gout enters an advanced stage, it is characterized by the following symptoms:
- Tophi. They are painless growths under the skin, resulting from the accumulationurate crystals. Tophi are usually localized on the elbows, behind the ears and on the skin around the affected joint. The formations are opened on their own, releasing a white curdled mass from the wound. Most often, tophi appear 5-6 years after the onset of the pathological process and the first gouty attack.
- Deformation of the joints. The accumulation of crystallized uric acid causes a significant limitation of the mobility of the affected joint and its progressive deformity. With a long course of gout, it becomes impossible to move without aids.
- Pathological process in the kidneys. These organs, performing cleansing functions, accumulate urates in themselves, while not producing a full excretion of these substances in the urine. Over time, this process provokes the formation of stones and sand in the kidneys.
The causes of gout symptoms are of interest to many.
Diagnostic measures
A specialist who diagnoses and treats gouty manifestations is called a rheumatologist. Diagnosis is based on the following examination methods:
- Collecting anamnesis and patient complaints.
- Physical examination showing inflamed joints and tophi.
- A blood test for biochemical composition, which helps to detect an increased amount of uric acid.
- X-ray examination. It will show the affected areas of the surface of the joints, as well as tophi, localized inside the articular bag. With a more severe course of the disease, an x-ray can reveal a symptompunch as the tophus grows into the bone structure.
- Puncture of the affected joint. In the presence of pathology, this study will show needle-shaped urates, the absence of an infectious agent and an increased content of leukocytes in case of an exacerbation.
- Tophi puncture. Helps to determine the composition of formations.
Differential Diagnosis
Although gout has specific characteristics, differential diagnosis is also important. A number of diseases are distinguished, for which a similar course is characteristic, as in the case of gout. These pathologies include:
- Septic type arthritis. This pathological condition occurs against the background of an infection of a general or dermatological type, as well as due to trauma or microtrauma of the periarticular tissues. Arthritis of the septic type is always accompanied by a significant increase in temperature. Diagnosis is carried out by puncture of the joint. The conclusion is made on the basis of the color of the received liquid.
- Pyrophosphate type arthropathy.
- Reactive arthritis. Pathology occurs as a result of damage to the body by an infectious pathogen. The disease is diagnosed and treated jointly by an infectious disease specialist and a rheumatologist.
- Rheumatoid-type arthritis. An autoimmune disease of unknown origin, occurring in a chronic form. Females are affected, which distinguishes rheumatoid arthritis from gout.
- Osteoarthritis. Quite often it plays the roleconcomitant gout disease.
- Arthritis of the psoriatic type. It is an inflammatory process that occurs along with dermatological pathology in the form of psoriasis.
The causes and treatment of gout are interrelated.
Treatment
The basis of therapeutic procedures in the treatment of gout is the elimination of pain. It is important for patients to remember the basic principles of pain relief during an attack:
- Ensuring rest of the affected limb.
- Applying a cold compress to the area of pain. It could be ice, a wet towel, or a bottle of water from the fridge.
Non-steroidal anti-inflammatory drugs such as Diclofenac, Voltaren, Naproxen, etc. The drugs can be used both in the form of tablets for oral administration and in the form of injections. Since injections can provoke an increase in pressure in the arteries, it is recommended to give injections in the morning during the treatment of the feet.
If treatment fails?
There are cases when the pain does not subside even while taking painkillers. In such a situation, intra-articular injections of steroid agents are indicated, as well as the introduction of "Colchicine" intravenously. Only a qualified specialist is able to prescribe the right treatment for gout, which will help achieve remission for a long time.
But for this it is important to correctly establish the cause of gout on the legs.
To avoid frequent relapses andrapid progression of the pathology, experts prescribe the following drugs:
- Nonsteroidal anti-inflammatory drugs.
- Corticosteroid drugs.
- Colchicine.
- Vitamins C and R.
- Orotic acid, Allopurinol and other uricodepressants.
- "Ketazon", "Benzbromanol", "Probenecid" and other drugs from the group of uricosuretics.
Physiotherapy
Physiotherapy treatments are also used to treat gout. However, they cannot be used during an exacerbation of the pathology. The main methods of physiotherapy for gout are UHF, healing mud, magnetotherapy, electrophoresis and paraffin applications.
The treatment regimen, including the duration of the medication and their dosage, should be determined by a specialist. The patient must be prepared for long courses of therapy, which can reach one year or more.
Surgical intervention is prescribed in case of significant deformity of the joint, which practically loses mobility.
We continue to consider the symptoms, causes and treatment of gout (in the photo you can see what a diseased joint looks like with this pathology).
Food
Special attention in the treatment of gout is given to proper nutrition. During the period of remission, it is recommended to use a special dietary table. It involves minimizing the amount of fat consumed. Basic Principlesnutrition for gout are:
- Soups should be predominantly vegetarian.
- The amount of meat is strictly limited, while the choice is made in favor of poultry.
- Lean fish no more than three times a week.
- Switching off milk in favor of fermented milk products.
- You can use cereals and pasta for garnish.
- No restriction on bread consumption.
It is allowed to eat any vegetables and fruits, except for spinach, cauliflower and raspberries. Preference in terms of food processing is given to cooking. It is acceptable to include dried fruits and nuts in the diet, as well as honey, marshmallows and molasses. Moderate amounts of olive oil are also considered beneficial. When choosing drinks, preference should be given to juices, green tea, compotes and fruit drinks.
Such a diet should be observed not only during periods of exacerbation, but throughout the course of the disease. Especially if there is an increased level of uric acid in the blood.
Every man should know about the symptoms, causes and treatment of gout.
Prevention
The fundamental point in the prevention of gout is proper nutrition. In addition to the selection of products described above, you should pay attention to the following rules:
- You need to keep a count of the calorie content of the food you eat, include in the diet as many fruits and vegetables as possible, as well as dairy products.
- When choosing bread, you need to pay attention to options with the addition of coarse flourgrinding.
- Another important point of prevention is compliance with the drinking regimen. Drink at least 2.5 liters of fluid per day.
- If gout is detected, you should stop drinking alcohol, as it provokes an increase in urate crystallization.
- Reduce s alt intake.
Sports
Preventive measures for gout involve mandatory sports. It can be brisk walking, cycling, gymnastics or swimming. Various breathing practices such as yoga and Pilates are also welcome. It is important to drink plenty of fluids while exercising. Dehydration of the body should not be allowed, as this provokes a malfunction of the kidneys and, accordingly, the accumulation of uric acid in the body.
With gout, you need to combine preventive measures and adherence to the appointments of a specialist in the treatment of pathology. It is necessary to plan fasting days and add one citrus fruit to the daily diet.
Choice of shoes
When gout appears on the lower extremities, it is important to choose the right shoes. It should be comfortable and not tight. After being on your feet for a long time, massages and baths can be carried out.
It is equally important to conduct regular medical examinations and examinations. It is advisable to do this at least once every six months. Doing sports during an exacerbation is not recommended.
We looked at the causes of gout.
