Gout in the literal translation from Greek means "trap for the feet."People who suffer from these chronic diseases understand the meaning of this phrase well, as the disease proceeds with bright pain symptoms, completely depriving them of the opportunity to live and move normally during periods of exacerbation.
At the heart of the disease is a violation of the exchange of purines, leading to the deposition of crystalline sodium sodium in tissues, and more often - in the joints of the first( large) toe and kidneys. In this case, affected areas can not function fully.
Gout is primary, acting as an independent disease due to genetically caused disorders of enzymes, and secondary, against a pathogenetic factor or disease( leukemia, intoxication lead, treatment with diuretics, riboxin, etc.).Primary gout is hereditary. Manifestes the disease with a sharp gouty attack that has a typical clinical picture( see symptoms and treatment of gout)
During the course of the disease,
- is given an acute recur
- chronic gout with the formation of tophi and polyarthritis of the affected joints.
Provocative agents of the disease
Provoking factors that lead to an increase in the concentration of uric acid in the body or to a violation of its excretion by urinary organs:
- Treatment with certain medications: cyclosporins, aspirin, diuretics, riboxin;
- Chronic diseases: obesity, blood diseases, diabetes, IHD, CRF, metabolic syndrome;
- Natural factors - cold, wind, high humidity;
- Lead poisoning;
- Postponed transplantation of organ( s);
- Postponed infectious disease;
- Operations, trauma and microtrauma, severe physical and mental stress, examination with the introduction of contrast agents;
- Prolonged fasting;
- Excessive purines in the diet - alcohol, fatty meats, seafood, drinks with gas, etc.
- risk groups men after 40 years old - the majority of
- women in the menopause period( see menopause symptoms in women)
Typical target sites
- plusnefalangovy joint of the foot - up to 60% of cases
- talural calcaneus joint
- ankle joint
- knee joint
- elbow joint
- small joints of the hand
- extremely rare: joints of the spine, hip joint, jaw joint
What?occurs when gout?
In simple terms, uric acid salts accumulate in the form of deposits in the joint, which leads to its inflammation and subsequent destruction of structures( cartilage, bone).This is a long pathogenetic process. The attack of arthritis begins against the background of falling into the joint cavity, or rather into the articular liquid of the sodium urate crystals.
Uric acid crystals are absorbed by both the neutrophils of the joint fluid and the cells of the articular shell - synoviocytes, which activates the lysosomal enzymes that trigger the inflammatory reaction. The LV of the articular fluid decreases, which contributes to the further precipitation of urate salts in the joint.
Symptoms of gout that precede the onset of an acute attack( 1-2 days before the onset) are as follows:
- unpleasant pulling sensations in the joint area, minor discomfort in the toe
- general malaise, nervousness
- fever, chills
Symptoms of goutyAttack
Acute arthritis begins with sharp pain in the area of the metatarsophalangeal joint( connecting the finger and the metatarsus) of the big toe with the following characteristics:
- begins at night time
- the pain is intolerable and instantly aggravated with the slightest leg motion, contact with the blanket, clothing
- rapid increase in pain within 2-6 hours
- arises the swelling of the joint
- the skin over the joint turns red, then after a couple of days beginspeeling
- , hyperthermia is noted up to 49 C and chills
The duration of the attack is 3-10 days, then the symptomatology subsides and gradually the function of the affected joint is restored. BUT!The gout will necessarily remind you of itself repeatedly. Attacks will occur after a certain period of time, from a couple of months to several years, then the exacerbations will be noted more often and will last longer, hitting and deforming all new joints.
The chronic course of gout is characterized by a triad of symptoms:
- Joint damage until deformation and immobilization;
- Formation of tophi or dense painful nodules 0,1 mm - 3-4 cm on hands, bends of elbows, ear shells, feet, less often - on sclera, tongue, and scrotum;
- The defeat of internal organs - kidneys, blood vessels, heart.
What should I do if I have an acute attack of gouty arthritis?
Immobilization of the affected area:
- Severe bed rest
- Immobilization of the diseased leg with fixation, raising the limb
- Avoiding contact of the sick leg with blankets, linen
Anesthesia and anti-inflammatory medication - oral medications
Non-steroidal anti-inflammatory drugs ( list from weak to verystrong drugs for analgesic effect): Ibuprofen, Diclofenac sodium, Indomethacin, Movalis, Butadione, Ketazon, Nimesulide( strong drug, The treatment of which should be strictly dosed). See the complete list of NSAIDs for injections of pain and ointment for pain.
Alkaloid troponovogo number - herbal preparation Colchicine! Many patients mistakenly believe that Colchicine is able to cure gout and take it during the interictal period. Such actions are absolutely wrong and dangerous tactics. Admission Colchicine from the beginning of harbingers of the attack, throughout the attack and 3-4 days after the end of the acute phase.
Urikozuricheskie drugs are used for active excretion of uric acid - Azaprozon, Propro-benecid, benzbrotheron, Sulfinpyrazon.
Inhibitors of uric acid production - Allopurinol, Milurit.
Corticosteroids - with ineffectiveness of other short course therapy. Prednisolone internally or by intraarticular injection.
Application to the affected joint with Vishnevsky liniment, Dimexid
Strict low-calorie diet
Liquid and semi-liquid food - vegetable broths, liquid porridges, one-component vegetable soups puree. When gout worsens, treatment will not produce the desired effect if the patient does not observe a special diet, which should become not just a temporary restriction, but a way of life.
Abundant alkaline drink - mineral alkaline water( Truskavets waters, Essentuki 17, 4, Borjomi), lemon juice and lemon water, oats decoction.
Elimination of products rich in purines - fatty meat and fish, alcohol, offal, green peas, cauliflower, etc.
Therapy of gout with folk methods
Treatment with folk remedies should be started in the interictal period and continued for a long time in order to prevent exacerbation or at leastextend the period of well-being. Any of these methods should be agreed with your doctor!
Folk remedies - decoctions, infusions and plants for internal use
- Alcoholic tincture of oats. For its preparation, the oats are poured into a jar for 3/4 of the volume and filled with medical alcohol. The mixture is insisted for about 2 weeks in the dark and taken in the diluted form: 15 drops of tincture of oats on a glass of warm water, 5 glasses throughout the day. The approximate course is 8-15 days. water garlic-lemon tincture. For its preparation, enough 3 heads of garlic and 4 large lemons, previously peeled. Pass the ingredients through a meat grinder and pour 7 cups of boiling water. The mixture is aged for 24 hours and filtered. Infusion take 40 ml before meals once a day. This method of treatment is possible for life-long use, but you should take breaks for 15 days after a month of treatment.
- Onion broth. Three medium bulbs in unrefined form pour 1 l of water and boil until softened vegetables. Take 100-150 ml on an empty stomach three times a day. The course of admission is 15 days.
- Infusions of plants - burdock, birch, physalis, cherry, autumn crocus, fennel, dandelion, ash. Raw materials from the above list( any) in the volume of 1 tbsp.pour 200 grams of boiling water and wait half an hour, filter. The resulting infusion is taken once a day before meals. Can be taken daily.
- Tea from celery seeds .This recipe is used in the acute period.1 tspseeds pour 300 grams of boiling water and stand for 10-15 minutes. It is recommended to take this tea 2-3 times a day in the period of exacerbation, and then - every day for 1 glass.
- The infusion of the Canadian small-petrel is used to lower the urate level of sodium in the body.20 grams of dried small-petaled flowers pour 1 liter of boiling water and stand for 10 minutes. Medicinal infusion drink 200 grams after meals three times a day for a long time, up to 2-3 months.
- Ash leaf infusion is used as a diuretic and strong anti-inflammatory agent. Brewed the same way as the previous infusion, filter. Take 1 liter a day for 10-15 days in a row.
- Strawberry berries. It is recommended to take them fresh in 5 glasses a day, divided into receptions: 2 cups on an empty stomach early in the morning, 1 glass for half an hour before lunch and 2 more glasses for 30-60 minutes before bedtime.
- Birch juice .Take should be 100 grams 3-4 times daily before meals.
Treatment of gout - ointments, baths and compresses for external use
- Warming and anti-inflammatory ointment, for the preparation of which take half a bulb, 5 cloves of garlic, 1 leaf of aloe, 20 g of beeswax and 1 tbsp.butter. All this is placed in a saucepan and kept to boil, cover with a lid and remove from heat. After 3-6 minutes, the mixture is ground to a uniform state and chilled. The obtained ointment is used at night. It is possible simply by a method of rubbing, and it is possible in the form of a warming compress.
- Poultices of activated charcoal and flaxseed. Take 2 tablespoons of finely chopped flax seed and 4 tablespoons of activated charcoal powder, dilute with warm water until a uniform consistency of thick sour cream is applied and apply the mixture on a sore spot overnight, covered with a warm cloth.
- Compress of salt and honey .1 tbsp each. Salt and honey are mixed on gauze and put on a sick area for the whole night.
- single-soda bath .For 3 liters of boiled hot water take 3 tsp.soda and 9 drops of alcohol tincture of iodine. The patient's leg is kept in water for 7 minutes, then the joint is lubricated with iodine and wrapped in wax paper overnight. In the morning, the treated area is oiled with olive oil. Repeat 4 times a week.
- Lotion from the tincture of valerian .3 bottles of alcohol tincture valerian mixed with 50 grams of medical alcohol and left overnight. Further, the sore spots are rubbed with lotion using a cotton swab, and wrapped on top with polyethylene.