Rheumatology
Rheumatology

Gout, what is it? Signs and treatment, nutrition for gout

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Gout( "disease of kings") is often associated with the formation of bumps on the big toe. However, the disease is not limited to one joint only, gradually hitting the joint structures of the body and internal organs.

Understanding the process of the onset of the disease and the factors provoking it gives a chance to correct the metabolic processes that have been knocked down, minimize painful exacerbations and, finally, to avoid disability - so what is it?

Contents of

  • 1 Gout: what kind of disease?
  • 2 Signs and treatment of gout, photo
    • 2.1 Diagnosis of gout
  • 3 Treatment of gout
    • 3.1 Treatment of gout at home
  • 4 Nutrition: menu for gout
    • 4.1 Complications of gout
    • 4.2 Prevention

Gout: what for the disease?

Gout

The development of the disease

Gout is a pathology( failure, impairment) of metabolic processes associated with excessive formation or inadequate excretion of uric acid from the body. There are 4 stages of gout formation:

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  1. Accumulation of uric acid in the body, which is recorded by an elevated level of its content in the blood.
  2. Formation of salt crystals in the joints.
  3. Aggression of immune cells against urate formations and inflammation of the damaged joint.
  4. Long-term manifestations of gout, kidney damage, joint deformities.

Gout is a purely age-related disease. Almost all elderly people from the age of 65 have signs of this disease. And in children and young people gouty changes are recorded in exceptional cases.

More often men suffer from gout, usually an ailment takes them by surprise after 40 years. This fact is due to the physiologically high content of uric acid in the male blood. The risk of developing pathology in women increases significantly with the onset of menopause( from 50 years).It is better to understand what gout is, the reasons for this "royal" disease will help.

The presence of gout in humans - an indicator of unreasonable life( low physical activity, malnutrition).This is why gout is long since called "the disease of kings" because of their idle lifestyle.

The concentration of uric acid in the blood rises for the following reasons:

  • Gastronomic predilections - overeating, fatty foods( fish / meat, smoked foods, pickles), alcohol abuse( including beer) and, as a result, obesity;
  • Hypodinamy - insufficiency of physical activity on the body;
  • Sharp weight loss due to illness, improperly selected diet;
  • Smoking( nicotine is actively built into metabolic processes);
  • Long microtraumatic joints( tight shoes, overloads on the foot);
  • Hormonal disorders( in women, first of all, menopause);
  • Long-term use of Aspirin, a diuretic.

However, not only external factors are capable of provoking the formation of urate deposits. Often gout develops against the background:

  • of chronic kidney failure;
  • kidney stones, gallbladder;
  • of diabetes mellitus;
  • hypothyroidism;
  • of a serious allergic pathology( eczema, psoriasis, bronchial asthma);
  • hypertension and high cholesterol levels in the blood;
  • hereditary predisposition( gout from blood relatives in previous generations).

Signs and treatment of gout, photo

Signs and treatment of gout

photo of gout exacerbation, the process of manifestation of the first symptoms of

Signs of gout can not be confused with another disease, so specific are its manifestations. The first symptoms appear in the area of ​​the joint of the big toes( one or both).It is this joint of the thumb that gout chooses as the first target.

Gouty arthritis does not give symptoms until the provocative moment: close shoes, feast with overeating and drinking alcohol.

A characteristic pattern of symptoms for a gout attack:

Pain

Suddenly, pain arises in the joint at night. This is one of the most powerful painful experiences that a person has ever experienced. Even strong and hardy people celebrate its unbearable intensity, practically immobilizing the entire foot. The situation is aggravated by the absolute inefficiency of painkillers.

Inflammation of

Signs of gout, photos of inflammation

Signs of gout, photos of inflammation

The affected joint swells, diffuse hyperemia appears. Often the body temperature rises to high figures( 39-40 ° C).

The attack of gout lasts up to 4 days, and then disappear on their own even without taking medications. Self-elimination of painful symptoms is based on the inclusion of phagocytes in the fight against inflammation. Temporary relief, lasting for several years, does not mean recovery.

Pathological changes affect the phalangeal joints of the fingers, the larger ankle and the wrist joint, often the knee. The increase in the joint in size and the limited mobility of the joint do not disappear with the departure of the gout attack.

progression of gout deformity of the joint

disease progression - joint deformation

For progressive gouty pathology, the following symptoms are characteristic:

Tofusi

Painless cones under the skin are a cluster of urates. Characteristic localization: behind the ears, elbows, skin over the affected joint. Tofusy are prone to self-opening, while the wound is a curdled white mass. A similar pattern is observed after 5-6 years from the first attack of gout.

Joint deformation

Accumulation of urate deposits in the joint leads to its permanent deformation( subluxation) and a significant limitation of mobility in it. With prolonged disease, the patient can not move without a cane.

Kidney damage

Kidneys, as a "cleansing station" of blood, accumulate urates in themselves, not providing full-scale excretion from the body with urine. This process gradually forms sand / stones in the kidneys.

Diagnosis of gout

If a suspected gout is suspected, you should contact a rheumatologist. The diagnosis is made taking into account:

  • specific symptoms of the disease;
  • visual inspection( inflammation of the joint, detection of subcutaneous tofusov);
  • biochemical blood test( high level of urates);
  • X-rays( involvement of the articular surfaces and tofusi inside the joint bag leading to a narrowing of the intra-articular fissure, with severe damage - a symptom of "piercer" - germination of tophi into bone tissues);
  • puncture of the patient joint( needle-shaped urate inclusions, no detection of an infectious agent of inflammation, leukocytes up to 20x109 / l with exacerbation of gout);
  • puncture of tofus( composition - urates).

Treatment of gout

Treatment of gout on legs

The first in the treatment of gout is the relief of pain. Patients suffering from gout should know the list of activities that can reduce pain during an exacerbation:

  1. Rest of the injured limb.
  2. Cold on a painful hearth: a wet towel, an ice pack, a bottle of cold water.
  3. Preparations NSAIDs( Orthofen, Voltaren, Naproxen, Diclofenac) in tablets or injections( injections slightly increase the a / d, it is recommended to do in the morning).

When seeking medical help and continuing pain, intraarticular steroid injections and intravenous injection of colchicine are possible.

How to treat gout and achieve a stable remission will tell only a qualified doctor, based on the results of diagnosis of a particular case. We are considering general measures of therapy.

For the prevention of recurrences and the development of the disease, the following drugs are prescribed( course treatment):

  • NSAIDs - take with caution, irritate the gastrointestinal mucosa;
  • Corticosteroids - are prescribed taking into account immunosuppressive properties and leaching of calcium from bones;
  • Colchicine - normalizes the exchange of uric acid, negatively affects the composition of blood and GIT;
  • Vitamins P and C - promote dissolution and release of urate;
  • Urinary depressants( Allopurinol, Orotic acid) - reducing the production of uric acid;
  • Urticazuretics( Benzbromanol, Ketazon, Probenecid) - excretes uric acid from the body, are contraindicated in chronic kidney failure, gastrointestinal diseases( especially the liver).

With high blood levels of uric acid and a small capacity of the kidneys( output with urine less than 3.56 mmol / day), combined use of uricosuretics and uricodepressants is advisable. Doses and the duration of reception of funds for the treatment of gout are determined individually. Therapeutic courses are long( up to 1 year) with a break of 2 months.

Beneficial effect on the affected joint of physiotherapy: UFD( with exacerbation), drug phonophoresis, paraffin treatment and ultrasound( during remission).

Surgical treatment( arthroplasty, prosthetics) is indicated with a significant deformation of the joint, a significant degree of immobility. Often, surgical manipulations are performed under local anesthesia with the help of arthroscopy( endoscopic method of treatment).

Treatment of gout at home

When treating gout at home, it is possible to use the following, the most effective recipes for gout: tinctures of lilac or cones of spruce, decoction of bay leaf.

It is worth remembering:

  • The use of medicinal raw materials is cured by the attending physician.
  • Such recipes have their contraindications. For example, a bay leaf is categorically forbidden to use pregnant( provokes premature birth and bleeding), a patient with peptic ulceration of the gastrointestinal tract and diabetes, with constipation.
  • Treatment with home remedies does not replace the prescribed medication prescribed by the doctor.

Nutrition: menu for gout

Diet for gout

No correction of nutrition, the effectiveness of drug therapy is significantly reduced. To normalize metabolic processes and prevent the development of exacerbations, it is necessary to adhere to a diet:

  • with reduced intake of fat,
  • restricting the intake of sodium,
  • with an emphasis on vegetable proteins and vitamins;
  • excluding preservatives.

The feeding regimen for gout prohibits the consumption of food:

  1. Salt( complete exception or daily intake of not more than 1/2 tsp).
  2. Cream cakes.
  3. Spices and spices( can be vinegar, bay leaf).
  4. Fatty meat / fish, smoked meat, dishes from offal( especially cold).
  5. Mushrooms.
  6. Figs, raspberries, raisins and fresh grapes.
  7. Bean cultures.
  8. Chocolate, cocoa, brewed tea, coffee.
  9. Alcohol. Greens - spinach, cauliflower, sorrel, lettuce leaves.

Allowed products:

  1. Bread( white, rye), pasta.
  2. Vegetables( better in fresh form), fruits( especially useful citrus and cherry).
  3. Milk, cottage cheese, kefir, butter.
  4. Bird, lean fish( recommended boiled 2-3 times per week menu).
  5. Unlimited sugar and honey( at a normal blood glucose level).
  6. Juice, mineral water.

Using a warm mineral water or a glass of water with the addition of lemon juice will accelerate metabolism. Also, metabolic processes are normalized at a weekly unloading day.

Details: therapeutic diet table 6 for gout.

Complications of gout

  • Severe deformity of joints, disability.
  • Gouty kidney, acute / chronic insufficiency, stones.
  • Hypertension, ischemia of the heart.
  • Osteoporosis.

Prevention

Avoiding the appearance of gout will help only a healthy lifestyle( physical activity, rejection of bad habits, proper nutrition).This "jaded" and often not taken seriously phrase protects the body from many diseases, including gout.

To stabilize the condition and eliminate complications, you should strictly follow the doctor's recommendations and strictly follow the diet prescribed for gout. Only then a long struggle with the disease will bring results.

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