In the article, we consider the causes and treatment of gout.
This pathology is also called the disease of kings and in many is associated with the appearance of a lump in the region 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, it is necessary to study the causes of gout and risk factors that can lead to it, and also have knowledge about what preventive measures can be taken to minimize the likelihood of future disability.
Causes
Gout occurs as a result of deposition of uric acid in the form of crystals in the cartilage articular tissues. The accumulation of these formations provokes an inflammatory process, which is characterized by severe pain. Sodium urate is converted to 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 provoke the appearance of gout:
- Uncontrolled intake of certain medications, such as diuretics, acetylsalicylic acid, cyclosporins, etc.
- The cause of gout on the legs in men is a history of pathologies such as coronary heart disease, diabetes mellitus, overweight, etc.
- Improper nutrition 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 years.
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, abuse of alcohol, citrus fruits, as well as a result of viral infections, psycho-emotional or physical overload, and prolonged use of certain drugs.
The causes of gout, we examined, then move on to the symptoms.
Symptoms
Gout is manifested in a specific way, inherent only to 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 of the pathological process. A type of gout such as gouty arthritis occurs latently until an attack is triggered. It can be caused by wearing tight shoes, overeating or abuse of alcoholic beverages.
A number of characteristic symptoms of foot or gout disease are distinguished during exacerbation:
- Pain syndrome. It occurs at night suddenly and is localized in a particular joint. The pain is very intense, 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, symptoms disappear on their own, even in the absence of treatment. This is due to the fact that phagocytes enter into the opposition to the inflammatory process. Relieving the condition does not mark recovery and the attack will recur, perhaps even after a few years. From the joints of the big toes, the pathology extends to the phalanges of the fingers, ankle, knee, wrist joint, etc. When the exacerbation goes away, inflammation and limited mobility of the affected joints remain.
Progressive signs
When gout enters a progressive stage, it is characterized by the following symptoms:
- Tofus. They are painless growths under the skin, resulting from the accumulation of urate crystals. Tofus, as a rule, is localized on the elbows, behind the ears and on the skin around the affected joint. The formations open independently, releasing a white curd mass from the wound. Most often, tofus appear 5-6 years after the onset of the pathological process and the first gouty attack.
- Joint deformation. The accumulation of crystallized uric acid causes a significant limitation of the mobility of the affected joint and its progressive deformation. With a prolonged course of gout, it becomes impossible to move without assistive devices.
- Pathological process in the kidneys. These organs, performing cleansing functions, accumulate urate in themselves, while not producing a complete withdrawal of these substances in the urine. Over time, this process provokes the appearance of stones and sand in the kidneys.
The causes of gout symptoms are of interest to many.
Diagnostic measures
A specialist who is involved in the diagnosis and treatment of gouty manifestations is called a rheumatologist. Diagnosis is based on the following examination methods:
- Collection of medical history and patient complaints.
- A physical examination that shows the presence of sore joints and tofuses.
- A blood test for a biochemical composition that helps to identify an increased amount of uric acid.
- X-ray examination. It will show affected areas of the surface of the joints, as well as tofus localized inside the joint bag. With a more severe course of the disease, an x-ray symptom can be detected with x-ray, when tofus 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 pathogen, and an increased white blood cell count in case of exacerbation.
- Puncture of tofus. Helps 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:
- Arthritis of the septic type. This pathological condition occurs against a background of an infection of a general or dermatological type, as well as due to trauma or microtrauma of the periarticular tissues. Septic arthritis is always accompanied by a significant increase in temperature. Diagnosis is through joint puncture. The conclusion is made based on the color of the liquid obtained.
- 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.
- Arthritis of the rheumatoid type. Autoimmune disease of unknown origin, occurring in a chronic form. Female representatives are affected, which distinguishes rheumatoid arthritis from gout.
- Osteoarthrosis. Quite often acts as a concomitant gout of the disease.
- Psoriatic arthritis. 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:
- Providing rest to the affected limb.
- Applying a cold compress to the site of pain. It can be ice, a wet towel or a bottle of water from the refrigerator.
Nonsteroidal 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 treatment of the feet.
If the treatment does not help?
There are cases when the pain does not subside even when taking painkillers. In this situation, intraarticular injections of steroid drugs are indicated, as well as the administration of Colchicine intravenously. Only a qualified specialist is able to prescribe the correct treatment for gout, which will help to 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 and the rapid progression of pathology, experts prescribe the following drugs:
- Nonsteroidal anti-inflammatory drugs.
- Corticosteroid preparations.
- Colchicine.
- Vitamins C and R.
- Orotic acid, Allopurinol and other uricodepressants.
- "Ketazone", "Benzbromanol", "Probenecid" and other drugs from the group of uricosuretics.
Physiotherapy
Physiotherapeutic procedures are also used to treat gout. However, they can not be used during an exacerbation of pathology. The main methods of physiotherapy for gout are UHF, healing mud, magnetotherapy, electrophoresis and paraffin baths.
The treatment regimen, including the duration of administration of drugs and their dosage, should be determined by a specialist. The patient should be prepared for long courses of therapy, which can reach one year or more.
Surgical intervention is prescribed in case of significant deformation 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 the diseased joint looks like with this pathology).
Food
Particular attention in the treatment of gout is given to proper nutrition. During remission, it is recommended to use a special dietary table. It provides for minimizing the amount of fat consumed. The main principles of nutrition for gout are:
- Soups should be predominantly vegetarian.
- The amount of meat is strictly limited, while the choice is made in favor of poultry.
- Eating lean fish is not more than three times a week.
- Refusal of milk in favor of dairy products.
- For garnish you can use cereals and pasta.
- The restriction does not apply to the use of bread.
All vegetables and fruits are allowed, except spinach, cauliflower and raspberries. The preference in terms of processing products is given to cooking. It is permissible to include dried fruits and nuts in the diet, as well as honey, pastilles and molasses. Olive oil in moderation is also considered beneficial. When choosing drinks, preference should be given to juices, green tea, compotes and fruit drinks.
Such nutrition should be observed not only during periods of exacerbation, but also 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
A 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:
- It is necessary to calculate the calorie intake of food, include as many fruits and vegetables, as well as dairy products in the diet.
- When choosing bread, you need to pay attention to options with the addition of wholemeal flour.
- Another important point of prevention is compliance with the drinking regime. At least 2.5 liters of fluid should be consumed per day.
- When gout is detected, alcohol should be abandoned, as it provokes an increase in the crystallization of urates.
- Reducing the amount of salt used.
Doing sports
Preventive measures for gout require mandatory sports. This can be fast-paced walking, cycling, gymnastics or swimming. Various breathing practices such as yoga and Pilates are also welcome. It is important to drink plenty of fluids during sports. Do not allow dehydration, as this provokes a malfunction in the kidneys and, accordingly, the accumulation of uric acid in the body.
With gout, preventive measures must be combined with adherence to the prescriptions of a specialist in the treatment of pathology. It is necessary to plan fasting days and add to the daily diet one fruit of the genus citrus.
Shoe selection
When gout appears on the lower extremities, it is important to choose the right shoes. It should be comfortable and not cramped. After a long stay on your feet, you can carry out massages and baths.
It is equally important to conduct regular medical examinations and examinations. It is advisable to do this at least once every six months. Exercising during an exacerbation is not recommended.
We examined the causes of gout.