Symptoms of the disease resemble arthritis. It all starts with inflammation of the joint, most often the thumb, knee or ankle. Pressing pain appears, the affected area swells and turns red. On palpation, you can notice that the area around the joint is hot.
The acute course of the disease is accompanied by an increase in body temperature up to 40 ° C. Symptoms of gout develop within an hour, and then stop.
Symptoms of the disease can pass after 3-10 days, and after a few months the attack is repeated again. With each new attack, the gap between periods of exacerbation is narrowing.
The pathogenesis of gout can be observed 5-6 years or longer, then complications in the form of gouty nodes (tofuses) develop. When they are opened, white content is released.
Tofus indicate a chronic stage of the disease. In 50-70% of cases, kidney damage occurs.
The classification of a disease such as gout is of two types.
- Primary It develops due to increased production of uric acid. It occurs in 10% of cases.
- Secondary It is a consequence of the wrong lifestyle.
- Idiopathic. The cause of this type of gout has not been established.
By clinical manifestations:
- Asymptomatic gout. This form of the disease occurs in 8-14% of patients, but more often the absence of pronounced symptoms indicates the onset of the disease. As the disease develops, the asymptomatic phase alternates with acute attacks.
- Acute gouty arthritis. This is a classic version of the development of gout. It manifests itself in 50-80% of patients. Monoarthritis is more common in men, and oligo – and polyarthritis in women.
- Polyarthritis of an infectious-allergic type. This form appears in 5% of patients. Signs of gout are: migratory pains in several joints at once, a rapid increase in inflammation.
- Subacute. The pain is most often localized in the metatarsophalangeal joint. Perhaps the development of arthritis of medium and large joints.
- Rheumatoid-like. The joints of the hands are the first to be affected.
- Periarthric. How does gout of this species appear? Bursa and tendons are affected, but the joints are not involved in the inflammatory process. Without treatment, chronic gouty polyarthritis develops. The symptomatology of the disease looks like this: articular tissues are deformed, dislocations of the fingers, bone growths, crunch during movement appear.
- Pseudo-phlegmatic. Gout is characterized by monoarthritis, joint inflammation, and fever. In the affected area, pain is felt, there is weak hyperemia of the skin.
With the development of chronic inflammation, seizures become severe, patients may lose their ability to work and the ability to move independently.
Which doctor treats gout?
How to treat gout? Only in the hospital, you can not self-medicate. It is hazardous to health. It is necessary to consult a therapist, and he will already refer you to the right specialist.
A rheumatologist is involved in the treatment of gout. This doctor treats all diseases of the joints, as well as heart defects of a rheumatic nature.
Treatment of gout is long, because the disease becomes chronic. The patient constantly needs to be monitored by a doctor.
Very often, a patient with gout needs help from both a rheumatologist and a urologist.
Treatment for gout should only begin after a final diagnosis has been made. The patient is prescribed these types of examinations:
- General blood analysis. The content of leukocytes is increased, which indicates an inflammatory process.
- Blood biochemistry. It is possible to detect an increase in the level of uric acid, fibrin, sialic acids and other substances.
- X-ray of the joint. An X-ray shows changes that indicate chronic polyarthritis or osteoporosis.
- Joint puncture Microcrystals of sodium urate are detected in the synovial fluid.
- Ultrasound of the kidneys. During the study, urate stones are detected.
The nature of pain
Gout pain is the first sign of the onset of the disease. They appear suddenly, accompanied by inflammation, swelling and a feeling of heat in the damaged area. Sometimes painful sensations are not localized in one place, but affect the entire area around the joint.
The patient may experience unbearable pain, and painkillers will not give the desired effect. In such cases, you can not drink Aspirin. This drug does not relieve pain during an attack of gout, but only enhances the symptoms. It causes an increase in uric acid levels in the blood.
Painful sensations occur at night, and decrease during the day. Most often, the pain gives to the big toe. The patient may experience pain for up to 1-3 weeks.
Complications appear if medical care was not provided on time. As they develop, gouty attacks are observed, which are accompanied by severe pain.
The joints are deformed, tofuses (gouty nodes) are formed – subcutaneous formations filled with uric acid. They can appear in different parts of the body, the body perceives them as a foreign body, so inflammation occurs. As a result of the inflammatory process, gouty arthritis appears.
Why is gout dangerous? Urinary salts can be deposited not only in the joints, but also in the kidneys and bladder. This provokes the appearance of stones in these organs.
Renal failure is a life-threatening consequence of gout. If a person is not provided with help in time, a fatal outcome is inevitable.
How to get rid of gout? All medicinal methods are aimed at stopping the attack. After the patient hears the diagnosis, he needs to change his lifestyle and take medication. Unfortunately, gout is not completely treated, but you still can’t do without therapy.
With the help of therapy, you can achieve a regression of the disease, minimize all its manifestations and protect yourself from serious consequences. How to treat gout with medication? Drug therapy is aimed at reducing the level of uric acid in the body, stopping inflammation and acute pain.
Medication for gout looks like this:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). The drugs stop the attack, relieve swelling and eliminate pain. Apply Metindol, Diclofenac, Indomethacin. The course is 1-2 weeks.
- Drugs to lower uric acid levels. Allopurinol, Orotic acid, Milurit, Hepatocatasal is suitable.
- Glucocorticoids. These are synthetic analogues of human hormones. Drugs reduce inflammation, but reduce immunity. They should be used only as a last resort, if there is no effect from therapy. Cortisone, prednisone, prednisone, or hydrocortisone may be prescribed.
Treatment of gout with drugs like Allopurinol is most effective.
Allopurinol is the most popular treatment for gout joints. It is a synthetic analogue of hypoxanthine. The drug reduces the concentration of uric acid in lymph, plasma, blood and urine, and also dissolves salt deposits in the kidneys, joints and tissues. Due to a number of side effects of the drug, the treatment of gout requires strict medical supervision.
After the start of the course of therapy, it will not be possible to immediately get rid of the attack. If the pain is unbearable, emergency measures are needed. What to do? Be sure to reduce the load on the sore joint. To reduce pain, it is necessary to observe bed rest. Lying in bed, put a pillow under your feet – lower limbs should be above body level.
If there is no strength to endure pain, apply ice to the affected area. After a cold compress, you can use Vishnevsky ointment or Dimexidum solution. These remedies will reduce inflammation.
There is no point in using painkillers, they will not relieve pain, but anti-inflammatory drugs will help. It is advisable to take drugs without steroid content.
How to treat gout with colchicine? This drug can be attributed to emergency care during an attack. It helps to cope with severe pain. It is advisable to drink a tablet in the first 12 hours after the onset of the acute stage. The treatment regimen for Colchicine looks like this: immediately 2 capsules, then 1 tablet after 1 hour, and after – 1 tablet 3 times a day for 7 days.
Colchicine has side effects in the form of nausea, vomiting, and diarrhea.
There are more cardinal ways to treat this disease, namely:
- puncture of intraarticular fluid;
- extracorporeal hemocorrection;
- physiotherapeutic procedures, for example, UFO.
Such methods of therapy are used to treat gout in acute form and in remission.
Treatment for gouty arthritis should be comprehensive. It makes no sense to undergo drug therapy if you do not follow a diet.
Proper nutrition should be aimed at the rapid elimination of uric acid and reduce the flow of this substance into the patient’s body.
Be sure to exclude such products and dishes:
- fish and meat broths;
- offal (kidney, liver and lungs).
First of all, it is worth getting rid of bad habits. You can not drink alcohol.
In a moderate amount, the use of legumes, radishes, sorrel, spinach, asparagus, eggplant, mushrooms and cauliflower is allowed. But it is better to coordinate the diet with your doctor. With his permission, you can eat eggs, lamb and low-fat fish. Useful foods containing ascorbic acid, especially citrus fruits. You can eat no more than 120 g of animal protein per day.
Food should not be too fat, patients need to monitor their weight. An important condition for diets is a plentiful drink. Patients with gout should drink up to 3 liters of fluid per day. It is advisable to drink alkaline drinks, for example, mineral water, rice broth and milk.
Add a little lemon juice to ordinary water. It dissolves uric acid salt deposits.
Sparkling water and store juices should not be drunk. As for mineral water, give preference to brands Essentuki, Borjomi and Narzan. In case of kidney disease, the volume of daily fluid should be agreed with your doctor.
Gout can occur several years after treatment, so preventive measures are needed.
Such recommendations will help prevent an attack:
- Be sure to follow a diet, control body weight and maintain water-salt balance. Drink at least 2 liters of clean water.
- If you have a genetic predisposition, if relatives have gout, regularly monitor uric ac >
Prevention of gout is necessary when undergoing chemotherapy. From the first day of a chemotherapeutic course, you need to take hypuricemic drugs, for example, Allopurinol.
With timely diagnosis and treatment, the prognosis is favorable. Gout can only progress if there are adverse factors such as diabetes mellitus, urolithiasis, and nephropathy.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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