Gout: treatment with medicines. Attack of gout

Gout occurs when violating purine metabolism in the human body. In this case, an overestimate concentration of uric acid is found in the blood, and the articular and / or periarticular tissues, kidneys and other organs suffer from deposits of urate - sodium urate salts.

Causes of gout

Excess uric acid is formed under the influence of increased synthesis of endogenous purines, reduced urate excretion, or a combination of these processes. Recognize the symptoms of primary and secondary disease. The latter case obliges to pay attention to medicines taken by a person who was struck by gout. The causes of the ailment require detailed consideration.

Gout, provoked by hyperproduction of uric acid

The surplus of purine bases and nucleosides is the main reason for the high concentration of uric acid. With unlimited consumption of food, in an abundance of substrates, forming purines, the hyperproduction of acid naturally occurs.

The symptomatology of secondary hyperproduction is caused by an excessively high cell disintegration occurring against a background of certain diseases (for example, a hemoglobose, paraproteinemia, hemolysis, alcoholism, anticancer chemotherapy becomes a provocateur). Hyperuricemia often accompanies psoriasis. However, the clinical pathology of gout in these cases develops infrequently.

Gout caused by decreased excretion of uric acid

In 90% of people who are burdened with gout, there is a reduced extraction of acid. The kidneys, intestines and skin integuments help to leave the uric acid organism. With reduced excretion of urate by the kidneys, they accumulate in excess in the body and crystallize. Tiny crystals are deposited in the joints, leading to inflammation and pain. A kidney in this case affects urate jade.

A similar phenomenon is sometimes caused by diuretics, alcohol, acetylsalicylic acid, aminophylline, caffeine, diazepam, dimedrol, L-dopa, dopamine, B12 and C vitamins in small dosages. Lead leads to epidemic outbreaks. Lead gout is caused by paints, surrogate alcohol and other sources containing heavy metal.

Symptoms of gout: signs of seizures

The onset of symptoms is associated with the deposition of salts formed by uric acid. The crystals settle in the joints and kidneys. The first attack of gout usually does not occur before the age of thirty. It is experienced more often by patients who have reached 40-60 years.

The attack is accompanied by swelling and redness of the joint, acute soreness. Without treatment, it does not go on for several days or even weeks. Evening and night - the main time of occurrence of fleeting seizures.

Provoked by a gout attack with abundant meat food, alcoholic beverages, individual varieties of fish, coffee and other products enriched with purine bases. The disease in most cases affects the big toe, although the defeat of other joints is not ruled out. Its bright symptom is acute arthritis, which unfavorably proceeds with pathologies of the kidneys.

Acute gout

Arthritis is an acute form of gout. It is expressed in a sudden onset gouty attack - a painful inflammation of the joint. With gouty arthritis, urate crystals fall out of the tissues into the joint cavity, causing inflammation. Gouty attacks occur, usually in the middle of the night.

It is provoked by alcohol, trauma, physical overload, surgical operations, a number of gout medications. Treatment with medicines can relieve attacks and ease the condition. When attacking the joint and neighboring tissues swell, the skin in the place of the hearth blushes, painful sensations increase.

Attacks of acute arthritis disappear within a few days (sometimes weeks), even if they are not treated. Repeated attack returns after six months or a year. Although periods of calm sometimes last for up to 10-20 years. In people who are not puzzled by treatment, the frequency of seizures increases, and several joints are involved in them at the same time. The duration of attacks increases, they become more pronounced.

Chronic gout

The chronic course of the disease is accompanied by characteristic signs:

• Chronic arthritis;
• A cluster of urate crystals;
• Kidney damage.

Prolonged gout is accompanied by all signs simultaneously. Chronic arthritis affects those who survived the secondary form of the disease, untimely or inadequately treated.

With affected kidneys there are 3 types of changes:

1. The kidney tissues are overgrown with urate crystals. They have a weak inflammatory reaction.
2. The intracellular pathways of urine outflow are clogged with urate crystals.
3. In the urinary tract formed uric acid stones.

The modifications are combined in various variations, resulting in the clinical term "gouty kidney." Stones, lain in the urinary tract, are asymptomatic or show signs of urolithiasis.

Methods of treatment

The task of treatment is to prevent gouty attacks and to remove acute arthritis. Support for adequate drinking regimen, discharge of excess weight, diet therapy, reduction of medicines, increasing hyperuricemia, excluding alcohol prevents gout. Treatment with medications can eliminate inflammation and pain.

Water reduces the concentration of urate, preventing them from falling into crystals that settle in tissues and organs. In addition, it promotes their leaching and withdrawal from the body. Alcohol is capable of a diuretic effect. In large doses, it dehydrates the body, promoting the crystallization of salts, triggering gouty attacks. In addition, it slows the excretion of urates from the body, giving them the opportunity to be deposited in the joints.

Weight loss helps reduce the risk of recurrent gouty attacks. The diet should reduce fat and reduce calories. The diet is combined with regular aerobic exercises.

Medication Therapy

The main aspects by which gout is controlled is the treatment with medications that relieve pain, eliminate inflammatory reactions, control the impaired metabolism leading to hyperuricemia. Anesthesia is carried out with acetaminophen (Tylenol) or other more potent analgesics.

Of non-steroidal anti-inflammatory drugs, indomethacin is recommended. However, it is not suitable for patients with an allergy to aspirin and patients with polyps in the nose. Colchicine is suitable for the removal of gouty attacks.

Patients' reviews focus on the fact that oral medication results in serious side effects associated with the frequency of its administration (once per hour or two hours, until the soreness significantly recedes or unwanted reactions appear).

Corticosteroids, belonging to powerful anti-inflammatory agents, relieve acute attacks. To avoid severe long-term side effects, they are prescribed short courses. They are prescribed to patients who have concomitant diseases of the liver and kidneys.

Prolonged periods patients take drugs that reduce the concentration of uric acid in the blood. They promote the dissolution of heavy tofusnyh deposits, prevent the formation of stone and the development of pathologies in the kidneys. Thanks to them, gout does not occur again. Treatment with medicines from this category either increases the excretion of urates, or reduces their synthesis from purines of food.

These drugs can worsen gouty attacks, so their reception begins after the damping of the inflammatory process. If they were treated before the attack, the course is not interrupted, and try to adjust the dosage (especially after its extinction). Since many patients with a high level of uric acid are not prone to stone formation in the kidneys and are not burdened with gout, treatment with drugs that affect the level of urate is of an exclusively individual character.

With the help of probenecid and sulfinpyrazone, uric acid excretion is enhanced. These drugs are not suitable for treating people with urolithiasis. They sometimes provoke the formation of concrements. Abundant drink, combined with their reception, promotes accelerated passage of acid through the urinary system and prevents the formation of conglomerates.

Thanks to allopurinol prevent the synthesis of uric acid. They block the metabolic conversion of purine bases to acid. He is cautiously appointed because of the risk of getting side effects to those who have weakened kidney function.

Use of home remedies

Home treatment methods help to remove the symptoms of gout, the current acute. The inflamed joint is lifted upward, providing him with peace. Soreness is reduced by applying ice. Exclude the use of aspirin-containing drugs (they inhibit the excretion of uric acid).

Treated with medicinal plants: dog rose and sea buckthorn, cranberries and strawberries, rowan and blueberries, barberry and St. John's wort, birch and linden, chicory and other herbs. They use homeopathic remedies.

Diet therapy for gout

Compliance with the diet provides a stable remission. Ideally, they achieve complete elimination of products enriched with purines. If an absolute exception is not possible, the maximum restriction on their consumption is introduced. Try to balance the amount of fat and drink abundantly.

In abundance are saturated with purines anchovies, sardines, goose, chicken and any fatty meat, by-products, meat extracts, legumes and dry wine. When diagnosing gout, tomatoes are eaten in moderation.

In tomatoes full of organic acids. Purines in them are not so much, as, for example, in meat. Therefore, nutritionists who are tormented by gout, do not prohibit tomatoes. On the contrary, they believe that a reasonable amount of tomatoes and dishes from them is beneficial to such patients.