Gout: symptoms and treatment at home. Than to treat gout

Gout - a type of arthritis which usually causes inflammation in a joint, begins suddenly. Over time, the inflammation begins to move to the rest of the joints and tendons. Gout is a common condition in men. The disease occurs on the background of increasing concentrations of uric acid in the blood, contributing to the formation of solid crystals and accumulation of these deposits in the joints.

Possible consequences of accumulation of uric acid in the body include gouty arthritis (acute / chronic), urolithiasis, the occurrence of localized deposits (tophi). Gout can occur as an independent disease (primary gout) or elapse against other diseases, drug administration (secondary gout).

What it is?

Gout - a metabolic disease characterized by the deposition in various tissues of the body of urate crystals in the form of sodium monourata or uric acid.

At the core lies the emergence accumulation of uric acid and reducing its excretion by the kidneys, which leads to an increase in the concentration of the latter in the blood (hyperuricemia). Clinically gout is manifested recurrent acute gouty arthritis, and the formation of nodes - tophi.

Kidney damage is also one of the major clinical manifestations of gout along with arthritis. Most often the disease occurs in men, but in recent years increasing prevalence of the disease among women, with age, the prevalence of gout increases. For the treatment used drugs affecting the pathogenetic mechanism of the disease, as well as drugs for symptomatic treatment.

What causes gout?

A major factor predisposing to the development of the disease is sustained high levels of uric acid in the blood. Its derivatives (urate) are deposited in the form of crystals in joints, as well as in several other organs (in particular - the kidney), which becomes the cause of gout. A compound such as sodium urate, tends to be deposited in the joint tissue, leading to its degradation over time.

Among the predisposing factors to the development of the disease include:

• genetic predisposition;
• consuming large amounts of protein foods of animal origin;
• overeating;
• lack of exercise;
• obesity (including on the background of endocrine disruption).

High levels of uric acid in gout may be due to its large intake, when breeding with even fail completely healthy kidneys. Another situation is possible when the body receives through the alimentary normal amount of the compound, but the activity is reduced renal function for one reason or another.

symptoms of gout

Begin the first signs of gout with the defeat of one joint, most commonly the big toe. Occurrence of acute arthritis may precede the abundant use of food, alcohol, trauma, surgery.

The disease develops suddenly, early in the morning there is a sharp pain, swelling and redness, symptoms of gout grow rapidly and reach a peak within 24 - 48 hours. Pain becomes pronounced, patients often can not wear socks or touch the affected joint. Acute gout may be accompanied by an increase in body temperature to 38 degrees. Sharp weakness, malaise. Even in the absence of treatment aggravation gouty arthritis disappears gradually within 5 - 7 days.

As the disease progresses in the absence of adequate treatment for arthritis attacks become more frequent and long, involved new leg joints. Appears joint deformation due to nodular deposits and bony excrescences, tophi. This uric acid crystals are deposited in periarticular tissues are painless, dense knots yellowish. Most often located in the area of ​​the ears, elbows, ankles, joints of the hands and feet.

Gradually there is joint stiffness, which makes it difficult to move patients. High risk of fractures. Each new exacerbation gouty arthritis worsens the disease, promotes the rapid development of complications.

What is gout: photo

The photo below shows how the disease manifests itself in humans.

stage

For classification by the severity of gout divided into 4 stages.

1. The first stage - asymptomatic hyperuricemia. At this stage, the patient reported no symptoms, but the level of uric acid in the blood exceeds 60 mg / l. This condition does not require special treatment, we need only regular monitoring of uric acid levels and maintaining a healthy lifestyle with dieting. When properly organized mode, gout symptoms can not be realized, or will be years before the onset of the first attack of the disease.
2. The second step - an acute attack. In this step, crystals of uric acid in the joints deferrable activate the inflammatory process that leads to pronounced pain and swelling in the affected joint. Pain subsides alone, even without the treatment, for 3 to 10 days. Since the first episode of the others will follow, should immediately seek help from a specialist. The interval between attacks may last for several months, but the chances of a second attack each day increases, so it is important to begin treatment in a timely manner and maintain control over the level of uric acid.
3. Third stage - subacute. This step assumes between bouts. At this time there are no symptoms, and joints working properly. However, deposition of uric acid crystals continues, and this can cause repeated, more severe and painful attacks of gout in future.
4. The fourth stage - chronic gout, nodular. In advanced cases, the disease becomes chronic, the outcome of which is the deformation and destruction of bone and cartilage in the lesion. Since the ongoing inflammation continues and increases the intensity, it does not exclude kidney disease with the development of renal failure.

Gout Home Treatment

The first in the treatment of gout - a pain relief. Patients with gout should be aware of the list of measures that can reduce pain during exacerbations:

1. Rest the injured limb.
2. Cold hearth on painful: wet towel, ice pack, a cold bottle of water.
3. NSAID drugs (Ortofen, Voltaren, Naproxen, Diclofenac) pills or injections (injections increase the number of A / D, it is recommended to do in the morning).

How to treat gout and to achieve stable remission tell only a qualified doctor, based on the results of diagnostics of a particular case. We consider the general safety of therapy.

How to take the pain of an acute attack of gout?

In acute gouty arthritis, inflammatory treatment is carried out. Most commonly used colchicine. It is prescribed for oral administration are usually in a dose of 0.5 mg every hour or 1 mg every 2 hours, and the treatment is continued until until:

1. Do not come relief of the patient;
2. Not appear adverse reactions from the gastrointestinal tract or
3. The total dose of the drug reaches 6 mg on a background of no effect.

Colchicine is most effective if treatment is initiated soon after the onset of symptoms. In the first 12 hours of treatment condition improved significantly more than 75% of patients. However, 80% of patients the drug causes side effects on the gastrointestinal tract, which may occur before clinical improvement or simultaneously therewith.

Ingestion colchicine maximum level in plasma is approximately 2 hours. Consequently, we can assume that its reception by 1.0 mg every 2 hours is less likely to determine the accumulation of toxic dose to therapeutic effect occurred. Since, however, the therapeutic action is related to the level of colchicine in leukocytes but not in a plasma treatment regime efficiency requires further evaluation.

When administered intravenously, colchicine side effects from the gastrointestinal tract do not occur, and the patient's condition is improving rapidly. It is important to remember that the intravenous route requires accuracy and that the drug should be diluted in 5-10 volumes of normal saline infusion and continued for at least 5 min. Both in oral and by parenteral administration colchicine can inhibit bone marrow function and cause alopecia, failure of liver cells, mental depression, convulsions, ascending paralysis, respiratory depression and death. Toxic effects are more likely to occur in patients with liver disease, bone marrow or kidney disease, as well as patients receiving maintenance doses of colchicine. In all cases, the dose should be reduced. It should not be used in patients with neutropenia.

In acute gouty arthritis and other effective anti-inflammatory agents, including indomethacin, phenylbutazone, naproxen, etoricoxib et al.

Indomethacin may be administered for oral use at a dose of 75 mg, followed by a 6 h every patient should receive 50 mg; treatment with these doses and continues to the next day after the disappearance of symptoms, and then the dose is reduced to 50 mg every 8 hours (three times) and up to 25 mg every 8 hours (three times, too). Side effects of indomethacin include gastrointestinal disorders, sodium retention in the body and the symptoms of the central nervous system. Despite the fact that the dosages may cause side effects in nearly 60% of patients, indomethacin typically transferred easier than colchicine and is probably selecting means for acute gouty arthritis.

Drugs that stimulate the excretion of uric acid, and allopurinol an acute attack of gout ineffective. In acute gout, particularly when contraindications or ineffectiveness of colchicine and nonsteroidal anti-inflammatory drugs, are the benefits of systemic or local (ie, intra-articular) administration of glucocorticoids.

For systemic administration, be it orally or intravenously should be administered in moderate doses within a few days, since the concentration of glucocorticoids decreases rapidly and their effects terminated. Intra-articular administration of long acting steroid (e.g. triamcinolone hexacetonide at a dose of 15-30 mg) may stop an attack monoarthritis or bursitis 24-36 hours. This treatment is especially useful if you can not use the standard drug regimens.

New data on the treatment of gout

According to recent data, gout most strongly predisposes obesity caused by excessive consumption of fatty foods of animal origin. In the group of risk takers frankfurters, sausages, bacon and hamburgers. That excess proteins entails excess uric acid and overweight creates an increased load on the joints and thereby accelerates the development of the inflammatory process.

American scientists also a direct relationship between deficiency of calcium and ascorbic acid, and the development of gout. With age, these essential substances for the body no longer enough even for those people who lead a healthy lifestyle and do not complain about the extra weight. Therefore, after forty years of age must be tested annually and take multivitamins prescribed by the doctor. a new drug has been developed recently, which suppresses the synthesis of uric acid - Benzobromaron. We are currently active in clinical trials of the drug, and in some Western countries it is already allowed and put on stream. But before the new product will settle in the domestic pharmaceutical market is likely to be a long time.

We also know about the experimental development of new non-hormonal anti-inflammatory drugs, acting directly on the protein interleukin provoking inflammation of arthritic joints and tissues. But the exact timing of these drugs on the open market is difficult to call.

Diet for gout

The diet should reduce the level of uric acid in the blood, reducing the likelihood of recurrent attacks of painful and slow the progression of joint damage.

diet for gout prohibits the use of products:

• Mushrooms.
• Figs, raspberries, raisins and fresh grapes.
• Legumes.
• Chocolate, cocoa, strong tea and coffee.
• Salt (total exclusion or daily consumption of no more than 1/2 hour. l.).
• Cream cakes.
• Seasonings and Spices (can vinegar, bay leaf).
• Fatty meats / fish, meats, dishes of offal (especially jelly).
• Alcohol.
• Greens - spinach, cauliflower, sorrel, lettuce.

Authorized products:

• Poultry, lean fish (boiled recommended 2-3 times a week à la carte).
• Sugar and honey without limitation (with normal levels of blood glucose).
• Bread (white, rye), pasta.
• Vegetables (preferably fresh), fruit (especially useful citrus and cherry).
• Milk, cottage cheese, yogurt, butter.
• Juice, mineral water.

Use of warm water or mineral glasses with the addition of lemon juice accelerate metabolism. Also, the metabolic processes are normalized at the bottom of the weekly discharge.

Physiotherapy

Physiotherapy treatments help finally to stop the inflammation of the joints in gout. They are prescribed only after reducing the symptoms of arthritis medication. In the acute phase of the disease, any physical treatments absolutely contraindicated.

What methods are used:

• application of paraffin and ozokerite,
• curative mud,
• UHF,
• magnetic therapy,
• electrophoresis,
• phonophoresis drugs.

Folk remedies

In addition to diet and medical treatment of the following folk remedies exist to facilitate the flow of gout:

1. Poplar buds. Powdered kidney defect poplar mixed with petroleum jelly or other vegetable oily base in a ratio of 1 to 4. The resulting ointment is applied on the affected joint 1 - 2 times a day during periods of exacerbations for pain relief.
2. Applications of turnip. Boil turnips to soft consistency, knead it into mush, and add as needed 1 - 2 tablespoons of sunflower oil. The resulting mixture was applied to the affected sites. If there is ulceration of the skin in the area of ​​tophi application is prohibited.
3. Celery root. 1 tablespoon celery odorous poured 400 ml of boiling water. The mixture was infused for 2 hours. Drink the infusion must be 3 - 4 times a day for half an hour before meal to deal with hyperuricemia (to reduce uric acid levels in the blood).
4. Mullein ordinary. Dried flowers mullein vodka poured or rubbing alcohol (50 g of leaves on 0.5 liters of fluid). The mixture was infused for 5 - 7 hours in a place sheltered from the sun and then used for rubbing into the skin over the affected joints. The facility also reduces the pain during acute attacks.
5. Chicory. 2 teaspoons chicory pour 200 ml of boiling water and insist 4 - 5 hours. Infusion drink half a cup of 2 - 3 times a day before meals. Chicory is also effective for controlling hyperuricemia.
6. Bath of chamomile. Applied in lesions gout hands or feet. For their preparation will need a 100 g dry camomile, 5 liters of lukewarm water and 10 - 15 g of salt. Taking a bath for 10 - 15 minutes until the water has cooled down to room temperature. A further finding of the extremities in water is risky because there is a risk of hypothermia and acute gout. Therefore limbs gently wipe dry with a towel and keep warm. Regular bath of chamomile reduces inflammation and swelling promote early remission.
7. Infusion of St. John's wort. Two tablespoons of Hypericum pour 1 liter of boiling water and infused for 2 - 3 hours. Strained through cheesecloth or strainer infusion drink for 50 - 70 ml 3 times per day. In chronic gout treatment can be several months. St. John's wort reduces hyperuricemia and several eases pain.

Lifestyle

After eliminating the pain doctor is obliged to make sure that the level of uric acid is safe for the patient, and the dosage of allopurinol matched correctly. For this purpose carried regular determination of the level of uric acid by biochemical blood analysis. At the beginning of the treatment is to be done every 2-4 weeks, then every 6 months.

If the optimal dose of the drug is chosen, the patient follow a diet returned to exercise, it does not interfere with gout attacks do not need to take painkillers and anti-inflammatories, allopurinol dose may be slowly decreased under control doctor. Practice shows that it is possible to completely abolish quite rare. Unfortunately, the vast majority of patients, allopurinol abolished, are forced to return to it after repeated gouty attack.

When the operation is necessary?

Surgical treatment of gout is rare. A brief description of the possible surgery and indications for him:

1. Removal of tophi - required when a strong sprouting or inflammation.
2. Opening of the joint cavity, drainage of purulent cavities. Autopsy demonstrated the presence of purulent complications gout (phlegmon, bursitis, arthritis).
3. Total joint replacement. This operation is carried out in patients with severe arthritic lesion of large joints (hip, shoulder, knee).

Most cases of gout can be successfully treated with conservative methods.

On the relief of arthritis takes about a week. Anti-relapse treatment duration of the course is carried out for life: it can be either a diet, or a diet with taking basic drugs.

Prevention of gout and forecast

To prevent new attacks and to reduce the symptoms of gout to a minimum, you should follow some rules:

1. Do not take aspirin, which can cause an increase in the volume of uric acid and cause aggravation.
2. Do not expose the affected joint as far as possible any stress. When the pain sensations to put on 15-20 minutes of ice to the affected joint.
3. At least half an hour a day to give physical education, regularly do exercises and exercises.
4. Conduct regular medical examination and measure the level of uric acid.
5. Reconsider their diet in favor of fruits, vegetables and grains, avoid eating offal, sausage, fat.
6. Drinking a day at least two liters of water to help the kidneys excrete, accumulated acid.

Favorable prognosis and recovery depends on the degree of disease and appropriate treatment compliance. The sooner a patient goes to the doctor to review their own lifestyle and begin treatment, the more likely a stable remission. Without proper treatment of gout quickly progresses, especially in patients prone to it advanced and mature, therefore refers to a disease on a "grab-Down" - categorically it is impossible.