Gout attack

Gout is a disease that occurs as a result of metabolic disorders. This condition is characterized by the deposition of large amounts of uric acid in the joints. An attack of gout develops under the influence of certain negative factors. Most often, this is preceded by nutrition and alcoholic beverages.

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Causes of gout attack

Various factors can influence an acute attack of the disease. They are based on the consumption of products with a high content of purines and excessive alcohol consumption. Together, they can cause a serious attack of gout, being the main causes of this process. A person suffering from the disease must constantly maintain his own condition and follow a special diet.

Excessive physical activity can influence an acute attack. If the affected joint is constantly overstrained, this will aggravate the situation. A severe injury and the presence of acute diseases can influence an attack. Infectious lesions can contribute to the process.

Attacks accompany a person throughout his life. In particular, if we are talking about its acute course. The person himself is able to control this process and influence the duration of the attack. Following the basic rules will help alleviate the condition.

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Pathogenesis

This process is based on a significant increase in the production of uric acid. Moreover, 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 also occurs with other diseases. Today, three main elements are distinguished that precede the development of the disease. This process is affected by the amount of uric acid compounds in the body. The rate of their accumulation is also taken into account. The second factor is the deposition of acid in the organs and tissues preceding them. The third element is the development of an acute attack. They occur at the site of damage. As a result, so-called tophi are formed. These cones are located around the inflamed joint and are characterized by increased pain.

Symptoms of a gout attack

Most people draw a fine line between gout and arthritis. However, these are slightly different diseases. Gout begins to develop abruptly, which is facilitated by breathing problems, increased heart rate and nausea. Not all people have gout attacks with such symptoms. Most often, it is a sharp pain, which appears preferably at night or in the morning. At the same time, the person seems to be climbing the walls. The pain is so aggravating that it feels as if the joints are twisting.

The pain syndrome is localized at the site of the lesion. These are mainly the joints of the thumbs. Sometimes the elbow, interphalangeal and knee joints are affected. If a person does not take measures to eliminate the 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 symptoms, gout is characterized by the formation of tophi. These are painless nodules located on the feet, hands and elbows. Very rarely, the lesion covers the tongue, scrotum and tendons. The size of tophi can vary, from small in diameter to quite large.

First signs

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

The victim feels extremely weak, and his body temperature is elevated. The affected area turns red, and the skin becomes hot. Often, the periarticular tissues become inflamed, and mobility is limited. These symptoms indicate an acute attack. Stress, trauma, and hypothermia can contribute to its development. The duration of the attack depends on the factor that provoked it and the actions taken by the person to eliminate the symptoms.

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Acute attack of gout

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

The process is negatively affected by excessive physical exertion, injuries, surgical interventions and hypothermia. When the first symptoms appear, it is necessary to begin the main measures to eliminate them. This will speed up the relief process and reduce the duration of the attack. Medication alone will not be enough, 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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Duration of gout attack

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

To quickly remove excess lactic acid from the body, you need to drink a lot of liquid. On average, this figure fluctuates between 5-6 glasses. How quickly the acid leaves the body depends only on how much of it has accumulated there.

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

Consequences

If attacks last a long time and are difficult to eliminate, the condition will only worsen in the future. The main consequences of gout arise as a result of the lack of necessary measures to eliminate and prevent the development of attacks.

If you do not fight the decrease in the level of uric acid in the body, it will eventually lead to joint deformation. Urate deposits negatively affect the process. Over time, tophi will appear in place of constant uric acid deposits. The disease can become chronic and in this case, you will have to fight attacks constantly. Gradually, the process will absorb other joints, organs and systems. This will affect the person's quality of life.

All this shows that it is not worth waiting for the consequences to manifest themselves. It is necessary to slow down the further development of the process by all means.

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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 possibility of rupture during mechanical loading is not excluded.

Gout also has a negative effect on 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. The complication entails a violation of the functionality of the kidneys and the development of acute or chronic failure. The possibility of developing urolithiasis is not excluded. Losses will begin to form in the kidneys. The risk of developing arterial hypertension remains.

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

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Diagnosis of a gout attack

Patients who are suspected of developing gout must visit a rheumatologist and urologist. Consultation with specialists will allow collecting all the information about the patient, his type of activity. Diagnosis of a gout attack does not end with data collection.

The first step is to take a general blood test, which will allow you to track the level of the main components. Diagnosis of a gout attack includes a biochemical blood test. When the process worsens, the level of uric acid increases.

Laboratory methods are followed by radiography of the joints. It will allow you to track their condition, identify deviations and notice lesions. In some cases, a puncture is performed. A sample of fluid is taken from the joint for examination. This process allows you to identify the content of uric acid.

Ultrasound of the kidneys is widely used. It is performed to exclude the formation of urate stones in the organ. These methods can be used both together and separately.

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Tests

In making the correct diagnosis, great importance is attached to the study of uric acid metabolism. It is necessary to track the amount of acid produced and how much is excreted. The normal content should not exceed 0.3 mmol / l, in daily urine 3.8 mmol / day, the average normal clearance of uric acid is 9.1 ml / min. However, these data vary depending on the type of hyperuricemia. This is far from the only analysis that must be taken.

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

Synovial fluid is also examined. It is taken by puncturing the affected joint. When examined carefully, small crystals of sodium urate are found.

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Instrumental diagnostics

Radiography does not show any abnormalities at early manifestations of the disease. Chronic urates on the radiograph are signs of destruction. As a result of this process, the joint space narrows. Instrumental diagnostics indicate defects in bone tissue. At the same time, the radiograph can show seals that form around the joint. These are the so-called tophi. They are visible without the help of diagnostic methods. Cones on the joints are visible to the naked eye.

At the first stage of the attack, cysts are formed. They do not affect the tissue. Often, compaction is observed in deeper layers. At the second stage, large cysts are visible on the X-ray. They are located around the joint, accompanied by the development of small erosions on the surfaces. The third stage is characterized by the presence of large erosions. In this case, the soft tissues are too compacted.

Instrumental diagnostic data alone are not enough to make an accurate diagnosis. Usually, they rely on the results of analyses and differential studies.

Differential diagnostics

A gout attack must always be differentiated from acute infectious arthritis. These diseases have identical symptoms. Correctly collected data, in particular anamnesis and information about attacks, will help to differentiate them. Differential diagnostics do not end there.

If the attack is polyarthritis-type and the lesion covers the joints of the hands, it should be differentiated together with rheumatic or reactive polyarthritis. A gout attack is characterized by bright coloring of the skin at the site of the lesion. This symptom is excluded in other cases.

To make an accurate diagnosis, it is necessary to take a blood and urine test. This will determine the quantitative composition of uric acid in the body. Then comes a biopsy, through which it will be possible to study the synovial fluid. These tests, together with instrumental diagnostic data, will be sufficient to make a diagnosis.

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Treatment of gout attack

In case of acute pain, it is recommended to take a tablet of Ibuprofen or Naproxen. This will help to relieve the pain a little. In case of severe pain, medications based on salicylic acid should not be used under any circumstances. They contribute to the retention of uric acid. Treatment of a gout attack is primarily aimed at reducing the pain syndrome and removing excess uric acid from the body.

Proper nutrition and plenty of fluids will help in this matter. The daily diet should be filled with vegetables, dairy products. You should drink about 5-6 glasses of liquid. Mineral water and citrus juices will do. Proper nutrition plays an important role in this process. It is recommended to do fasting days, once a week, regardless of attacks.

In case of an acute attack, it is necessary to resort to the help of traditional medicine. Make compresses aimed at relieving the inflammatory process. It is medications and special traditional medicine that form the basis of attack treatment.

It should be noted that the disease is eliminated in a comprehensive manner. Not only medications are used for this, but also physiotherapeutic procedures. The severity of the process and the presence of concomitant diseases are taken into account.

How to relieve an attack of gout?

Rheumatologists recommend relieving acute attacks of gout with the help of special anti-inflammatory drugs. They should always be at hand for a person suffering from these symptoms. Diclofenac and Indomethacin have an excellent effect. They are used in the same way. You can take 1-2 tablets at a time, the regularity of taking no more than 4 times a day. The drugs should be used until the condition improves. How to relieve the further course of a gout attack, everyone who faces this problem should know.

Medicines will help relieve acute pain, but this is not enough. It is necessary to calm the inflammatory process and remove excess acid from the body. A person should immediately start eating right and exclude foods rich in purines. Alcohol should not be consumed under any circumstances. Every day it is necessary to drink 5-6 glasses of water. This will help to quickly remove lactic acid from the body.

Cabbage leaf compresses will help to cope with inflammation. However, not in all cases a person is able to touch the affected area. In this case, compresses are excluded. The problem is eliminated by means of medications and large fluid intake. Most importantly, the affected limb should always be slightly elevated.

How to relieve a gout attack at home?

If an acute attack has begun, the affected joint must be provided with complete rest. Excessive movement will only worsen the situation and add unpleasant symptoms to the picture. It is recommended to place the affected limb on a slight elevation. If there is a pronounced inflammatory reaction, a warming compress will help. How to relieve an attack of gout at home is something every person suffering from this disease should do.

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.

Medicines will help relieve pain. Antihistamines and antikinin drugs play a special role. Anti-inflammatory drugs will also help. However, taking medication does not guarantee that the attack will disappear instantly. The main symptoms go away within 12 hours. If there is no effect after taking the drugs, preference is given to glucocorticoids. They can relieve inflammation, but you should not expect a lasting effect from them.

It is advisable to treat the area for docking with a 50% solution of dimexide. It will relieve inflammation and calm the pain. Applications based on Analgin, Novocaine and Indomethacin are suitable.

Medicines

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

• Allopurinol. The tablets are taken orally, and they need to be washed down with plenty of liquid. The daily dose is 100-300 mg. It can be used both in one dose and in 3 doses. The duration of therapy is determined by the doctor. The drug cannot be used in case of hypersensitivity, liver and kidney dysfunction. It can lead to depression, hyperglycemia, nausea and vomiting.
• Febuxostat. This drug is relatively new in the treatment of gout. The dosage is prescribed individually depending on the patient's condition. The drug should not be used in case of hypersensitivity. No side effects were identified.
• Pegloticase. The drug is administered intravenously. It is used only with the permission of the attending physician and in an individual dosage. It cannot be used in case of hypersensitivity and during pregnancy. It can lead to nausea, vomiting and kidney and liver dysfunction.
• The following medications will help relieve swelling and pain: Colchicine, Cortisone and Prednisolone. Preference is also given to non-steroidal anti-inflammatory drugs, in particular: Diclofenac and Ibuprofen.
• Colchicine. The drug must be used according to a specific scheme. On the first day of an attack, it is used 3 times a day, 1 mg. On the second and third days, 1 mg 2 times a day. The drug should not be used in case of hypersensitivity, pregnancy, old age, and alcoholism. It can lead to the development of gastrointestinal tract disorders.
• Cortisone. It is administered orally or intramuscularly. In tablet form, it is used 3-4 times a day at 0.1-0.2 mg. Intramuscularly, 0.025-0.05 g is administered once a day or 2 times at intervals of 8-12 hours. The drug cannot be used during pregnancy and hypersensitivity. It can cause gastrointestinal disorders and hormonal imbalances in women.
• Prednisolone. The dose is determined individually. On average, the drug is used 4-6 tablets per day. The duration of therapy is prescribed by a doctor. It cannot be used in severe hypertension, pregnancy and hypersensitivity. It can cause allergic reactions and gastrointestinal disorders.
• Diclofenac. It is used intramuscularly 1-2 times a day at 75 mg or orally 1-2 tablets per day. The duration of therapy is prescribed individually. It cannot be used in case of hypersensitivity, during pregnancy and in case of gastric ulcer and duodenal ulcer. It can lead to the development of nausea, vomiting, allergic reactions.
• Ibuprofen. The drug is used 800 mg 3 times a day. For moderate pain, 400 mg 3 times a day. The drug should not be used in case of hypersensitivity, pregnancy, ulcerative colitis and hematopoiesis disorders. May lead to the development of nausea, vomiting, flatulence.

Folk remedies

Folk remedies have a pronounced effect. It is not for nothing that they were widely used in ancient times. Folk treatment has also proven itself in gout. After all, it is not so easy to stop an attack with medications alone. It is necessary to use folk remedies as auxiliary measures.

• Recipe #1. Chamomile decoction. It will help relieve inflammation and alleviate the general condition of a person. To prepare an effective remedy, you need to take chamomile flowers and pour boiling water over them. The resulting medicine is used in the form of baths, 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 ingredients are mixed together. When the solution is infused, it can be used as a bath.
• Recipe #2. Ordinary spruce cones have a wonderful effect. Their action is aimed at cleansing the joints from excess lactic acid. To prepare the remedy, take a cone with seeds and pour 1.5 cups of boiling water. Leave everything overnight. The resulting tincture is taken orally 30 minutes before meals, 3 times a day. Use until relief occurs.
• Recipe #3. Bay leaf will help cleanse joints. Take 5 leaves and pour 1.5 cups of boiling water over them. Boil it all for 5 minutes. It is not recommended to open the lid during this process. Bay leaf contains essential oils, which can evaporate as a result of boiling. The resulting decoction should be wrapped in a towel and left for 3 hours. Then consume during the day.
• Recipe #4. Boiled rice has a beneficial effect on joints. You need to take 2 tablespoons of the main ingredient and rinse under water. Then pour it into a 500 ml jar and fill it with water. The rice should stand overnight. In the morning, it is removed, rinsed and the procedure is repeated again. This should be done 4 times. Only then can you eat the rice, but do not add oil and salt to it.

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Herbal treatment

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

• Chamomile. A wonderful bath can be prepared from the decoction of this plant. It will help relieve inflammation and alleviate the general condition of a person. To prepare, take 100 chamomile and 10 liters of water.

• Chamomile and elderberry. Together, these plants will help eliminate pain. Mix the ingredients in equal parts, then pour boiling water over them. The resulting mixture is heated, but it cannot be boiled. The remedy is used not only for acute gout attacks, but also for headaches and back pain.
• Succession. If you regularly drink succession infusion, you can get rid of many ailments. This plant can replace tea. You need to brew it in boiled water for 15 minutes. The result is a beautiful and tasty golden drink. During preparation, you need to watch the succession.
• Common lilac. Fill a glass bottle with lilac flowers. Do not compact them. Then pour 200 ml of vodka or alcohol over everything. Infuse the remedy for a week, shaking constantly. Take 20-30 drops of the resulting tincture 3 times a day with food.

It is worth noting that treatment with folk remedies must be accompanied by walking and moderate physical activity.

Homeopathy

Gout is an acute disease characterized by severe pain. It occurs 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 of the upper and lower extremities. Homeopathy will help to fight gout correctly.

At the beginning of an acute attack, preference is given to ACONITE 30. This remedy will suppress unpleasant symptoms. In the chronic course of the disease, AMMON. PHOS. 30 will help. If the sore joint cannot be touched, ARNICA 30 will provide immediate help. In case of typical manifestations, you cannot do without BELLADONNA 30.

If there is severe swelling, BRYONIA 30 should be used. COLCHICUM 30 will help eliminate sharp pain and the inability to touch the sore joint. If there are tophi, GUAIACUM 30 cannot be avoided.

If the condition worsens when the affected joint is exposed to heat, LEDUM 30 is used. Acute and chronic attacks can be eliminated with SABINA 30.

Detailed information about medications and treatment regimens can be provided by an experienced homeopathic doctor. It is not recommended to use the products on your own.

Surgical treatment

Surgical intervention for gout is used extremely rarely. There is no need for this process. However, surgical treatment may be necessary if a person has developed large tophi. As a rule, they interfere with normal life. Their location on the extremities, in particular - the legs, does not allow you to wear shoes normally. And in general, tophi bring a lot of inconvenience.

Formations do not resolve on their own. Often the process affects periarticular tissues. Most often, the skin suffers, resulting in fistulas. In this case, removal of deposits is recommended. Everything is done through surgical intervention. However, the removal of tophus does not guarantee that it will not reappear in the future.

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

Prevention

Gout development is influenced by heredity. However, additional factors are also needed for it to occur. These may include excess weight, a diet high in purines, and excessive alcohol consumption. If preventive measures are taken, there is a chance to prevent the development of the disease. Disease prevention is based on proper nutrition. It is necessary to exclude such products as meat, canned food, rich broths, and jellied meat. Almost everything should be excluded from drinks, including alcohol, of course. Preference should be given to vegetables, cereals, and dairy products. You can drink a lot of liquid, the main thing is that it is mineral water. Citrus juices are also allowed.

Following the recommendations regarding proper nutrition will help avoid attacks of the disease. Certain medications are prescribed as supportive therapy.

Forecast

Many patients have gout without any complications. In this case, we mean tophi, arthropathies and pathological processes in the kidneys. This indicates that the prognosis is favorable. At the same time, the person retains his ability to work.

If the condition is severe, disability may occur within a few years. This happens when the main recommendations regarding treatment and elimination of the main signs of the disease are ignored. If uric acid is not removed from the body, the risk of vascular deformation is high.

The patient's life expectancy directly depends on the severity of the situation. Thus, if cardiovascular or renal pathology has developed, life expectancy is significantly reduced. In most cases, death occurs due to the progression of uremia. However, with coronary disease, people also die often. All this indicates that the prognosis depends on the person himself and the actions taken in time.

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