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Attack of gout

 
, medical expert
Last reviewed: 17.10.2021
 
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Gout is a disease that occurs as a result of metabolic disorders. This condition is characterized by the deposition of a large amount of uric acid in the joints. The attack of gout develops under the influence of certain negative reasons. Most often this is preceded by food and spirits.

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Causes of a gout attack

Various factors can affect an acute attack of the disease. At the heart of them lies the use of products with a high content of purines and excessive consumption of alcohol. Together they can cause a serious attack of gout, being the main reasons for this process. A person suffering from a disease must constantly maintain his own condition and observe a special diet.

Influence on an acute attack is capable of excessive physical activity. If the affected joint is constantly susceptible to overexertion, this will exacerbate the situation. Affect the attack is capable of severe trauma and the presence of acute diseases. Infectious lesions can contribute to the process.

Attacks accompany a person throughout his life. In particular, if we talk about its acute flow. The person himself is able to control this process and influence the duration of the attack. The implementation of the basic rules will make it easier.

trusted-source[3], [4], [5]

Pathogenesis

This process is based on a significant increase in the production of uric acid. And it is not excreted from the body, but gradually accumulates in it. As a result of this process, acid is deposited in the joints. All this provokes the development of an inflammatory process with acute attacks. This is the pathogenesis of the disease.

Hyperuricemia can be observed not only with gout, this process occurs in other diseases. To date, there are three main elements that precede the development of the disease. This process is affected by the amount of uric acid compounds in the body. The speed of their accumulation is also taken into account. The second factor is the deposition of acid in the organs and the tissues that precede them. The third element is the development of an acute attack. It arises in the place of defeat. As a result of this, so-called tofusi are formed. These cones are located around the inflamed joint and are characterized by increased soreness.

Symptoms of a gout attack

Most people draw a fine line between gout and arthritis. However, these are several different diseases. Gout begins its development dramatically, contributing to problems with breathing, increased heart rate and nausea. Not all people have gout attacks that have such symptoms. More often it is an acute pain, appearing preferably at night or in the morning. Thus the person as if climbs on a wall. The pain is so burdensome that it feels like the joints are being twisted.

Pain syndrome is localized at the site of the lesion. Basically it's the joints of the thumbs. Sometimes elbow, interphalangeal and knee joints are affected. If a person does not take measures to eliminate an attack, the consequences can be severe. Up to the point that any movement of the affected joint will be accompanied by severe pain.

In addition to all the above-described symptoms, the formation of tofus is characteristic of gout. These are painless nodules located on the feet, hands and elbows. Very rarely the lesion covers the tongue, scrotum and tendons. The size of tofus can vary from small diameter to fairly large.

First signs

Gout may begin to show itself with various symptoms. An acute attack is characterized by the appearance of severe pain, sometimes it is simply unbearable. Thus the person is not capable to touch the amazed joint. In this case, it is difficult even to take any measures to eliminate the pain. The first signs include not only pain syndrome, but also general deterioration of health.

The victim feels excessive weakness, the body temperature is elevated. The lesion site turns red, the skin becomes hot. Often inflamed okolosustavnye tissue, mobility is limited. This symptomatic testifies to the presence of an acute attack. To contribute to its development are capable of stress, trauma and hypothermia. The duration of an attack depends on the factor that provoked it and the actions taken by a person to eliminate symptoms.

trusted-source[6], [7], [8]

Acute attack of gout

An acute attack of the disease simply does not occur. This process is influenced by certain negative factors. Most often, an acute attack of gout develops against the background of eating foods rich in purine content. Such food speeds up the process of lactic acid production and its deposition in the joints. Alcohol also has a similar effect. Even if a person eats properly and does not drink alcohol, the attack can develop.

The process is adversely affected by excessive physical exertion, trauma, surgical intervention and hypothermia. When the first symptomatology appears, it is necessary to begin the main measures for its elimination. This will speed up the process of relief and reduce the duration of the attack. There will not be enough medications, it is necessary to remove excess acid from the body, in this case only a large amount of liquid will help.

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Gout attack time

In this case, everything depends on the reason for the acute attack. In general, the duration of a gout attack does not exceed 3-7 days. During this period, it is necessary to perform certain actions aimed at stopping pain and inflammation.

For the prompt removal of an overabundance of lactic acid from the body, it is necessary to consume a lot of liquid. On average, this figure varies between 5-6 glasses. How quickly acid will leave the body depends only on how much it accumulates there.

In some cases, seizures last too long. This is due to the abuse of banned food and alcohol. Some people do not try to monitor their own condition. In this case, the attack can be prolonged for a long time. Moreover, sometimes only that the completed acute period is able to immediately change to a new one. Therefore, everything depends on the patient.

Effects

If the seizures last long, and eliminate them is difficult, in the future the condition will only worsen. The main consequences of gout occur as a result of the lack of necessary measures to eliminate and prevent the development of seizures.

If you do not fight with a decrease in the level of uric acid in the body, eventually it will lead to deformation of the joint. Deposits of urate negatively affect the process. Tofuy will appear in the place of permanent deposits of uric acid. The disease can take a chronic character and in this case it will be necessary to constantly fight the attacks. Gradually, the process will absorb other joints, organs and systems. This will affect the level of human life.

All this shows that you should not wait for the consequences to manifest themselves. It is necessary to blunt the further development of the process by all methods.

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Complications

The main consequence of gout is the development of gouty arthritis. As a result of this process, uric acid is deposited in the joints. This complication leads to deformation and damage to soft tissues. The probability of rupture is not ruled out when performing a mechanical load.

Gout negatively affects the kidneys. It is possible to develop a gouty kidney. This process is characterized by the deposition of uric acid in the tubules and glomeruli of the organ. Complication entails a disruption in the functionality of the kidneys and the development of acute or chronic insufficiency. Do not rule out the appearance of urolithiasis. In the kidneys, loss will begin. There is a danger of developing hypertension.

Other complications include the appearance of tofus, the development of coronary heart disease, osteoporosis and metabolic syndrome. There is a risk of arterial hypertension.

trusted-source[14], [15], [16], [17]

Diagnosis of a gout attack

Patients who have a suspicion of developing gout are mandatory to visit a rheumatologist and urologist. Consultation with specialists will allow to collect all information about the patient, the type of his activity. The diagnosis of a gout attack does not end with the collection of data.

The first thing is a general blood test, it will allow you to track the level of the main components. The diagnosis of a gout attack includes a biochemical blood test. With an exacerbation of the process, the level of uric acid increases.

Following the laboratory methods should be the radiography of the joints. It will allow you to track their condition, identify abnormalities and notice lesions. In some cases, a puncture is performed. A fluid sample is taken from the joint for examination. This process can reveal the content of uric acid.

Widely used ultrasound of the kidneys. It is conducted to exclude the formation of urate calculi in the organ. These methods can be used both in aggregate and separately.

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Analyzes

In the formulation of the correct diagnosis, the study of uric acid metabolism is of great importance. It is necessary to track how much acid is produced and how much it is extracted. The normal content should not exceed 0.3 mmol / l, in daily urine 3.8 mmol / day, the average normal uric acid clearance is 9.1 ml / min. However, these data vary depending on the type of hyperuricemia. This is by no means the only analysis that must be submitted.

According to the standard, blood and urine are susceptible. Particular attention is paid to the indicator of ESR. During the period of exacerbation, it increases, and sometimes mild leukocytosis is observed. Other indicators are in the acute phase of inflammation. Urinalysis indicates a decrease in its density, leukocyturia and microhematuria.

The synovial fluid is also studied. It is taken with the help of a puncture of the affected joint. When it is thoroughly examined, small crystals of sodium urate are found.

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Instrumental diagnostics

Radiography on early manifestations of the disease does not show any deviations. Chronic urates on the roentgenogram are signs of destruction. As a result of this process, the joint space is narrowed. Instrumental diagnosis indicates defects in bone tissues. Together with this, on the roentgenogram, one can see the seals that form around the joint. This is the so-called tofus. You can see them without the help of diagnostic methods. Cones on the joints can be seen not with an armed eye.

At the first stage of development of an attack cysts are formed. They do not affect the tissues. Often, condensation is observed in deeper layers. In the second stage, large cysts are seen on the X-ray. They are located around the joint, accompanied by the development of small erosion on the surfaces. The third stage is characterized by the presence of large erosion. The soft tissues are too compact.

There is little data for instrumental diagnostics, for the precise diagnosis. They usually start from the results of the analyzes and the differential analysis.

Differential diagnostics

Gout is always necessary to differentiate with acute infectious arthritis. These diseases have identical symptoms. To distinguish them among themselves will allow competently collected data, in particular anamnesis and information about seizures. This differential diagnosis does not end there.

If the attack proceeds according to the type of polyarthritis and the lesion covers the joints of the hands, it must be differentiated with rheumatic or reactive polyarthritis. For an attack of gout, a bright coloration of the skin in the lesion is characteristic. This symptom is excluded in other cases.

To make an accurate diagnosis it is necessary to pass a blood and urine test. This will determine the quantitative composition of uric acid in the body. Then a biopsy follows, whereby the synovial fluid can be studied. These analyzes, together with instrumental diagnostic data, will be sufficient for the diagnosis.

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Treatment of a gout attack

In acute pain, it is recommended to take an Ibuprofen or Naproxen tablet. This will allow you to pacify the pain syndrome a little. With severe pain, in no case should you use medicines based on salicylic acid. They contribute to the retention of uric acid. Treatment of a gout attack is primarily aimed at reducing pain syndrome and removing excess uric acid from the body.

In this matter, proper nutrition and abundant drinking will help. The daily diet should be filled with vegetables, dairy products. You should drink about 5-6 glasses of liquid. Suitable mineral water and citrus juices. Proper nutrition in this process plays an important role. It is recommended, regardless of seizures, to do unloading days, once a week.

In case of an acute attack it is necessary to resort to alternative medicine. Do compresses aimed at removing the inflammatory process. It is medicines and special means of alternative medicine that underlie the treatment of an attack.

It should be noted that they eliminate the disease in a complex way. For this, not only medicines, but also physiotherapy procedures are used. This takes into account the severity of the process and the presence of concomitant diseases.

How to relieve a gout attack?

Rheumatologists recommend removing acute gout attacks with the help of special anti-inflammatory drugs. They should always be at hand for a person suffering from these manifestations. Diclofenac and Indomethacin have an excellent effect. They are used identically. At one time you can drink 1-2 tablets, the regularity of taking no more than 4 times a day. Drugs should be used until the condition improves. How to remove the further course of a gout attack, every person facing this problem should know.

Medication will help to relieve acute pain, but this is not enough. It is necessary to calm the inflammatory process and remove excess acid from the body. The person should immediately sit down on the right diet and exclude foods rich in purines. Do not use alcohol in any way. Every day you need to drink 5-6 glasses of water. This will facilitate the early removal of lactic acid from the body.

Cope with inflammation, help compresses, based on cabbage leaf. However, not in all cases a person is able to touch the affected area. In this case, compresses are excluded. Elimination of the problem occurs by means of medicines and high fluid intake. Most importantly, the affected limb should always be on a small elevation.

How to relieve a gout attack at home?

If an acute attack has begun, the affected joint should be kept at rest. Excessive movement will only exacerbate the situation and complement the picture with unpleasant symptoms. It is recommended to place the patient's limb on a slight elevation. If a pronounced inflammatory reaction is observed, a warming compress will help. How to remove a home attack of gout should be everyone who suffers from the disease.

The victim needs to drink a lot. This will speed up the process of removing excess lactic acid from the body. The total daily volume should not be less than 2 liters.

The pain will be helped by medication. A special role is given to antihistamine and antikinin drugs. Help and anti-inflammatory drugs. However, taking a medication does not guarantee a lightning-fast disappearance of an attack. The main symptoms go away within 12 hours. If the effect after taking drugs is not observed, preference is given to glucocorticoid. They are able to relieve inflammation, but there is no need to expect a lasting effect.

It is desirable to treat the place for cupping with a 50% solution of dimexide. It will remove the inflammation and calm the pain. Appropriate applications based on Analgin, Novokain and Indomethacin.

Medications

During the elimination of an acute attack of gout, medications play an important role. It is not recommended to select medicines independently, this issue is decided by the attending physician based on the patient's condition. To stop the attack, medicines from different categories are used. The following remedies reduce the level of uric acid in the body: Allopurinol, Phoebusostat and Peglotisis.

  • Allopurinol. Tablets are taken orally, and they need to be washed down with a lot of liquid. The daily dose is 100-300 mg. It can be used as a single dose, and for 3. The duration of therapy is determined by the doctor. Use the drug is not possible with hypersensitivity, violations of the liver and kidneys. Can lead to a depressed state, hyperglycemia, nausea and vomiting.
  • Phoebusostat. This drug is relatively new in the treatment of gout. Dosage is assigned individually, depending on the patient's condition. Do not use if hypersensitivity. No adverse reactions were identified.
  • Pelopathy. The agent is administered intravenously. It is used only with the permission of the attending physician and in an individual dosage. Do not use if hypersensitivity and during child bearing. May cause nausea, vomiting, and impaired renal and hepatic function.
  • Remove the edema and pain will help the following medications: Colchicine, Cortisone and Prednisolone. Preference is given to non-steroidal anti-inflammatory drugs, in particular: Diclofenac and Ibuprofen.
  • Colchicine. The agent must be applied according to a certain scheme. On the first day of the attack, he is used 3 times a day for one mg. On the second and third day, 1 mg 2 times a day. You can not use the medication with hypersensitivity, pregnancy, in old age and with alcoholism. Can lead to the development of violations from the gastrointestinal tract.
  • Cortisone. Assigned inside or intramuscularly. In the form of tablets, it is used 3-4 times a day for 0.1-0.2 mg. Intramuscularly administered to 0,025-0,05 g once a day or 2 times at intervals of 8-12 hours. Use the product is not possible in pregnancy and hypersensitivity. It can cause disorders of the gastrointestinal tract and hormonal failures in women.
  • Prednisolone. The dose is set individually. On average, the drug is used for 4-6 tablets per day. The duration of therapy is prescribed by a doctor. Do not use if you have severe hypertension, pregnancy and hypersensitivity. May cause allergic reactions and disorders of the gastrointestinal tract.
  • Diclofenac. It is applied intramuscularly 1-2 times a day for 75 mg or orally 1-2 tablets a day. The duration of therapy is assigned individually. Use it is impossible at a hypersensitivity, in vynashivanija the child and at a stomach ulcer of a stomach and a duodenum. May lead to the development of nausea, vomiting, allergic reactions.
  • Ibuprofen. The agent is applied 800 mg 3 times a day. With pain syndrome of moderate intensity, 400 mg 3 times a day. Use the drug is not necessary for hypersensitivity, pregnancy ulcerative colitis and hematopoietic disorders. May lead to the development of nausea, vomiting, flatulence.

Alternative treatment

Alternative drugs have a pronounced effect. No wonder they were widely used in ancient times. With gout, alternative treatment also proved successful. After all, it's not so easy to stop an attack with medications alone. Alternative measures should be used as supportive activities.

  • Recipe number 1. Decoction of chamomile. It will remove the inflammatory process and alleviate the general condition of a person. To make an effective tool, you need to take chamomile flowers and pour them with boiling water. The resulting medicine is used in the form of trays, so the ingredients must be taken in sufficient quantities. So, chamomile flowers - 100 grams per 10 liters of water. To improve the effect, add 20 grams of salt. All the ingredients are mixed together. When the solution is infused, it can be used as a bath.
  • Recipe number 2. Perfect effect is made by ordinary fir cones. Their action is aimed at cleaning the joints of excess lactic acid in them. To make a preparation, you need to take a cone with seeds and pour 1.5 cups of boiling water. Everything is left for the night. The obtained tincture is taken inside 30 minutes before meals, 3 times a day. Use until there is relief.
  • Recipe number 3. Clear the joints will help the bay leaf. It should take 5 leaves and pour them 1,5 cups of boiling water. All this must be boiled for 5 minutes. During this process, it is not recommended to open the lid. The bay leaf contains essential oils, as a result of boiling, they are able to erode. The resulting broth should be wrapped in a towel and left for 3 hours. Then use within a day.
  • Recipe number 4. Favorably affects the joints of boiled rice. It is necessary to take 2 tablespoons of the main ingredient and rinse underwater. Then fill in a 500 ml jar and pour water. The rice should stand all night. In the morning it is removed, washed and the procedure is repeated again. You need to do this 4 times. Only then you can eat rice, but do not add oil and salt to it.

trusted-source[28], [29], [30]

Herbal Treatment

Herbs have always been a powerful tool in the fight against many diseases. Herbal treatment involves the use of various decoctions, infusions and compresses. And the tool can be based on one component, and on several.

  • Pharmaceutical camomile. From the broth of this plant you can make a wonderful bath. It will remove the inflammatory process and alleviate the general condition of a person. For cooking, you need to take 100 chamomiles and 10 liters of water.
  • Chamomile and elderberry. Together, these plants help to eliminate pain. Mix the ingredients in equal parts, then pour boiling water. The resulting mixture is heated, but it can not be boiled. The remedy is used not only for an acute attack of gout, but also for headache and spinal pain.
  • The sequence. If you regularly use the infusion from the turn, you can get rid of many ailments. This plant is able to replace tea. Brew it in the boiled water for 15 minutes. The result is a beautiful and delicious golden drink. During cooking, you need to follow the sequence.
  • Lilacs are common. The glass bottle must be filled with lilac flowers. At the same time, they should not be compacted. Then everything is poured in 200 ml of vodka or alcohol. Insist means should be for a week, while constantly shaking. The obtained tincture is taken for 20-30 drops 3 times a day with food.

It should be noted that the treatment with alternative means must necessarily be accompanied by walking and moderate exercise.

Homeopathy

Gout is an acute disease characterized by severe pain. They arise as a result of the deposition of urate crystals in the joints. The affected areas look red and shiny. The disease can affect the joints on the upper and lower limbs. Correctly to struggle with a gout homeopathy will help.

At the beginning of an acute attack, ACONITE 30 is preferred. This remedy will suppress unpleasant symptoms. In the chronic course of the disease, AMMON will help. PHOS. 30. If it is impossible to touch the affected joint, ARNICA 30 will immediately provide relief. In typical cases, BELLADONNA 30 can not be avoided.

If there is a strong swelling, you need to use BRYONIA 30. Sharp pain and inability to touch the patient's joint will help to eliminate COLCHICUM 30. If tofusov can not do without GUAIACUM 30.

If the condition worsens when exposed to heat, LEDUM 30 is used. Acute and chronic seizures will eliminate SABINA 30.

Detailed information about medications and treatment schemes should be provided by an experienced homeopathic doctor. Independently use of funds is not recommended.

Operative treatment

Surgery for gout is very rarely used. In this process, there is no need. However, surgical treatment may be necessary in the event that a person has large tofuy. As a rule, they interfere with normal life activity. Their location on the limbs, in particular - the legs, does not allow to wear shoes normally. And in general, tofuys bring a lot of inconvenience.

Education itself does not resolve. Often the process involves the periarticular tissues. Most often, the skin suffers, resulting in fistulas. In this case, removal of sediments is recommended. Everything is done through surgery. However, the removal of tofus does not guarantee that it will not appear again in the future.

Tofusy not able to resolve under the influence of special drugs. If they are not remedied in time, there is a risk of limiting the mobility of the joint. Gradually tofuys lead to deformation, and then to complete destruction of the cartilage. In this case, a person becomes disabled.

Prevention

The development of gout affects heredity. However, for its emergence, additional factors are also needed. It can be overweight, food with a high content of purines and excessive consumption of alcohol. If preventive measures are taken, there is a chance to prevent the development of the disease. Prevention of disease is based on the observance of proper nutrition. It is necessary to exclude products such as: meat, canned goods, rich broths and chillies. Almost everything is excluded from drinks, of course, and alcohol. Preference should be given to vegetables, cereals and dairy products. You can drink a lot of liquid, the main thing is that it was mineral water. You can also use citrus juices.

Adherence to recommendations for proper nutrition will avoid bouts of the disease. As a supportive therapy, certain medications are prescribed.

Forecast

In many patients gout proceeds without any complications. In this case, we mean tofusy, arthropathy and pathological processes in the kidneys. This indicates that the outlook is favorable. At the same time the person keeps working.

If the condition is severe, disability may occur within a few years. This happens when you ignore the main recommendations regarding treatment and elimination of the main signs of the disease. If you do not excrete uric acid from the body, the risk of vascular deformity is great.

The patient's lifespan depends directly on the complexity of the situation. So, if the cardiovascular or renal pathology developed, the life span is significantly reduced. In most cases, the fatal outcome is due to the progression of uremia. However, in coronary disease, people die also often. All this shows that the forecast depends on the person himself and on the time taken actions.

trusted-source[31], [32], [33]

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