Gout
- one of the oldest diseases described in medicine. In the 5th century BC, Hippocrates called “gout” (from the Greek words “under” - leg, “agra” - trap) acute pain in the foot. It was called “the disease of kings and the king of diseases,” a disease of aristocrats, and was even considered a sign of genius. Such famous people as Leonardo da Vinci, Alexander the Great, many members of the Medici family from Florence, Isaac Newton, Charles Darwin suffered from it. And this list is far from complete.
Gout is a disease associated with a disorder of purine metabolism, which leads to an increase in uric acid in the blood (hyperurecemia) and its deposition in the tissues of the musculoskeletal system and internal organs.
In the human body, purine bases are broken down into uric acid and excreted by the kidneys. When the concentration limit of uric acid in tissues is exceeded, the deposition of its crystals in the form of monosodium urate begins in the joints, kidneys, and soft tissues. Clinical manifestations of arthritis (inflammation of the joint), soft tissue formations (tophi), urate nephropathy (kidney damage) and nephrolithiasis (formation of kidney stones) appear.
Changes in dietary habits and lifestyles have resulted in gout affecting 1-2% of the population in industrialized countries.
Causes of gout development
- Taking medications: diuretics (thiazide diuretics), low doses of aspirin (1g per day), cyclosporines.
- Diseases and conditions that lead to the appearance of gout: diabetes, obesity, coronary heart disease, arterial hypertension, metabolic syndrome, chronic renal failure, lead poisoning, organ transplantation, psoriasis, blood diseases. Exacerbation of gout is facilitated by intravenous administration of contrast (during X-ray examinations), trauma, and surgical interventions.
- The risk of gout is extremely high in people who have a habit of consuming foods containing large amounts of purine bases (fatty meats, seafood, alcoholic beverages, carbonated drinks).
- Gout develops more often in men (age 30-60 years); in women, gout develops much less frequently and mainly during the menopausal period.
Useful qualities of the product
It can be used raw, stewed, fried. Sauerkraut has proven itself quite well It contains a large amount of vitamin C. A small amount can fully provide the daily dose of this component. Besides this there is also:
- minerals;
- folic and pantothenic acids;
- cellulose;
- glucose;
- sucrose;
- microelements.
- It is famous for its ability to eliminate pain. This allows you to cope with pain without the use of synthetic drugs. Other effects that cabbage has on the body:
- relieves swelling,
- eliminates inflammatory foci;
- normalizes the diuretic process;
- normalizes metabolism; restores blood circulation.
Gout symptoms
Acute gouty arthritis begins with damage to one joint, most often the big toe. The onset of acute arthritis may be preceded by heavy food consumption, alcohol intake, trauma, or surgery. The disease develops suddenly, with sharp pain, swelling and redness occurring early in the morning, symptoms increase rapidly and reach a peak within 24 to 48 hours. The pain becomes severe, patients often cannot put on socks or touch the sore joint. Acute gout can be accompanied by an increase in body temperature up to 38 degrees. Severe weakness, general malaise. Even without treatment, exacerbation of gouty arthritis disappears gradually within 5 to 7 days.
Acute gouty arthritis
As the disease progresses and in the absence of adequate treatment, attacks of arthritis become more frequent and prolonged, and new joints of the legs are involved. Joint deformation appears due to nodular deposits and bone growths, tophi.
Tophi are uric acid crystals that are deposited in the periarticular tissues and are painless, dense yellowish nodules. Most often they are located in the area of the ears, elbow, ankle joints, joints of the hands and feet.
Joint stiffness gradually appears, making it difficult for patients to move. There is a high risk of fractures. Each new exacerbation of gouty arthritis significantly worsens the course of the disease and contributes to the rapid development of complications.
Uric acid is mainly excreted by the kidneys; the deposition of uric acid salts in the renal pelvis leads to the development of urolithiasis. The passage of concrements (stones) is manifested by intense pain in the lumbar region - renal colic.
Benefits of the substance
You can often hear it called the white death. But this is only true if it is used uncontrollably. An excess in a person’s diet can lead to the development of all kinds of diseases. But if its daily dose does not exceed 1 tsp, then it can bring a lot of benefits. You can often find sea salt in recipes to treat gout. This is due to its effect on the body. The most useful manifestations are:
- formation of hydrochloric acid;
- provides muscle movement;
- maintains water and electrolyte balance;
- transmits nerve impulses;
- tones the body;
- transports oxygen;
- destroys microbes.
Diagnosis of gout
- Blood chemistry. Detection of hyperurecemia: increased uric acid levels in men over 0.42 mmol/l, in women over 0.36 mmol/l. Determination of blood creatinine level - to identify renal failure.
- Examination of the synovial fluid of the affected joint. Chemical or microscopic examination reveals uric acid crystals; there is no bacterial flora in the culture.
- X-rays of joints determine changes in chronic gouty arthritis.
- Ultrasound of the kidneys. Identification of X-ray negative calculi (stones).
Treatment of gout
Compliance with dietary recommendations is important to prevent gout exacerbation. This is a restriction on the consumption of: meat and fish products, legumes, sorrel, spinach, cauliflower, raspberries, figs, chocolate, strong tea, coffee. The consumption of alcohol, especially wine and beer, is prohibited.
It is recommended to increase the volume of fluid you drink to 2 liters per day, unless there are contraindications. These are cranberry juice, juices, alkaline mineral waters. Gradual normalization of body weight is mandatory for the patient, as it helps reduce the level of uric acid in the blood.
The goal of drug treatment is to reduce pain during an attack and treat disorders of purine metabolism.
During an acute attack of gout, the patient is recommended to rest completely, especially on the affected limb. You should put your foot in an elevated position, apply an ice pack to the sore joint, and after the pain subsides, apply a warm compress. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat an attack. The drug, its dose, frequency of administration, and duration are recommended by the attending physician.
To achieve a stable decrease in uric acid, which prevents the progression of gout, anti-gout drugs (alopurinol, sulfinperazone, uralit, etc.) are used. These drugs are used for a long time (years). The required drug is selected by the attending physician individually for each patient, depending on age, concomitant diseases, and the level of uric acid in the blood.
When large tophi are formed, tissue ulceration, or the presence of fistulas, surgical treatment is recommended - removal of tophi, since they can no longer resolve when taking anti-gout drugs, and can significantly limit the function of the joints.
How to quickly relieve acute gout pain during an attack?
People suffering from gout often wonder: “Is there a remedy that can quickly relieve pain?” Before answering it, it’s worth understanding what gout is and why it occurs. In fact, this disease is associated with a metabolic disorder, which causes an increase in uric acid levels. It begins to form into crystals and accumulate in tissues. This type of disease is called paroxysmal, and the increase in indicators in this case is called hyperuricemia.
What is gout and why does it occur?
The first information about this disease has come to us since the time of Hippocrates. Today its occurrence is 0.3%. The average age of people suffering from this disease is 40-50 years. At the moment, in medicine there are two main types of this disease: gouty arthritis and the appearance of tophi. Tophi is a kind of knot that is formed due to the deposition of uric acid crystals in the soft tissues.
The main cause of the disease is an increase in the level of urate in the body. Nowadays, scientists identify two reasons for the occurrence of this type of disease:
- There is an increase in the production of uric acid, which leads to the inability of the kidneys to process such an amount of incoming fluid;
- Another reason for the occurrence is obesity, when a person eats absolutely everything, without thinking that the kidneys may not be able to process many foods.
Sometimes gout can also occur due to a malfunction of the kidneys themselves. In this case, urates begin to be deposited in those places that are poorly supplied with blood. It mainly occurs in cartilage, joints and tendons. The occurrence of this type of disease can worsen kidney function. The following factors can also provoke the disease:
- Fatty foods;
- Legumes;
- Hereditary predisposition;
- Coffee consumption;
- Alcohol abuse;
- Excessive consumption of red meat;
- Physical inactivity;
- Presence of obesity;
- Congenital or acquired pathology associated with dysfunction of the liver and kidneys.
- Lack of water consumption.
The first signs of gout and disease prevention
Nowadays, gout is considered an incurable disease. But you shouldn’t despair, because you can stabilize her and live with her calmly. At the very first stages of development, the disease proceeds almost unnoticed. Before the first pain in the joints appears, which occurs more often at night. It seems to you that someone is twisting or gnawing the joint. Then redness begins to appear on it, and it swells. Often the disease begins to appear on the big toe. During the day, the pain becomes weaker. This goes on for a whole week. And then gout goes into a kind of hibernation, which can last from three months to twenty years. But just because the disease does not manifest itself does not mean that you are healthy. It's just remission time.
How to protect yourself from the possibility of illness? The same as for most diseases. Start eating right and don't forget about exercise. He should be given no less than thirty minutes. Minimize your intake of the following foods:
- alcohol;
- mushrooms;
- cocoa;
- beverages;
- fatty fish;
- fat meat;
- legumes and grains.
And be sure to drink more water.
What medications are most suitable for treating gout?
In order to stop attacks of the disease, it is necessary to reduce the level of uric acid. Doctors recommend using the following medications:
- Allopurinol, which inhibits uric acid. Due to the fact that it dissolves acid in the kidneys and joints, the pain goes away much faster.
- Very often, doctors use Febuxostat, which interferes with the synthesis of uric acid by inhibiting xanthine oxidase.
- The drug Pegloticase contains enzymes that dissolve uric salts.
- Probenecid, which helps uric acid be absorbed back into the kidney tubules.
- To avoid incredibly severe pain, it is often recommended to use Fullflex. It relieves inflammation and swelling.
- And Colchicine, which relieves pain very well. It relieves gout attacks.
What folk remedies are used to treat gout, and what can be done at home?
Doctors recommend using traditional methods of treatment not as primary, but as auxiliary, because they rather have a general application, but do not respond to a specific type of pain.
Traditional methods of treatment include: rubbing sore spots with a tincture of mullein flowers; the use of ointments made from badger fat, juniper and laurel, chestnut-based ointment; applying compresses made from fir and garlic oils, yeast and wheat flour; the use of baths with the addition of herbs; as well as teas and various tinctures.
If you have a gout attack at home, then there is nothing to worry about. The first thing to do is to provide rest to the sore leg. Find or create an elevation using a pillow. Next, the most effective remedy will be ice. Apply it to the area of pain and repeat this until it becomes easier. Of course, you need to drink as much water as possible.
Treatment of any gout attack involves two goals: pain relief and prevention. Therefore, if you know that you have such a problem, it is better to always have a pain reliever and something for compresses in your first aid kit. Do not treat yourself, but rather consult a doctor, because even a lull does not mean that everything is fine, and it will not happen again. gout treatment
– this is a complex and time-consuming process, so it is better to protect yourself and prevent the disease.
But even if you follow all the instructions, there is still the possibility of an attack. And with it it is impossible to relieve pain immediately, so try to simply reduce the pain. Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr
Physiotherapy for gout
In the acute period, applications of dimexide solution are used on the affected joint.
It has analgesic and anti-inflammatory effects. Before starting the procedure, tests are carried out for sensitivity to dimexide (the presence of an allergic reaction), and procedures begin 24 hours after the test. For applications, use a 30-50% solution of dimexide (pure dimexide is diluted with boiled water). A napkin soaked in the solution is placed on the sore joint. Initially, the duration of the procedure is 10 minutes, later it is increased to 2 hours. During the period of remission, applications with mud, paraffin, and ozokerite are used, which helps improve joint function and reduces the urate content in them. During the period of remission, patients are recommended to undergo sanatorium-resort treatment. Health measures have a beneficial effect on the health status of patients and the course of the disease:
- dietary food,
- taking alkaline mineral waters,
- balneotherapy,
- mud therapy