Gout is a disease of cartilage. This disease develops, usually due to impaired metabolism, since the formed salts of uric acid are deposited in the joints. Learn more about the etiology, pathogenesis, clinic, diagnosis and treatment of gout later in the article.
Causes
Any human disease arises from something, not an exception and gout. Men are most affected by it, the female part of the population rarely suffers from this ailment, and only after the onset of menopause. Among the main causes of 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 appear with a 100% probability, but in the presence of provoking factors, such 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 enzymes.
- Purine bases that enter the body. 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 kidney function, they are still diagnosed with a disorder in which they cannot clear the blood of purine metabolites even at their normal concentration.
Also, the cause of gout can be a sedentary lifestyle, poor nutrition, hypertension, renal failure, diabetes of various types, the use of large doses of coffee or fat, severe surgical treatment of joints, transferred infectious diseases in severe forms.
Alcohol consumption
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 need to be consumed constantly with gout, and increases the likelihood of side effects. Also, alcohol retains fluid in the periarticular tissues, increases swelling, and provokes intense pain.
Symptoms of Gout
The course of gout is characterized by severe attacks. Between them, long intervals of rest are observed. Symptoms of gout can be observed only during periods of acute attacks. The main one is pain around the joint. It all starts with an unpleasant sensation, 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, as a rule, lasts about a week, after which there comes a period of rest, and all the symptoms completely disappear. Its duration is from several months to 1-2 years. In chronic gout, the frequency of seizures increases with age, and dormancy periods decrease. People suffering from gout are advised to exclude alcohol and fatty foods from their diet, as these products lead to excessive formation of uric acid.
According to the clinical classification, seven forms of the disease are distinguished:
- classic (typical) attack of acute gouty arthritis,
- subacute
- pseudo-phlegmonous,
- polyarthritis of an infectious-allergic type,
- rheumatoid-like
- low symptom
- periarthric.
Gout Diagnosis
If the patient complains of joint pain, the doctor first interviews him to determine which disease he encountered. You can judge gout if:
- the patient has had joint pain more than once, the first symptoms begin with small joints of the hands and feet;
- there have been cases of gout in the family.
In addition, factors such as bad habits, an abundance in the diet of meat food, and the use of insufficient amounts of 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 the joints.
- CT scan (computed tomography).
- X-ray
- Technetium pyrophosphate scintigraphy.
Characteristic changes in joints with gout during ultrasound can be seen only during an exacerbation of the disease. Since the joints swell during acute pains, soft tissues become denser, etc. After 5 days it will be almost impossible to detect these changes.
CT is good for use in the late stages of the disease, in this case high-precision images are obtained, allowing a detailed examination of the deformation of the joints, to accurately determine the localization of the changes. In the early stages with CT, it is difficult to detect any signs of the disease, it will be possible to notice only tissue compaction during exacerbation of the disease.
X-rays also provide little information in the early stages of the disease. Usually it is prescribed at the initial stage of the disease when there are other disorders or joint diseases. X-rays will also be more useful in the chronic course of the disease.
At the initial stage, the most effective method for the diagnosis and analysis of gout is scintigraphy. During the procedure, a special substance is injected into the patient’s blood, which, with further scanning of the body, allows you to identify all available urate deposits. This method is good at the initial stage of the disease, as it allows you to identify any articular defects before the start of the deformation process.
Additional research
In addition, if there is a suspicion of gout, the doctor will suggest a differential diagnosis of gout. The method will help to identify a more accurate picture of the disease, and will also distinguish it from other similar ailments. To diagnose gout, the tests will require the following:
- General analysis of urine and blood.
- Biochemical analysis of blood and urine.
- The study of fluid in the joints.
- The study of tofus and their contents.
Each of the methods for laboratory diagnosis of gout has different criteria, but in the aggregate they will help to get a complete picture of the course of the disease, as well as prescribe an adequate and timely treatment.
Drug treatment
The use of pharmaceutical substances during the period of 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 doctor sets the dose. "Colchicine" is especially effective if it is started to be used as soon as the initial signs of the disease appear. A significant improvement in the condition of patients is already observed in the first twelve hours of taking this medication in 75% of cases. But side effects may occur, for example, in the form of disorders of the gastrointestinal tract.
In addition, with exacerbation of gout, other anti-inflammatory drugs are prescribed, including Indomethacin, Phenylbutazone, Naproxen, Etoricoxib and others.
In the event that there are contraindications to the intake of the above substances, then with an exacerbation of gouty arthritis, oral administration or intra-articular administration of glucocorticoids, for example, preparations with triamcinolone hexacetonide, can be effective.
Another way is the external use of creams and gels, which include non-steroidal anti-inflammatory substances. The most popular drugs of 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. Before use, you need to consult a doctor.
Physiotherapy
As a component of complex treatment, physiotherapy for gout is extremely effective. It improves the condition of cartilage and prevents their decay. We analyze the most popular types of physiotherapy, which, as a rule, are prescribed between periods of attacks:
- Electrophoresis is a procedure in which stable electrical impulses act on the body. This gives a local therapeutic result. In addition, electrophoresis can enhance the penetration of pharmaceuticals through the skin. For gout, Analgin and Novocain are used for pain relief, and zinc, sulfur and lithium are used to stimulate cartilage.
- Mud therapy 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 procedures promote resorption of uric acid deposits. For this purpose, patients are given paraffin and ozokerite applications.
- Balneotherapy is one of the most pleasant types of physiotherapeutic procedures. The impact on the joints occurs during bathing. With gout, a cycle of radon, hydrogen sulfide or sodium chloride baths is usually prescribed.
- Bischofite is a natural mineral. Magnesium salt is obtained from it, from which a healing solution is prepared. Compresses with bischofite effectively relieve inflammation and anesthetize the affected area.
In addition to everything else, with gout, UVT, sound and magnetotherapy, exercise therapy and massage are safely used. It is difficult to judge which method will be most effective. The treatment regimen, including physiotherapeutic procedures, is prescribed by the doctor, taking into account the characteristics of each particular case. Most physiotherapeutic procedures, as a rule, are easily accessible during the course of the spa treatment.
Alternative treatment
Traditional medicine for gout can be very effective. The main thing is to consult with your specialist and not to abandon the traditional methods of treatment on your own. So, the most effective natural remedies to combat gout:
- A healing decoction of chamomile flowers is perfect in order to improve the condition of the limbs. In order to prepare this decoction, you need flowers (100 g) and water (10 l). After that you need to add ordinary salt (200 g) and mix thoroughly. Use the solution in the preparation of baths for hands and feet affected by gout.
- Regular spruce cones are a great remedy for treating joints. In order to prepare the broth, it is necessary to fill the unopened cones with the seed (5-6 pcs.) With hot water (1.5 tbsp.) And leave to brew overnight. The resulting broth must be divided into three doses, taken half an hour before a meal. Drink the infusion until complete recovery.
- Bay leaf is a very unusual and effective tool. It is necessary to pour 5 grams of bay leaf with water (1.5 tbsp.) And cook in a water bath for five minutes, then cover and let stand for three hours. After this, the broth should be drunk in small portions throughout the day.
- 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 there, leave it overnight. In the morning, get the rice, rinse, pour water and bring to a boil. After he boils, his need to rinse again and bring to a boil again. The whole procedure is performed four times. After that, it should be eaten without salt and oil.
Food
Gout is a very unpleasant disease, which is why it is very important to follow a proper diet during the treatment period. Useful foods and dishes that should be consumed during gout:
- Fruits. They are very important, since their composition contains many useful substances, special attention should be paid to citrus fruits.
- Vegetables. Actively eat 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, such as shrimp and squid, is very beneficial for gout.
- Flour products and cereals should also be present in the diet, but do not abuse them much.
- Nuts are very useful for gout. Recommended to eat a small handful of pine nuts, almonds, hazelnuts, avocados or pistachios.
- Borsch, pickles, vegetarian soups, beetroot - you can’t refuse these liquid dishes, they must be on the menu.
- Greens (dill, cilantro, parsley, etc.).
With regard to harmful products with gout, salt, any sausages, smoked products, mushrooms, pickles refers to them. With caution, you should eat spinach, sorrel, cauliflower, radish, celery.
It is also recommended to remove by-products from the diet (brain, liver, kidney, lung). Doctors advise to refuse smoked fish, spicy dishes, exclude cocoa, chocolate, strong tea and coffee from the menu. Alcohol during this disease is generally prohibited especially, this applies to wine and beer. All spicy spices and sauces are also prohibited, as they cause irritation and have a very negative effect on the state of health.
Gout Prevention
For the prevention of gout, it is necessary, firstly, to follow a certain diet. Its main rules:
- fewer high-calorie meals, more yoghurts, cottage cheese, vegetables and fruits, eat one citrus fruit every day;
- wholemeal bread;
- the amount of water consumed should be at least 2.5 liters per day, so it will be better to wash the kidneys and reduce the amount of uric acid in the blood;
- alcohol should be deleted from your life, as it promotes the crystallization of uric acid;
- salt intake in minimal quantities;
- Do not 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 assistant in the prevention of gout . If the pain intensifies, then the sport should be abandoned. It is also necessary to minimize hard physical work. It is worth paying special attention to your shoes and trying to choose the most comfortable. It's best to walk barefoot at home. It is recommended twice a year to visit specialists (surgeon, therapist, neuropathologist) and take tests.
In the article, we examined the features of classification, clinic, diagnosis and treatment of gout. If we look at 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 reviews people are advised to start eating right and moving - this is an effective preventive and therapeutic measure. Do not, according to them, write off traditional medicine, as well as spa treatment, which, in combination with drug therapy, give good results.