What causes gout and how can it be prevented. How to alleviate gout pain quickly at home. What are the most effective treatments for gout flare-ups. Which dietary changes can help reduce uric acid levels. How do traditional and herbal remedies compare for gout relief. What lifestyle modifications can prevent future gout attacks. When should you seek medical attention for gout symptoms.

Understanding Gout: Causes, Symptoms, and Diagnosis

Gout is a form of arthritis characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in joints, often starting in the big toe. It occurs when urate crystals accumulate in your joint, causing inflammation and intense pain.

What Causes Gout?

Gout develops when there’s an excess of uric acid in the body, a condition called hyperuricemia. Uric acid is a waste product created when the body breaks down purines, substances naturally found in your body and in certain foods. Normally, uric acid dissolves in the blood and passes through the kidneys into urine. However, sometimes the body produces too much uric acid or the kidneys excrete too little, leading to a buildup.

Who is at Risk for Gout?

• Men over 40 years old
• Post-menopausal women
• People with a family history of gout
• Those with certain medical conditions (e.g., high blood pressure, diabetes, kidney disease)
• Individuals who consume a diet high in purines
• People who drink alcohol excessively, especially beer
• Those who are overweight or obese

Recognizing Gout Symptoms

Gout attacks often occur suddenly, frequently at night. Common symptoms include:

• Intense joint pain, particularly in the big toe
• Swelling and redness in affected joints
• Limited range of motion
• Lingering discomfort after the severe pain subsides

While the big toe is the most common site for gout, it can affect other joints such as ankles, knees, elbows, wrists, and fingers.

Diagnosing Gout

If you suspect you have gout, it’s crucial to consult a healthcare professional. The diagnosis typically involves:

1. A review of your medical history
2. Physical examination of the affected joint(s)
3. Blood tests to measure uric acid levels
4. Joint fluid analysis to check for urate crystals
5. Imaging tests (X-rays, ultrasound, or CT scans) to rule out other causes of joint inflammation

Immediate Relief: How to Alleviate Gout Pain Quickly

When a gout attack strikes, the primary goal is to reduce pain and inflammation as quickly as possible. Here are some strategies for fast relief:

Over-the-Counter Pain Relievers

Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. Options include:

• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve)

Always follow the recommended dosage and consult with a healthcare provider if you have any concerns or underlying health conditions.

Ice and Elevation

Applying an ice pack to the affected joint can help reduce swelling and alleviate pain. Wrap the ice pack in a thin towel and apply for 20-30 minutes at a time. Elevating the affected limb can also help reduce swelling.

Rest and Immobilization

Rest the affected joint as much as possible during an acute attack. Using a cane or crutches can help take pressure off the painful joint while walking.

Hydration

Drinking plenty of water can help flush uric acid from your system. Aim for at least 8-10 glasses of water per day during a gout attack.

Dietary Changes to Reduce Uric Acid Levels

Making long-term dietary changes can help prevent future gout attacks by reducing uric acid levels in the body. Here are some key modifications to consider:

Foods to Limit or Avoid

• Organ meats (liver, kidney, sweetbreads)
• Red meat and fatty fish
• Shellfish
• High-fructose corn syrup
• Alcohol, especially beer
• Sugary beverages

Foods to Include

• Low-fat dairy products
• Whole grains
• Fruits (especially cherries)
• Vegetables
• Lean proteins (chicken, turkey, fish in moderation)
• Nuts and legumes

Incorporating these dietary changes can significantly reduce the frequency and severity of gout attacks. How effective is cherry consumption for gout prevention? Studies have shown that eating cherries or drinking cherry juice can lower the risk of gout attacks by up to 35%. This is likely due to their high antioxidant content and ability to reduce inflammation.

Medications for Gout: Prescription Options

When lifestyle changes and over-the-counter medications aren’t sufficient, your doctor may prescribe medications to manage gout. These typically fall into two categories:

Medications for Acute Attacks

• Colchicine: Reduces inflammation during gout attacks
• Corticosteroids: Powerful anti-inflammatory drugs for severe attacks
• Prescription-strength NSAIDs

Medications to Prevent Future Attacks

• Allopurinol: Reduces uric acid production
• Febuxostat: An alternative to allopurinol for those who can’t tolerate it
• Probenecid: Improves kidney function to remove uric acid

What factors does a doctor consider when prescribing gout medication? The choice of medication depends on several factors, including the severity and frequency of your gout attacks, your overall health, potential side effects, and any other medications you’re taking. Your doctor will work with you to find the most effective treatment plan.

Lifestyle Modifications to Prevent Gout Attacks

In addition to dietary changes, several lifestyle modifications can help prevent gout attacks and improve overall health:

Weight Management

Maintaining a healthy weight can significantly reduce the risk of gout attacks. Excess weight increases uric acid production and decreases the body’s ability to eliminate it. How much can weight loss impact gout risk? Studies have shown that losing weight can lower uric acid levels and reduce the frequency of gout attacks by up to 40-50%.

Regular Exercise

Engaging in regular physical activity can help maintain a healthy weight and improve overall health. Low-impact exercises like swimming, cycling, and yoga are particularly beneficial for those with gout.

Hydration

Drinking plenty of water helps flush uric acid from the body. Aim for at least 8 glasses of water per day, more if you’re physically active or live in a hot climate.

Limiting Alcohol Consumption

Alcohol, especially beer, can increase uric acid production and decrease its excretion. If you choose to drink, do so in moderation and opt for wine instead of beer or spirits.

Stress Management

Stress can trigger gout attacks in some people. Incorporate stress-reduction techniques such as meditation, deep breathing exercises, or yoga into your daily routine.

Natural and Herbal Remedies for Gout Relief

While scientific evidence is limited for many natural remedies, some people find relief from gout symptoms using the following:

Cherries and Cherry Extract

As mentioned earlier, cherries have anti-inflammatory properties that may help reduce gout symptoms. Eating fresh cherries or taking cherry extract supplements may be beneficial.

Apple Cider Vinegar

Some people claim that apple cider vinegar helps alkalize the body and reduce uric acid levels. While scientific evidence is lacking, it’s generally safe to try mixing 1-2 tablespoons in water and drinking daily.

Ginger

Ginger has anti-inflammatory properties that may help reduce pain and swelling associated with gout. You can consume ginger as a tea, in capsule form, or add fresh ginger to your meals.

Turmeric

Curcumin, the active compound in turmeric, has potent anti-inflammatory effects. While more research is needed specifically for gout, turmeric supplements or adding the spice to your diet may be beneficial.

Epsom Salt Soaks

Soaking the affected joint in warm water with Epsom salts may help reduce pain and inflammation. Add 1-2 cups of Epsom salt to a warm bath or foot soak and soak for 20-30 minutes.

Are natural remedies as effective as conventional gout treatments? While some natural remedies show promise, they generally aren’t as well-studied or consistently effective as conventional medical treatments. It’s important to discuss any natural remedies with your healthcare provider, especially if you’re taking other medications.

When to Seek Medical Attention for Gout

While many gout attacks can be managed at home, there are situations where medical attention is necessary:

Severe Pain or Prolonged Symptoms

If your pain is severe, doesn’t respond to home treatments, or lasts longer than 10 days, consult your doctor.

Fever

A fever accompanying joint pain could indicate an infection rather than gout. Seek immediate medical attention if you experience a fever with joint symptoms.

Multiple Joints Affected

If multiple joints are affected simultaneously, especially if it’s a new occurrence, consult your healthcare provider.

Worsening Symptoms

If your symptoms are getting worse despite home treatment, or if you’re experiencing new symptoms, seek medical advice.

Frequent Attacks

If you’re experiencing frequent gout attacks (more than once or twice a year), it’s time to discuss long-term management strategies with your doctor.

How quickly should you expect relief from gout symptoms with proper treatment? With appropriate treatment, most gout attacks begin to subside within 12-24 hours and resolve completely within a few days to a week. If your symptoms persist beyond this timeframe, it’s important to follow up with your healthcare provider.

In conclusion, while gout can be painful and disruptive, there are numerous strategies to manage symptoms and prevent future attacks. By combining dietary changes, lifestyle modifications, appropriate medications, and natural remedies, most people with gout can effectively control their condition and improve their quality of life. Remember to work closely with your healthcare provider to develop a comprehensive management plan tailored to your individual needs and circumstances.

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Migraine vs. Headache: Differences and Similarities

Headaches are the most common reason why a person goes to the doctor or other healthcare professional for treatment. There are different types of headaches, for example, migraine, tension, and cluster headaches. The most common type of headache is tension headache. Migraine is much less common. There are few similarities between migraine and other headaches, for example, the severity of the pain can be the same, mild, moderate, or severe; and they can occur on one side or both sides of the head. However, there are many differences between migraine and other types of headaches. Migraine headaches also have different names, for example, migraine with aura and menstrual migraine.
Symptoms of migraine that usually aren’t experienced by a person with another type of headache include nausea, vomiting, worsens with mild exercise, debilitating pain, eye pain, throbbing head pain.
Migraine trigger include light, mild exercise, strong smells, certain foods like red wine, aged cheese, smoked meats, artificial sweeteners, chocolate, alcohol, and dairy products, menstrual period, stress, oversleeping, and changes in barometric pressure.
Untreated migraine attacks usually last from 4 to 72 hours, but may last for weeks. Most headaches resolve within 24-48 hours. Doctors don’t know exactly what causes migraine headaches; however, other headaches like tension headaches have more specific triggers and causes. Additional tests usually are required to diagnose migraine from other types of headaches, diseases, or other medical problems. Most headaches can be treated and cured with home remedies like essential oils, massage, and over-the-counter pain medication like acetaminophen (Tylenol) and NSAIDs (nonsteroidal anti-inflammatory drugs) like naproxen (Aleve, Anaprox, Naprosyn) or ibuprofen (Advil, Midol, Motrin). Most headaches resolve with OTC and home remedy treatment, while your doctor may need to prescribe medication to treat your migraines. If you have the “worst headache of your life,” seek medical care immediately.

How to Get Rid of Gout Pain Fast?

Knowing how to prevent and relieve gout is the best start to managing the condition effectively.

All About Gout

What is gout pain like? Gout is an uncomfortable and painful condition that occurs due to increased

uric acid in your blood. Uric acid is a normal by-product of the metabolic process, made up of salts

and urates and excreted through urine.

Gout process

High uric acid levels means an accumulation these salts that aren’t being flushed out the body.

Symptoms

The onset of gout is typically accompanied by a severe pain in the big toe, although it can also occur in other joints like the knee or ankle. High uric acid causes inflammation, which causes the pain and it most often happens during the night.

Diagnosis

If you suspect you have gout, see your doctor to review your medical history, do a physical exam and take blood to confirm a diagnosis. A medical examination assesses other possibilities like an infection.

Causes

Gout is common in men over 40 years, post-menopausal women, and in some cases, genetic.

However, there are external factors that you can control, which play their part in causing gout:

• Specific medication e.g. aspirin and water pills;

• Existing conditions e.g. rheumatoid arthritis;

• Heavy alcohol consumption;

• High purine diet e.g. organ meats and red meat;

• Sugar sweetened soft drinks;

• Even fruit juices and fruit increase the risk of gout in sufferers.

Different Gout Treatments

If you’re desperate to find out how to ease gout pain, experiment with the following treatments to

find the most effective relief for you.

Traditional Treatments

The first step is modifying your diet. Eliminate gout-causing foods and drinks and increase your intake nutrients that lower uric acid levels. Skimmed milk reduces the risk of attacks. Weight loss is also an effective strategy. Cherries appear to have a strongly protective effect, reducing the risk of attacks.

Film x-ray both foot and arthritis at first metatarsophalangeal joint

Only when advised by a doctor, medication can decrease the production of uric acid and reduce

inflammation.

Herbal Remedies

Good scientific studies of herbal remedies are lacking. There are suggestions that turmeric based

products and traditional chinese remedies may be helpful, but they have not been adequately studied to make sound recommendations.

Treating Gout At Home

This section on how to relieve gout pain is a very useful reference for those nights when you wake

up in agony. When you have a gout attack, you need to get the uric acid out of your system and treat

the pain.

1. Relax and keep your body calm.

2. Take proper medication.

3. For some people an over the counter anti inflammatory such as ibuprofen may be helpful but read the package insert carefully or discuss with the pharmacist.

4. Ice the affected area and elevate the joint.

5. If the pain is severe and doesn’t diminish, it’s recommended to seek medical advice.

Prevention

To know what helps ease gout pain is as beneficial as knowing how to prevent it. A healthy lifestyle,

balanced diet and regular exercise minimizes a variety of health problems but will help get rid of gout.

Gout is a disease that’s caused by high uric acid in the blood. This can be aggravated by kidney

disease or other medication. It may need review and you may need medication to control the uric acid level and prevent attacks.

Home Treatments & Remedies for Gout Pain and Uric Acid

If you have gout, you know the signs that a flare-up is on the way. There’s nothing you can do to stop an attack once it starts, but you can ease some of the symptoms at home.

Warning Signs of a Gout Flare-Up

Some people with gout, also known as gouty arthritis, say an attack begins with a burning, itching, or tingling feeling in a joint maybe an hour or two before the flare-up starts. The joint may feel a little stiff or a bit sore. Not long after, the telltale signs of gout begin. If you get repeated attacks, you’ll learn your body’s signals that one is about to begin.

Sometimes, people with gout have no early signs that a flare is about to start. They may just wake up in the middle of the night with a very painful joint.

When the flare starts, most people have redness, swelling, and severe pain, usually in one joint. The most common place for gout is the base of the big toe, but it can happen in other joints such as the elbow, knee, wrist, ankle, and instep.

Home Care for a Gout Flare-Up

If your doctor has diagnosed you with gout and given you medicine for a flare-up, take the medicine as directed when you know you’re having one. In most cases, that will probably be as soon as the first signs begin.

Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) such as celecoxib, indomethacin, meloxicam, or sulindac or suggest you take over-the-counter NSAIDs, like naproxen or ibuprofen. Depending on your medical history, your doctor may prescribe steroids or other medicines to reduce inflammation, such as colchicine (Colcrys).

In some cases, you already may be taking medicine like colchicine to prevent gout flare-ups. Your doctor may have also suggested:

If you can’t take allopurinol or it is not effective, your doctor may prescribe febuxostat (Uloric). It should be used with caution, however, because it has been linked to increased risk of death from heart disease and from other causes.

Just because you have a flare doesn’t mean these medicines aren’t working. In the first few months that you take them, you may have an attack as your body adjusts to the drug. Your doctor will likely have given you something to take if this happens, too.

If you’ve been taking preventive gout medicine for a long time and you’re having flares for the first time in a while, call your doctor. They may talk to you about changing your dosage or your medicine.

Pain Relief Without Medicine

Use cold. If your pain isn’t too bad, try cold packs or compresses on the joint to lower inflammation and soothe the ache. Wrap ice in a thin towel and apply it to the joint for up to 20 minutes several times a day. Do not apply ice to your hands or feet if you have nerve problems from diabetes or other causes.

Rest the joint. It’s a good idea to rest it until the pain eases up. You probably won’t want to move it much anyway. If you can, raise the joint on a pillow or other soft object.

Drink water. When your body doesn’t have enough water, your uric acid levels rise even higher. Stay hydrated to help keep those levels normal.

Watch what you eat and drink. Foods that are high in substances called purines, such as some seafood, organ meats like liver, and fatty foods, can raise the uric acid in your blood even more. So can fructose-sweetened drinks and alcohol — especially beer.

When to Get Help for a Gout Flare

It’s always a good idea to let your doctor know that you are having a flare. Sometimes, you may need to follow up to make sure your treatment plan is working or if your symptoms don’t improve. Call your doctor if:

This is your first flare-up. There are several other conditions, such as a joint infection, that have some of the same symptoms as gout attacks.

You have a highfever and chills. Gout attack symptoms may include a mild fever, but a higher temperature may be a sign of an infection.

Your symptoms don’t get any better after 48 hours or don’t end after about a week. If you don’t start to feel somewhat better after a few days, call your doctor. They may suggest a different treatment. Most gout attacks will go away by themselves in several weeks, even without treatment.

6 Gout Remedies and Natural Treatments that Work

Gout is something that plagues more and more people every day, and it’s caused from uric acid buildup in the body. I want to go over my top six home gout remedies — all-natural ways to beat gout symptoms — but right before that, go over the diet that is crucial to get rid of gout, along with the worst food offenders.

So if you have gout, the first thing you have to do is eliminate the excess sugar and grains in your diet, as well as processed meat. That means you need to kick that sugar addiction, as sugar feeds yeast in the body and conventional grains turn into sugar. Meanwhile, those meats are full of unhealthy hormones and antibiotics, and they’re so acidic to your system. In terms of beverages, it’s important to stay away from alcohol. Diet- and drink-wise, those are the best things you can do right now to eliminate gout symptoms.

In terms of a gout diet, it’s key to begin eating plenty of vegetables, fruits and organic meats. Some of the best foods include bone broth and my Chicken Vegetable Soup recipe.

6 Natural Remedies for Gout

Studies show that many of the dietary items we consume lead to gout as well as other health problems. Changing your diet and lifestyle may be the easy solution to beating gout. One of the first things to do is eliminate certain foods and beverages from your diet to beat gout.

Now here are my top six all-natural gout remedies to get rid of gout for good. If you follow these tips, you can get rid of gout in 24 hours or less. Yes, that fast, you can get rid of gout pain for good.

1. Celery Seed Extract

Step No. 1 is to consume celery seed extract and celery juice. Celery seed extract actually has been shown to decrease uric acid buildup in the body.

Researchers have identified over a dozen different types of antioxidants that are responsible for the benefits of celery — these include such phenolic acids as caffeic acid and ferulic acid, plus flavaols like quecetin. This makes celery useful for treating a wide range of conditions that are made worse by inflammation: joint pain (such as from arthritis), gout, kidney and liver infections, skin disorders, irritable bowel syndrome, and urinary tract infections, just to name a few.

You can buy the supplement or celery seed extract. You can also use a vegetable juicer to produce celery juice or just eat celery throughout the day — all of which are great for getting rid of gout.

2. Black Cherry Juice

The No. 2 home remedy for gout is black cherry juice or cherry juice extract. Treating gout is one of the many health benefits of cherries. A study published in Arthritis & Rheumatism evaluated 633 individuals with gout who were treated with cherry extract over a two-day period. This cherry treatment was associated with a 35 percent lower risk of gout attacks. When cherry intake was combined with allopurinol use, a prescribed medication for gout and kidney stones, the risk of gout attacks was 75 percent lower.

Cherry juice, then, has very similar benefits to celery juice: It reduces inflammation and uric acid buildup in the body. If you just add celery and black cherry juice to your diet, you will see very fast results in getting rid of gout.

3. Nettles

The third thing you can add is nettles. Nettles is a powerful anti-inflammatory phytonutrient, and you can buy it in tea form. A review of commonly used herbal remedies, including nettles, published in Toxicology and Applied Pharmacology, relays the standing of nettles as an anti-inflammatory food. So again, you can buy nettles as a supplement or drink it as a tea, and it’s great for getting rid of gout.

4. Fish Oil

No. 4 on the gout remedies list is fish oil. Now, fish oil doesn’t act as fast as the first two, but over time, fish oil can decrease your risk for gout because one of the health benefits of fish oil is it’s packed with omega-3 fatty acids that reduce disease-causing inflammation in your body.

Since gout is a form of arthritis and fish oil has been proven to be an effective treatment for arthritis, it only makes sense its omega-3 content benefits people with gout.

5. Proteolytic Enzymes

In terms of supplements proteolytic enzymes like benefit-rich bromelain can treat gout as well. Bromelain is found in the core of a pineapple, and it’s a digestive enzyme that’s been shown to help reduce uric acid and inflammation.

A review of gout treatment published in the Iranian Red Crescent Medical Journal mentions bromelain, along with many other foods, as part of a gout treatment diet.

6. Magnesium

One other remedy that’s been very beneficial in treating gout is magnesium. Magnesium is an alkaline mineral. That alkaline mineral can also decrease uric acid formation in the body, and studies show magnesium is an effective treatment for gout, particularly acute cases of gout.

If you have signs of magnesium deficiency, you may be susceptible to gout, so it’s a good idea to add magnesium-rich foods or magnesium supplements to your list of natural gout remedies.

If you get rid of the things that I talked about earlier — the excess alcohol, the sugar, the grains, the conventional meats — and if you add in a diet higher in fruits and vegetables along with those six home gout remedies, you will see your gout disapper in 24 hours or less.

The Gout Diet

Gout, also known as gouty arthritis is caused by the buildup of uric acid, a metabolite of protein and can be extremely painful. Gout generally occurs more often in men and second most in post menopausal women.

The excess of uric acid leads to the formation of small crystals of urate (uric acid crystals).  Some of these crystal deposits form in the synovial fluid (lubricating fluid around joints) that then cause inflammation and result in this painful condition.

When someone has a gout attack it can be extremely painful in the area of the big toe and signs also include redness and swelling in the joint.  Other joints may be affected and the pain can be so intense that even touching the area can be excruciating.

Causes of gout include: a diet high in hydrogenated fats, alcohol, conventional meat and refined carbohydrates.  Also having conditions such as insulin resistance, obesity, kidney disease, stress, high blood pressure, and an acidic system can greatly increase the risk of developing gout.

If you want to overcome gout then diet is key. Follow this gout diet for fast relief and do actually address the cause of gout and get rid of it forever.

• High-fiber foods – High fiber foods include fruits, vegetables, nuts and seeds that are high in fiber which can help reduce uric acid.
  
• Potassium-rich foods – Foods high in potassium like avocado, raw cultured dairy, coconut water, salmon, squash, bananas and apricots can help balance intracellular fluid relieving gout.
  
• Fresh berries and cherries – Berries and especially cherries can help neutralize uric acid.
  
• Wild-caught fish – Omega-3s help reduce inflammation and can help overcome gout pain.
  
• Water – Drink plenty of water, at least 8 oz every 2 hours to flush uric acid out of your system.

You also want to avoid the following foods:

• Foods high in purines – Purines are an amino acid that forms uric acid. Foods that have purines include: fatty red meat, shellfish, small fish, mushrooms, organ meats, peas, lentils, and spinach.
  
• Fried foods and hydrogenated oils – Fried foods and hydrogenated oils like soybean, vegetable, corn, and canola oil can aggravate gout.
  
• Sodium – A diet high in sodium can cause tissue swelling and increase gout symptoms.
  
• Alcohol  – Increases uric acid and toxicity of the liver.
  
• Refined carbohydrates – Sugar and other refined carbohydrates can make insulin resistance and gout worse.

Gout Causes

Gout is said to be caused by lifestyle and eating choices. Today the staple American diet has shifted to one full of highly processed foods. Many of these highly processed foods contain high fructose corn syrup which is believed to be a leading contributor to gout.

In fact, a recent study showed that men who consumed two or more sugary drinks per day were 85% more likely to develop gout than those men who only consumed less than one sugary beverage a month. This high sugar intake increases the levels of uric acid in the body. High levels of sugar in the body lead to a number of serious health problems including gout.

It’s also been shown that half of all gout sufferers are obese or overweight. And again, a high intake of sugar is shown to lead to obesity.

Another cause of gout is consuming too many high purine foods. These are organ meats, anchovies, herring, asparagus, and even mushrooms.  Eating less high purine foods is one way to try to ward off gout.

Conventional Gout Remedies

There are pharmaceuticals that are used to treat gout but I urge you to use these as a last resort. Some of the pharmaceuticals used to treat gout are NSAIDs, Colchicine, corticosteroids, Corticotropin (adrenocorticotropic hormone),Febuxostat, Aloprim, and Zyloprim.

Not only do many of these drugs not work for gout sufferers the side effects of these toxic pharmaceuticals are not worth the risk. This is especially true when diet and lifestyle changes can end or successfully help to manage gout.

Some of the side effects of these dangerous pharmaceuticals are the following:

Side Effects of Pharmaceuticals Used to Treat Gout

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Rash
• Dizziness
• Headaches
• Drowsiness
• Fluid retention
• Shortness of breath
• Kidney failure
• Liver failure

When there are all natural alternatives available to you to fight off gout I suggest you try these methods before you opt for pharmaceuticals and their dangerous side effects.

Additional Tips for Treating Gout Naturally

Studies show that many of the dietary items we consume lead to gout as well as other health problems. Changing your diet and lifestyle may be the easy solution to beating gout. One of the first things to do is eliminate certain foods and beverages from your diet to beat gout.

1. Eliminate or reduce sugar intake

As many studies are now illustrating, gout is common in people with excessive sugar intake, especially high fructose corn syrup (HFCS.) It’s wise to read the labels of all your food and drinks. If you find HFCS then eliminate that from your diet. In addition, look for sugar added under the guise of other common names for sugar; look for ‘cose’ at the end of words and these are probably types of sugar you don’t want to be consuming.

2. Eliminate grains

Grains in the body are converted to sugars so again you want to limit or avoid grains altogether. They are also very inflammatory to your body.

3. Limit alcohol consumption

Again, alcohol becomes sugar once ingested so eliminate this completely unless you have a healthy body already. Any substance that will be converted to one or another type of sugar by the body should be avoided at all costs. In order to get your uric acid levels down you must consistently avoid sugar in your diet.

4. Eliminate soda and diet soda

Soda and diet sodas are loaded with sweeteners either natural or artificial. It’s vital to eliminate them from your diet altogether if you want to be gout-free. Remember the study I mentioned earlier in which just two to three sweet beverages a week increased men’s chance of getting gout by a whopping 85%.

5. Consume cherries and strawberries daily

In order to combat the inflammation try adding fresh, organic cherries and strawberries to your diet. Cherries are rich in anthocyanicns and bioflavonoids both which help to relieve and prevent arthritis. In addition, both are high in antioxidants which will help to fight off free radical damage.

6. Exercise

Since obesity is linked to gout, it’s a good idea to exercise regularly if you’re trying to relieve gout from your life. Include burst training and weight training to maximize your health benefits from exercise. Exercise should be a part of your life no matter if you have gout or not. Burst Training is the best way to get in shape and keep your body healthy. Click here for my burst workout ideas.

As with many health problems there are all natural treatment methods that often involve lifestyle changes that should take place before you opt for pharmaceuticals or other methods.  The same is true for gout. Try these solutions and live an overall healthy lifestyle and you’ll be pain free from gout in no time.

If you want to learn more natural remedies and natural cures, subscribe to my YouTube channel.

Read Next: The Arthritis Diet & Supplementation Plan

Worst Foods & Beverages for Your New Year Diet

Now that the holiday feasts are over and the New Year is here, it’s a good time to take stock of your diet and consider healthy changes – especially if you have gout.

Gout is a common form of inflammatory arthritis that can unleash intensely painful flares in individual joints, often in the big toe. An estimated 8 million Americans experience gout attacks, which can last for a few days. The condition can also become chronic and lead to the destruction of joints. Although there’s no cure, there are medications to control gout, as well as lifestyle changes you can make to manage the condition – and reduce or even eliminate attacks.

Gout develops in some people who have high levels of uric acid in the blood; the uric acid can form needle-like crystals in soft tissues and joints. Uric acid is produced when the body breaks down chemicals called purines. Purines occur naturally in your body but are also found in certain foods and beverages. If your body can’t get rid of the uric acid efficiently enough (it’s cleaned out of the blood by your kidneys and eliminated in urine), the uric acid in your blood can build up and reach levels that could cause problems (above 6mg/dl).

One way to minimize the risk of a gout flare is to cut back on high-purine foods. The DASH diet – a low-sodium diet that emphasizes fruits and vegetables over red meats and processed foods – is recommended for people with gout. The Mediterranean diet – which emphasizes fruits, veggies, whole grains and healthy fats – may also help. Find more gout info here.

For specific foods and beverages, keep the following tips in mind:

Worst Foods & Beverages for Gout

• At the top of the list of what to avoid is booze. Beer and liquor readily convert to uric acid and they slow down its elimination. Studies have shown mixed results about whether wine is OK in moderation.
• Drinking sugary beverages, such as sodas sweetened with high fructose corn syrup, fruit juices or other sugar-containing drinks, is associated with gout. Notable exception: cherries, especially tart cherries, may be beneficial for gout.
• Go light on red meats, particularly organ meats like liver, tongue and sweetbreads, which are all high in purines. Also avoid or minimize the amount of bacon, venison and veal you eat.
• Maybe surprising: Turkey and goose are very high in purines. Chicken and duck are better bets.
• Some seafoods also are high in purines, including anchovies, sardines, mussels, scallops, crabs, lobsters, oysters and shrimp.
• Some vegetables are on the watch list, too: Consider cutting back on mushrooms, asparagus and spinach – but veggies of any kind are much less likely to trigger a gout flare than alcohol or organ meats.
• Learn more about foods to accept or reject here.

What’s Left?

There are also many things you can add to your diet to help avoid or manage gout. Drink plenty of water, milk and tart cherry juice. Drinking coffee seems to help as well. Be sure to talk with your doctor before making any dietary changes.

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Gout – Diagnosis and treatment

Diagnosis

Doctors usually diagnose gout based on your symptoms and the appearance of the affected joint. Tests to help diagnose gout may include:

• Joint fluid test. Your doctor may use a needle to draw fluid from your affected joint. Urate crystals may be visible when the fluid is examined under a microscope.
• Blood test. Your doctor may recommend a blood test to measure the levels of uric acid in your blood. Blood test results can be misleading, though. Some people have high uric acid levels, but never experience gout. And some people have signs and symptoms of gout, but don’t have unusual levels of uric acid in their blood.
• X-ray imaging. Joint X-rays can be helpful to rule out other causes of joint inflammation.
• Ultrasound. This test uses sound waves to detect urate crystals in joints or in tophi.
• Dual-energy computerized tomography (DECT). This test combines X-ray images taken from many different angles to visualize urate crystals in joints.

Treatment

Gout medications are available in two types and focus on two different problems. The first type helps reduce the inflammation and pain associated with gout attacks. The second type works to prevent gout complications by lowering the amount of uric acid in your blood.

Which type of medication is right for you depends on the frequency and severity of your symptoms, along with any other health problems you may have.

Medications to treat gout attacks

Drugs used to treat gout flares and prevent future attacks include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include over-the-counter options such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), as well as more-powerful prescription NSAIDs such as indomethacin (Indocin, Tivorbex) or celecoxib (Celebrex). NSAIDs carry risks of stomach pain, bleeding and ulcers.
• Colchicine. Your doctor may recommend colchicine (Colcrys, Gloperba, Mitigare), an anti-inflammatory drug that effectively reduces gout pain. The drug’s effectiveness may be offset, however, by side effects such as nausea, vomiting and diarrhea.
• Corticosteroids. Corticosteroid medications, such as prednisone, may control gout inflammation and pain. Corticosteroids may be in pill form, or they can be injected into your joint. Side effects of corticosteroids may include mood changes, increased blood sugar levels and elevated blood pressure.

Medications to prevent gout complications

If you experience several gout attacks each year, or if your gout attacks are less frequent but particularly painful, your doctor may recommend medication to reduce your risk of gout-related complications. If you already have evidence of damage from gout on joint X-rays, or you have tophi, chronic kidney disease or kidney stones, medications to lower your body’s level of uric acid may be recommended.

• Medications that block uric acid production. Drugs such as allopurinol (Aloprim, Lopurin, Zyloprim) and febuxostat (Uloric) help limit the amount of uric acid your body makes. Side effects of allopurinol include fever, rash, hepatitis and kidney problems. Febuxostat side effects include rash, nausea and reduced liver function. Febuxostat also may increase the risk of heart-related death.
• Medications that improve uric acid removal. Drugs such as probenecid (Probalan) help improve your kidneys’ ability to remove uric acid from your body. Side effects include a rash, stomach pain and kidney stones.

Lifestyle and home remedies

Medications are often the most effective way to treat gout attacks and prevent recurrent symptom flares. However, lifestyle choices also are important, and you may want to:

• Choose healthier beverages. Limit alcoholic beverages and drinks sweetened with fruit sugar (fructose). Instead, drink plenty of nonalcoholic beverages, especially water.
• Avoid foods high in purines. Red meat and organ meats, such as liver, are especially high in purines. Purine-rich seafood includes anchovies, sardines, mussels, scallops, trout and tuna. Low-fat dairy products may be a better source of protein for people prone to gout.
• Exercise regularly and lose weight. Keeping your body at a healthy weight reduces your risk of gout. Choose low-impact activities such as walking, bicycling and swimming — which are easier on your joints.

Preparing for your appointment

Make an appointment with your doctor if you have symptoms that are common to gout. After an initial examination, your doctor may refer you to a specialist in the diagnosis and treatment of arthritis and other inflammatory joint conditions (rheumatologist).

Here’s some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

• Write down your symptoms, including when they started and how often they occur.
• Note important personal information, such as any recent changes or major stressors in your life.
• Make a list of your key medical information, including any other conditions for which you’re being treated and the names of any medications, vitamins or supplements you’re taking. Your doctor will also want to know if you have any family history of gout.
• Take a family member or friend along, if possible. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.

Questions to ask the doctor at the initial appointment include:

• What are the possible causes of my symptoms or condition?
• What tests do you recommend?
• Are there any treatments or lifestyle changes that might help my symptoms now?
• Should I see a specialist?

Questions to ask if you’re referred to a rheumatologist include:

• What are the possible side effects of the drugs you’re prescribing?
• How soon after beginning treatment should my symptoms start to improve?
• Do I need to take medications long term?
• I have these other health conditions. How can I best manage them together?
• Do you recommend any changes to my diet?
• Is it safe for me to drink alcohol?
• Are there any handouts or websites that you’d recommend for me to learn more about my condition?

If any additional questions occur to you during your medical appointments, don’t hesitate to ask.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:

• What are your symptoms?
• When did you first experience these symptoms?
• Do your symptoms come and go? How often?
• Does anything in particular seem to trigger your symptoms, such as certain foods or physical or emotional stress?
• Are you being treated for any other medical conditions?
• What medications are you currently taking, including over-the-counter and prescription drugs as well as vitamins and supplements?
• Do any of your first-degree relatives — such as a parent or sibling — have a history of gout?
• What do you eat in a typical day?
• Do you drink alcohol? If so, how much and how often?

March 06, 2021

Show references

1. Gout. Centers for Disease Control and Prevention. https://www.cdc.gov/arthritis/basics/gout.html. Accessed Dec. 23, 2020.
2. Goldman L, et al., eds. Crystal deposition diseases. In: Goldman-Cecil Medicine. 26th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Dec. 23, 2020.
3. Ferri FF. Gout. In: Ferri’s Clinical Advisor 2021. Elsevier; 2021. https://www.clinicalkey.com. Accessed Dec. 23, 2020.
4. Gout. American College of Rheumatology. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Gout. Accessed Dec. 23, 2020.
5. Caffo AL. Clinical manifestations and diagnosis of gout. https://www.uptodate.com/contents/search. Accessed Dec. 23, 2021.
6. AskMayoExpert. Gout or pseudogout (adult). Mayo Clinic. 2020.
7. Gloperba prescribing information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=210942. Accessed Jan. 21, 2021.
8. Perez-Ruiz F. Pharmacologic urate-lowering therapy and treatment of topic in patients with gout. https://www.uptodate.com/contents/search. Accessed Dec. 23, 2021.
9. FitzGerald JD, et al. 2020 American College of Rheumatology guideline for the management of gout. Arthritis Care & Research. 2020; doi:10.1002/acr.24180.
10. Chang-Miller A (expert opinion). Mayo Clinic. Jan. 22, 2021.

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Basics of gout

Gout is a disease that causes sudden severe episodes of pain and tenderness, redness, warmth and swelling (inflammation) in some joints.

Gout is a dramatic example of a type of arthritis called crystal arthritis, sometimes called microcrystalline arthritis because the crystals are very small. The crystals form in the joint space. As the body tries to remove the crystals, a painful inflammation occurs.

It usually affects one joint at a time–often the large joint of the big toe. It also can affect other joints such as the knee, ankle, foot, hand, wrist and elbow. In rare cases, it may later affect the shoulders, hips or spine.

Facts and myths

Gout once was mistakenly thought to be a disease of the wealthy because it seemed to be caused by eating rich foods and by drinking too much alcohol. Although diet and excessive drinking do have something to do with gout, they are not the main cause of the disorder.  

Prognosis

Gout affects everyone differently. Some people have one episode and never have any other problems with it. Others have several episodes along with lasting joint pain and damage.

There is no cure for gout, but it can be controlled quite well with medication. Proper treatment can help you entirely avoid attacks and long-term joint damage.

Incidence

Gout affects more than one million Americans from all walks of life. It can occur at any age but the first attack often affects men between the ages of 40 and 50.

Gout affects women as well. In fact, the number of postmenopausal women who have gout is increasing. However, it sometimes is difficult to diagnose gout in these women because they also may have osteoarthritis, a disease that causes the breakdown of joint tissue leading to joint pain and stiffness. Among the affected joints are finger joints, the joint at the base of the thumb and the joint at the base of the big toe. The confusion occurs because urate (the salt of uric acid) crystals tend to deposit in areas where osteoarthritis already has caused joint damage such as in the hands and feet.

Symptoms

Attacks of gout usually develop very quickly. The first attack often occurs at night. You may go to bed feeling fine but then wake up in the middle of the night with extreme joint pain.

During an episode you may notice:

• sudden, severe joint pain
• joint swelling
• shiny red or purple skin around the joint
• extreme tenderness in the joint area–the area may be so tender that even the touch of a bed sheet may cause severe pain.

An episode of gout can be triggered by:

• drinking too much alcohol
• eating too much of the wrong foods
• surgery
• a sudden severe illness
• crash diets
• injury to a joint
• chemotherapy

Progression

At first episodes usually are few and far between. They last only a week or so and then everything seems to go back to normal with no symptoms between episodes. If the disease is not controlled by medication, attacks may occur more often and may last longer. Repeated episodes can damage the affected joint(s). If your joints have been damaged, you may have joint stiffness and limited motion after an attack.

Gout generally occurs in three phases:

1. A sudden onset of joint pain and swelling (often in the big toe) that goes away after five to 10 days (or longer in some instances).
2. A period of time when there are no symptoms at all, followed by other acute severe attacks.
3. After a number of years, if not treated, the development of persistent swelling, stiffness and mild to moderate pain in one or more joints after numerous acute (generally severe but short-lived) episodes.

Causes

Figure 1 – Joint with gout versus a normal joint. Click to enlarge.

The pain and swelling of gout are caused by uric acid crystals that deposit in the joint. Uric acid is a substance that normally forms when the body breaks down waste products called purines. Uric acid usually is dissolved in the blood and passes through the kidneys into the urine. In people with gout, the uric acid level in the blood is so high that uric acid crystals are deposited in joints and other tissues. This causes the joint lining (the synovium) to become inflamed.

After several years, the uric acid crystals can build up in the joint(s) and surrounding tissues. They form large deposits called tophi that look like lumps just under the skin. Tophi often are found in or near severely affected joints on or near the elbow, over the fingers and toes and in the outer edge of the ear. If the tophi are not prevented or treated, they can damage joints (see figure 1).

Uric acid crystals can form stones in the kidneys, in the ureters (tubes connecting the kidneys and bladder) or in the bladder itself. Several factors may cause the formation of these deposits. For example, the deposits may be caused by not drinking enough liquids. Because of this lack of fluid, the urine is unable to dissolve all the uric acid. Deposits also may form as a result of metabolic abnormalities such as the body’s inability to make urine-less acid. In other instances, diet may be the culprit. With some people, a diet rich in foods that further increases the production of uric acid may increase their chances of developing kidney stones. If your doctor suspects that diet is a contributing factor, you may be asked to collect several urine samples. Tests then will be conducted to determine the amount of uric acid your body produces. These tests are particularly helpful because some people with gout produce and eliminate a large amount of uric acid. These people may be more likely to develop kidney stones. People with gout also may have high blood pressure or kidney infections. Since these problems can cause kidney damage, your doctor will check for signs of these problems and treat them if they occur.

Almost all people with gout have too much uric acid in their blood, a condition called hyperuricemia. However, there are many people who have hyperuricemia but not gout. Hyperuricemia is caused by one or both of the following:

• The kidneys can’t get rid of uric acid fast enough.
• The body makes too much uric acid.

Hyperuricemia often is caused by using diuretic medications (“water pills”). Diuretics are used to get rid of excess body fluid and to lower high blood pressure. However, diuretics can hamper the kidneys’ ability to remove uric acid, thus raising uric acid levels in the blood.

Other factors such as inherited traits and environmental factors (such as weight, alcohol use and diet) also can play an important role in causing gout.

Diagnosis

To diagnose gout, your doctor will examine you and ask you to describe your symptoms. Your doctor may take blood tests to measure the amount of uric acid in your blood. Remember: A high level of uric acid in your blood doesn’t necessarily mean you have gout nor does a normal level mean you don’t have gout.

Your doctor may check for other types of arthritis such as CPPD deposition disease and infectious arthritis. These conditions resemble gout but are not caused by uric acid crystals. To determine which type of arthritis you might have, your doctor may have to remove fluid from an affected joint and examine it for crystals.

Treatment

Treatment for gout mainly consists of taking medication(s) and watching your diet.

The goals of treatment are to relieve pain, shorten the duration of inflammation during an acute attack, prevent future attacks and prevent joint damage.

Diet

There are many myths about diet and gout. Here are the facts:

1. Obesity can be linked to high uric acid levels in the blood. If you are overweight, work with your doctor to develop a weight-loss program. Don’t fast or try to diet too severely because that can raise your uric acid level and make the gout worse. If you are not overweight, watch your diet carefully so you don’t become overweight.
2. Usually, you can eat what you like within limits. If you have kidney stones due to uric acid, you may need to avoid or limit foods that raise your uric acid level such as those listed below. Talk to your doctor about what foods you may have to avoid.

You may need to completely avoid these foods which may raise uric acid levels:

• Brains
• Kidney
• Broths, gravies
• Sardines, anchovies
• Liver
• Sweetbreads

You can drink coffee and tea. However, talk to your doctor about drinking alcohol. Too much alcohol may raise your uric acid level and bring on a gout episode. Drink at least 10-12 eight-ounce glasses of non-alcoholic fluids daily, especially if you have had kidney stones. This will help flush the uric acid crystals out of your body.

Medications

Using medications for gout can be complicated. The treatment needs to be tailored for each person and may have to be changed from time to time. People who have hyperuricemia, but no other problems, usually do not require medications.

Medications are used to:

• Relieve the pain and swelling of an acute attack–these medications include nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, corticosteroid drugs and/or adrenocorticotropic hormone (ACTH).
• Prevent future episodes–these medications include colchicine, probenecid, sulfinpyrazone and allopurinol.
• Prevent or treat tophi–these medications include probenecid, sulfinpyrazone and allopurinol.
• Prevent uric acid kidney stones (with allopurinol).

All of these drugs are powerful so you need to understand why you are taking them, what side effects may occur and what to do if you have any problems.

Medications to treat acute attacks

Colchicine has been used to treat gout for over 2,400 years. It relieves the pain and swelling of acute attacks. It usually is taken by mouth in several small doses every day. It works best if taken during the first two days of an attack. When taken by mouth, colchicine can cause diarrhea, nausea and abdominal cramps. If side effects occur, stop taking the drug and notify your doctor. To prevent future episodes, you may have to continue taking a small dose of colchicine after the attack has cleared.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are sometimes used to relieve the pain and swelling of an acute attack. They usually begin working within 24 hours after you start taking them. These medications are as effective as colchicine but may have less frequent side effects. However, side effects from NSAIDs may include stomach upset, headache, skin rashes and sometimes ulcers.

Doctors teach many people with gout how to begin treatment on their own. When a gout episode begins, call your doctor and begin taking your medication. Your doctor may suggest that you keep a supply of medication on hand to take at the first sign of trouble.

Medications that control uric acid levels

The medications listed below are used to treat or prevent tophi and to prevent future gout episodes. (In addition, allopurinol is used to prevent kidney stone formation.) However, these medications do not relieve the pain and inflammation of an acute attack. These medicines start working slowly over many months. They may cause you to have more gout episodes when you first start taking them, so you may have to take colchicine or an NSAID at the same time for the first three to six months to prevent such attacks. Many people with gout do not require these medicines. If you must take them, however, you’ll probably have to do so for the rest of your life in order to prevent future problems.

Allopurinol (Lopurin, Zurinol, Zyloprim) reduces the amount of uric acid in your blood and urine by slowing the rate at which the body makes uric acid. It is the best medicine for people who have kidney problems or kidney stones caused by uric acid.

Occasional side effects include skin rash and stomach upset. Stomach problems usually go away as your body adjusts to the drug. In rare cases, this drug can cause a severe allergic reaction. If you have a skin rash along with hives, itching, fever, nausea or muscle pain, contact your doctor right away. This drug also may make some people drowsy or less alert. Make sure you know how you react to this medicine before you drive or operate machinery.

Some drugs lower the uric acid level in your blood by increasing the amount of uric acid passed in your urine. They help dissolve tophi and prevent uric acid deposits in joints. The drugs commonly used to lower uric acid levels in gout are probenecid (Benemid, Parbenem, Probalan) and sulfinpyrazone (Anturane). They usually are taken by mouth on a daily basis. Your doctor will adjust the amount of medication you take based on your blood uric acid level. When a normal level of uric acid is reached, no more crystals will be deposited in your joint(s). Those already present will start dissolving.

Common side effects include nausea, skin rash, stomach upset or headaches.

While the skin rash sometimes can be serious, other side effects usually are not serious and may go away as your body gets used to the medicine. If any side effects continue to bother you, contact your doctor.

Take these medications with plenty of liquids. Do not take aspirin with these drugs because it blocks their effects on the kidneys. Read the labels of any prescription or over-the-counter medicines you take to be sure they don’t contain aspirin.

Tips for taking Probenecid, Sulfinpyrazone or Allopurinol

At first, probenecid or sulfinpyrazone may increase your risk for kidney stones by increasing the uric acid content of the urine. To prevent this problem, keep your urine diluted by drinking 10-12 eight ounce glasses of fluid every day.

Probenecid, sulfinpyrazone and allopurinol also may cause you to have more frequent gout episodes at first. During this time, you may have to take colchicine or an NSAID for the first three to six months to prevent an episode.

Take your medicine exactly as your doctor instructs. In order to be effective, these medicines must be taken continuously. This will help your body get rid of excess uric acid and will keep the uric acid level from rising again.

Do not take double doses of your medicine. If you forget to take a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the dose you missed.

Talk with your doctor about all the drugs you’re taking. This includes over-the-counter drugs such as aspirin or diuretics. Some of the gout medications will not work properly if you are taking other drugs at the same time. Don’t start any new drugs without being sure they will work properly with the ones you’re already taking. The amount of medications you take will depend upon your symptoms and laboratory test results. You may only need to take one drug. On the other hand, it may be necessary to take a combination of the drugs listed here. Not all people with gout require these drugs. Whether you take these drugs depends on your doctor’s judgment and your willingness to make a lifelong commitment to taking daily medications.

Surgery

Surgery is rarely used to treat gout. If you have large tophi that are draining, infected or are interfering with the movement of your joints, you and your doctor may decide to have them surgically removed. There are several kinds of operations that can be done to relieve pain and improve the function of the affected joints.

Credits

Some of this material may also be available in an Arthritis Foundation brochure. 

Adapted from the pamphlet originally prepared for the Arthritis Foundation by Louis A. Healey, Jr., M.D. and Herbert S. Diamond, M.D. This material is protected by copyright.

90,000 Treatment of gout with folk remedies at home

Pathogenesis of the disease

With an excessive intake of purine compounds from food, their gradual accumulation occurs. In particular, the course of the disease worsens against the background of renal failure. Example: purine compounds are supplied in normal quantities, but the kidneys cannot cope with the excretion of their metabolite – uric acid, so it gradually settles in the internal organs and joints. The cause of the pathology is quite easy to diagnose by conducting a complete biochemical blood test.

Most often, gout occurs in people who lead an unhealthy lifestyle. The typical patient is an older man, between 40 and 60 years old, who regularly drinks alcohol and eats fatty foods. Usually, during the examination, such a person reveals not only gout, but also obesity, diabetes, arterial hypertension, hypercholesterolemia (lipid metabolism disorder).

Due to hormonal characteristics, women of reproductive age are much less likely to experience this disease.After menopause, the incidence of gout in women increases. In part, this phenomenon is influenced by both malnutrition and a decrease in kidney function. According to statistics, about 9% of the living adult population on the planet suffers from gout, so this ailment is a common disease.

Causes of occurrence

There are two reasons for the onset of the disease:

1. Decreased renal excretory function, due to which uric acid is not excreted in the required volume, and gradually accumulates in the joint capsules and internal organs.
2. Excessive intake of purine compounds in the body through food and drink, which leads to their accumulation in the body.

If the first factor is associated with serious disorders in the body that lead to kidney disease, then the second – with an incorrect lifestyle, heredity. Therefore, it is important to consider all the predisposing factors that contribute to the onset of gout at an older age:

1. Presence of inflammatory processes in the kidneys – glomerulonephritis, pyelonephritis.Without proper treatment, these diseases can provoke a deterioration in organ function in the future, which will negatively affect the glomerular filtration rate.
2. Arterial hypertension. Increased pressure negatively affects the state of the vascular wall, impairs renal function, which leads to the accumulation of uric acid in the future.
3. Obesity. It is usually associated with improper diet and is a provoking factor not only for gout, but also for metabolic syndrome.
4. Sedentary lifestyle.Against the background of physical inactivity, a slowdown in metabolism occurs, therefore, with age, the risk of metabolic disorders, including gout, increases.

Separately, it is necessary to consider the factor of malnutrition, which is key in the pathogenesis of the disease, if the patient does not have renal failure. Gout appears in people who eat fatty, fried and meat foods, often consume low-alcohol drinks.

What foods contribute to the appearance of excess uric acid in the body:

1. Fatty meat, fish, fried mushrooms.
2. Extractive substances – broths from meat, fatty poultry, seafood, mushrooms. Also, many types of leafy vegetables are classified as extractives, since they are rich in oxalic acid – cilantro, onions, garlic, parsley, dill, sorrel and spinach.
3. Many types of greens contain large amounts of oxalic acid, which negatively affects kidney function and promotes the accumulation of uric acid in the body. These include sorrel, spinach, onions, citrus fruits, parsley, and dill.
4. Meat by-products – liver, lungs, heart, stomachs, kidneys.
5. Alcohol. Without exception, all alcoholic beverages contain a large amount of purine compounds. The record holders in this matter are two drinks – wine and beer.
6. Legumes – peas, chickpeas, lentils.
7. Carbonated sugary drinks, commercial packaged juices, tea, coffee and cocoa are also rich in uric acid.
8. Among the sweets – chocolate, cream, pastries.

How to eat to prevent gouty attacks, list of foods:

1. The best source of animal proteins – lean meat of chicken, turkey, rabbit, eggs.Red and fatty meat is prohibited – duck, pork, beef, lamb.
2. Among dairy products, cheese, cottage cheese, kefir, skim milk are suitable.
3. Recommended sources of carbohydrates are cereals. Rice, buckwheat and pearl barley porridge are ideal.
4. Green leafy vegetables containing a large amount of oxalic acid are excluded from the diet, but a safe source of greens is added – tomatoes, eggplants, cucumbers.
5. Any fruit other than citrus products can be used as a source of fruit.
6. From sweets, honey, marshmallow, marmalade, dried fruits are suitable – instead of chocolate products and pastries.
7. From drinks allowed herbal tea, compote, uzvar, rosehip infusion. A complete rejection of alcohol, coffee, cocoa and black tea follows.
8. Recommended fats – vegetable fats, which include unrefined oils, nuts, avocados. Animal fats and trans fats should be avoided.

In addition to a properly formulated diet, the patient should drink plenty of water, at least 1.5 liters per day so that the kidneys can excrete more uric acid from the body. You can not starve, it is recommended to eat fractional portions, but often. If the stage of the disease is not started and is corrected only by dietary nutrition, traditional medicine recipes can be used. In advanced cases, the patient is prescribed medications. The use of home prescriptions should be discussed with your doctor.

Is it possible to treat gout with folk remedies

The effectiveness of how to treat gout at home directly depends on several factors – the causes of joint pain and edema, the stage of development of the disease.If the patient has genetic disorders or a reduced production of certain enzymes in the body, it is impossible to do without taking medications. Alternatively, it is possible to agree with the attending physician the possibility of additional use of medicinal plants with a diuretic effect in order to remove excess uric acid from the body with plenty of drinking.

If gout has arisen against the background of metabolic disorders, autoimmune processes or rheumatism, then in this case they also focus on the drug solution to the problem with attacks of the disease.It is possible to take folk remedies if the inflammatory process does not intensify and the attacks do not occur for a long time, which indicates the achievement of a stable remission. With the help of traditional medicine, you can stop a slight inflammatory sluggish process, because some herbs have an analgesic effect.

The most common cause of gout in older age is the abuse of fatty foods and alcohol. In this case, the use of traditional medicine methods is most appropriate, since many herbs have a diuretic, anti-inflammatory and tonic effect.To normalize the condition, it is enough to eat right and use folk recipes, if the disease is not too advanced. In severe cases, you will need to use medications to help remove uric acid from the body. The dosage of drugs is selected individually by the doctor, taking into account the high risk of side effects.

Available treatments for gout with folk remedies

Traditional medicine uses recipes for both external and internal use. What can be used:

1. Compresses.This is an external way of using a remedy. Typically, the active ingredient is applied to gauze and firmly applied for an extended period of time. The result is an effective and long-term effect on the affected area. Compresses relieve tension, discomfort and swelling. Usually, a compress is applied after intense physical exertion, long walking, when the weather changes. The simplest version of a compress without heating is a cabbage leaf, plantain, burdock. You can also scald these plants in boiling water, dry them, rub them with alcohol and put them under a gauze bandage.Leaves for compresses are also used in two ways – they are ground into a fine gruel and mixed with a fat cream, applied to the skin. The second option is to grind the leaves until the juice comes out, mix with honey and apply to the affected area.
2. Application is a physiotherapeutic treatment procedure, the essence of which is to apply active substances to the body that accelerate tissue healing, relieve inflammation, and trigger local regeneration. Usually they use hot clay, ozokerite, paraffin, medical bile.Many of the medicinal ingredients are anti-edematous, which is helpful for gout. It is impossible to use the method of treatment with the help of application during the period of exacerbation, since the hot components will intensify the inflammatory process, which will lead to a general deterioration in the condition. The duration of the procedure is about an hour, after which the remnants of the product are washed off with warm water, and a moisturizer is applied to the skin.
3. Alcohol infusions. Suitable for both external and oral use. Usually they take the necessary component, grind it and pour it over with alcohol, and then leave it in a dark place to infuse for several weeks.After the specified time, the mixture is filtered to remove the remaining solid content. Then, according to the instructions or recommendations, take the finished mixture in a small amount. In the case of gout, such methods of preparing medicinal products are usually not used, since alcoholic beverages are categorically contraindicated in the presence of this disease.
4. Broths and teas. It is easier to prepare a decoction than a tincture, since you do not need to spend a lot of time on the recipe. Usually they take a dry herbal mixture, pour it over with boiling water, infuse for 15 minutes and take it before or after a meal.This is how tea is made. The broth must be boiled for half an hour in a water bath, strain and leave to infuse for about an hour.

Traditional methods of treating gout – recipes

It is completely impossible to cure gout. It is possible to get rid of gout by the method of symptomatic therapy, drowning out the signs of exacerbation. To eliminate joint pain, an integrated approach is recommended, aimed at eliminating uric acid in the blood and stopping attacks of gouty arthritis.A gout attack usually occurs suddenly, so it is recommended to prepare solutions of home medicines in advance in case of a sharp deterioration in health. Ideal adherence to a low-purine diet and the addition of light exercise are important.

You can treat gout on the feet with the following recipes:

1. Simple honey and salt compress. It is necessary to mix a tablespoon of honey and salt in equal proportions, apply on gauze and cover the area of ​​the affected joint for several hours. The course of treatment is up to 10 days.It is best to apply a compress before bed.
2. A compress of mustard and honey will help against severe pain syndrome. It is a popular remedy that helps relieve symptoms within 7-14 days, if used regularly. It is necessary to mix mustard powder and honey in equal proportions, adding a little soda. If the mixture is too thick, you can add a little liquid to make it easier to apply. The resulting mixture should be rubbed well, in the area of ​​the fingers of the affected joint.Then a thick layer of gauze is applied on top to warm up the leg. The compress has a weak warming effect, therefore it is more suitable in the presence of chronic pain. It is necessary to apply the product daily, for two weeks.
3. Infusion for oral administration based on a lemon-garlic mixture will help to avoid acute attacks caused by the deposition of uric acid salts. You need to take 4 lemons and 4 cloves of garlic, twisting them through a meat grinder. Then the mixture is poured with a glass of boiling water and left to infuse for three days in a dark place.Then the mixture is filtered and taken 3 times a day before each meal for 1 tbsp. spoon.
4. To combat gout at home, it is useful to treat with the help of apple broth. You need to put 4 medium apples in a saucepan and remove the skin first. Then peeled fruit is poured with a liter of water. When the water boils, you need to cook the apples over low heat for 15 minutes. It is required to drink at least 3 cups per day. The method is simple, although it will not help to get rid of the disease forever, it will significantly ease the course of joint damage.
5. External tincture for a sore joint with bay leaves. You need to mix a teaspoon of crushed bay leaves and pour 100 g of ammonia, letting it brew in a sealed container for a week. Then the mixture is filtered and rubbed in as a rub in the area of ​​the affected joint. A single dose of the mixture – no more than 2-3 g. Use the product once a day.
6. Herbal mixture for joint pain in external form. It is required to grind fresh plantain and wormwood into porridge in equal proportions.In order for the plants to acquire the consistency of an ointment, you need to add 2 tbsp. tablespoons of butter. Then the plants are mixed again, and the ointment is applied to the area of ​​the affected joint.
7. To slow down the formation of tophi in the joint area, it is useful to use medicated foot baths. It is enough to take a warm bath of water, adding 50 g of baking soda and a few drops of iodine. This mixture works well with swelling in the joint area. Foot baths are done daily before bedtime. The course of treatment is 3 weeks, after which they take a break.If necessary, a series of joint procedures are repeated.
8. External remedy – apple cider vinegar ointment. It is necessary to mix 100 g of apple cider vinegar undiluted, egg yolk. The components are mixed until smooth. It is easier to beat the mixture until a thick foam appears. Apply ointment to the affected joint 3-4 times a day. Store the ointment in the refrigerator.
9. Compress for joints based on sea coli. It is necessary to mix in equal proportions sea salt, ordinary flour, pouring a tablespoon of water.From the resulting mixture, roll out a thin layer of dough, and the strips of the product are applied to the joint area. Clay film is tied on top and left for several hours. The compress can be applied daily to the affected area for several weeks.
10. Anti-inflammatory fresh fish compress. A folk recipe for minced fish helps to cope with inflammation in the joint area. You need to take river fish, grind it into minced meat and apply to the affected areas. Keep the compress on your leg all night.The duration of therapy is 1 – 1.5 weeks.
11. Celery infusion for oral administration. It is necessary to chop the roots of celery and pour 1.5 liters of boiling water. Cover the mixture in a saucepan with a towel and leave for 4 hours. You need to drink an infusion before meals, a tablespoon 3 times a day. The product is stored in the refrigerator.
12. It is necessary to boil 3 potatoes with peels, after thoroughly washing the roots. A decoction of potatoes should be infused after readiness for several hours. Next, you should drain the top layer and drink a mixture of 100 g 2 times a day.Duration of admission is up to two weeks.

Editorial Opinion

Folk remedies for gout on the legs work well as part of a comprehensive treatment. If the patient carefully follows the diet, takes drugs that reduce the production of uric acid in the body, and supplements the therapy with home treatment, then the inflammation of the joints practically ceases to bother. If you have questions regarding gout therapy, you can leave comments at the bottom of the article.

How to treat gout: modern methods and methods

Recently, not only the elderly, but also middle-aged people, and sometimes even young people, suffer from joint diseases.Such ailments significantly affect the lifestyle and general well-being, because they are the cause of pain, stiffness of movements, and discomfort. One of the most common joint diseases is gout. Is it possible to cope with this disease? Let’s figure this out.

Peculiarities of gout treatment

Gout, or gouty arthritis, is a joint disease caused by the deposition of uric acid salts in them. The painful condition can be noted in the joints of the elbows, knees, feet, hands, fingers.The most common form of gout is a condition of the toes.

The presence of uric acid and its salts in the body is considered the norm: substances are metabolic products. In healthy people, these compounds are excreted by the kidneys. With an excess, they begin to be deposited in the joints. As a result, there is inflammation and pain. The pain begins suddenly, the joint becomes inflamed, becomes hot to the touch, and the affected area turns red. Exacerbations of the disease usually occur after heavy drinking and overeating.For a while, the disease does not make itself felt, then attacks begin again.

Uric acid is a product of the breakdown of purines – special substances that are independently produced in the body, and also come from food. A large amount of purines is found in fatty meats and fish, meat offal, in alcohol (especially in beer and grape wine), unnatural juices, sugary carbonated drinks, coffee. In the case of a plentiful feast or excessive enthusiasm for the listed products, a huge amount of uric acid is produced in the body and the kidneys cannot cope with its excretion.

This is interesting
Since the Middle Ages, gout has been considered the “disease of kings”, since it was the holy persons who had the opportunity to regularly indulge themselves with plentiful meals. And later they paid for their own gluttony with sore joints.

Gout is most often diagnosed in men aged 40-50 years. As for women, they face the disease during menopause and later. It is believed that this is due to the effect of estrogens on the excretion (excretion) of uric acid.In the younger generation, the appearance of gout is explained by a violation of the synthesis of uric acid in the body. The addiction of young people to alcoholic beverages, in particular, to beer, also plays a negative role.

Gout must be treated. Otherwise, the attacks become more frequent, the pain becomes more intense, other joints are affected, and pathological processes begin in the kidneys and urinary tract. Unfortunately, it is impossible to completely get rid of gout. But there are a number of complex measures that can significantly improve the patient’s condition and avoid acute attacks.

Statistics
The prevalence of gouty arthritis in different regions ranges from 5 to 50 cases per 1000 men and from 1 to 9 per 1000 women.

Principles and treatment regimens for gout

First of all, it should be noted that the methods of treatment of an acute attack of gout and disease at the stage of remission differ. During the period of exacerbation, anti-inflammatory therapy is carried out. The drugs can be administered orally, intramuscularly or intraarticularly – this is decided by the doctor.The selection of medicines and their dosage are set in each case individually. Most often, during an exacerbation, the patient needs hospitalization.

If gouty arthritis has just been diagnosed or the patient is in remission, then treatment is mainly aimed at preventing recurrence of exacerbation, at eliminating concomitant symptoms: obesity, increased blood lipids, low sugar levels, hypertension, atherosclerosis. Also, treatment provides for the prevention of the formation of uric acid stones in the kidneys.Therapy can be carried out under the supervision of a rheumatologist or nephrologist at home, in a hospital or in a specialized sanatorium. The effectiveness of measures depends on their correct combination: the best result can be achieved by intelligently combining pharmacological agents, physiotherapy, proper nutrition and a healthy lifestyle, that is, a comprehensive treatment of gout will be the most successful.

Drug treatment

The use of drugs during an exacerbation is most effective.Colchicine is often prescribed during anti-inflammatory therapy for gouty arthritis. The drug is taken orally or administered intravenously, the dosage is prescribed by the doctor. Colchicine is especially effective when used as soon as the first symptoms of the disease appear. A significant improvement in the condition of patients already in the first 12 hours of taking this medication is noted in 75% of cases. However, side reactions may occur in the form of disruption of the gastrointestinal tract.

Also, with exacerbation of gout, other anti-inflammatory drugs are prescribed, among them: indomethacin, phenylbutazone, naproxen, etoricoxib and others.

In addition, if there are contraindications to taking the above drugs, then with an exacerbation of gouty arthritis, oral or intra-articular administration of glucocorticoids, such as triamcinolone hexacetonide, can be effective.

Another method: external treatment. For this, creams and gels are used, which include non-steroidal anti-inflammatory drugs. The most popular on this list are diclofenac, ketoprofen, nimesulide.

In the “quiet” period of the course of the disease, drugs are prescribed that normalize the level of uric acid in the body.These are drugs based on benzbromarone, allopurinol, Avisan and others. Before use, a doctor’s consultation is required.

Modern physiotherapy methods for treating gout

As an element of a comprehensive treatment, physiotherapy for gout is very effective: it improves the condition of cartilage tissues and prevents their decay. Consider the most common physiotherapy methods that are usually prescribed in the periods between attacks.

• Electrophoresis – a procedure during which the body is exposed to constant electrical impulses.This has a local therapeutic effect. Also, electrophoresis can enhance the penetration of external drugs through the skin. For gout, analgin and novocaine are used for pain relief, and zinc, sulfur and lithium are used to stimulate cartilage tissues.
• Mud is a popular method for improving the condition of patients with gout. This procedure is often prescribed during spa treatment.
• Thermal treatments help dissolve uric acid deposits.For this, paraffin and ozokerite applications are made to patients.
• Balneotherapy is one of the most enjoyable methods of physiotherapy. The impact on the joints occurs while taking a bath. With gout, a cycle of radon, hydrogen sulfide or sodium chloride baths is prescribed.
• Bischofite is a natural solution containing sodium, calcium, potassium, iodine, copper, iron, titanium. Compresses with bischofite can relieve inflammation and numb the area affected by gout.

Among other things, UVT, ultrasound and magnetic therapy, exercise therapy and massage are successfully used for gout. Which method will be most effective in each case is determined by the doctor. Most physiotherapy treatments are usually available during a spa treatment. The most famous domestic sanatoriums of this specialization are located in the Crimea (Saki), southern Russia (Pyatigorsk, Mineralnye Vody), Altai (Belokurikha), etc.

Traditional methods

Traditional medicine has long invented means to help get rid of gout pain.Here is some of them.

• Chamomile decoction trays . Pour the flowers of the plant with water, add salt, bring to a boil, keep on low heat for 10 minutes. Let the solution brew and make a bath for the sore joint.
• Spruce Cones Extract helps cleanse joints. To prepare it, you need to take an unopened spruce cone and pour a glass of boiling water over it. Leave to brew for 7-9 hours. Take one tablespoon 30 minutes before meals.
• Infusion of madder roots . Pour a teaspoon of the roots of this plant with a glass of boiling water. Let it brew. It should be taken in the morning and in the evening for half a glass.
• Salt Compress . Pour 0.5 kilograms of iodized salt into a saucepan, add water, boil until the water evaporates. Then add 200 grams of petroleum jelly or chicken fat, mix. Use the resulting composition for a compress.

There are many other traditional methods used to combat gout.However, before resorting to traditional medicine, you should consult your doctor – each “recipe” has contraindications.

Diet as an effective treatment for gout

To improve the condition of a patient suffering from gout, it is important to immediately switch to an appropriate diet.

To do this, first of all, you need to limit the use of products containing purines by patients. This list includes offal, fatty meats and fish, rich broths, legumes, mushrooms, spinach.For a gout patient, meat should be cooked for a long time – then hazardous substances, purines, will remain in the broth. In general, protein intake should be limited as it promotes the formation of uric acid. In addition, you need to minimize the amount of fatty and spicy foods as much as possible, and also exclude strong tea, coffee and alcohol from the diet. It is recommended to increase the fluid intake to 2.5–3 liters, as this promotes the elimination of salts from the body. The emphasis should be on clean drinking water.Salt intake should be limited to 6-8 grams per day.

Be sure to eat fruits, berries, vegetables every day. Also, patients with gout are shown porridge, cottage cheese, sour cream, yogurt, vegetable and sometimes milk soups, flour, but not pastries. Boiled meat and fish should be eaten 2-3 times a week.

Nutritionists call the type of food recommended for patients with gout as “Pevzner Table No. 6”.

Prevention

The probability of getting gout is quite high among those who abuse alcohol, fatty foods, lead a sedentary lifestyle, neglect a healthy diet.Also at risk are people who are overweight and have high blood pressure, as well as those who have relatives in the family suffering from gout.

Preventive measures are simple: proper nutrition, exercise, fresh air, avoiding alcohol, weight control. By observing them, many problems can be avoided.

Thus, today, many methods have been developed to combat gout. Correctly selected therapy can bring high results.But only a specialist can appoint it.

Treatment of acute gout attack | Clinical Rheumatology Hospital No. 25

For the treatment of an acute attack of gout , the well-known non-steroidal anti-inflammatory drugs (NSAIDs) are widely used, which have a number of advantages:

• Low frequency of side effects

• Possibility of substitution with other drugs

• Fast effect

• Good tolerance

Preparations of the NSAID group (nimesulide, meloxicam, celecoxib) are widely used in chronic gout.Sometimes a drug of combined action is very effective – allomaron (already in the second week of administration, the balance of uric acid approaches normal Due to their use, pathological substances are removed from the patient’s body, thereby significantly reducing the severity of the course of gout, reducing the severity of the articular syndrome, improving the indicators of renal function, immunological characteristics.

To prevent recurrent attacks of gouty arthritis, it is necessary to achieve a decrease in the level of uric acid in the plasma, for this two groups of drugs are used: drugs that promote the excretion of uric acid by the kidneys (urocosuric) and drugs that reduce its synthesis (uricodepressive)

Thus, adherence to diet, regular intake of basic drugs (uricosuric, uricodepressive), NSAIDs if necessary, as well as EG courses at intervals of 6-8 months contribute to reducing the severity of gout and gouty arthritis

One of the auxiliary methods of treating gout is HIRUDOTHERAPY – treatment with leeches, especially if physiotherapy is contraindicated for the patient.

According to our observations, kind and intelligent people, as a rule, suffer from gout; and this pattern requires further study.

CAPACITY OF RESORBTSIЇ UNDERGROUND TOFUSIV IN THE PERFORMED URATZNIZHUVALNO THERAPY: KLINICHNE SPOSTEREZHENNYA

Summary. It seems that tofushi is established in case of “natural” overload of gout and during the day of adequate urate-lowering therapy in the middle after 7-10 rounds from the debut of sickness, the frequency of these occurrences reached 34%.Uratus reduction therapy for primary reduction and control of the level of seic acid, as well as for the reduction of crystal deposits in ailments for chronic gout. In the last few years, there was evidence of the possibility of resorption of tofus right up to the redeployment in case of retinal monitoring of secular acid in the blood and adequate indications of urate-lowering drugs. An hour, necessary for the identification of deposits of crystals, dressings from triviality, over-the-top crystalline additions and an extended portion of sechaic acid.Presented is a class of precautions for changing the growth of tofus in a patient with severe tofus gout when substituting alopurinol for febuxostat and reaching a whole dose of sech acid.

Summary. It is known that tophuses are formed during the “natural” course of gout and the absence of adequate urate-lowering therapy on average after 7-10 years from the onset of the disease, the frequency of their detection reaches 34% and increases in parallel with the duration of the disease. Urate-lowering therapy is used to initially lower and control the level of uric acid, as well as to eliminate the deposition of crystal deposits in the tissues of patients with chronic gout.In recent years, data have appeared on the possibility of resorption of tophi, up to their complete dissolution with careful monitoring of the level of uric acid in the blood serum and adequate use of urate-lowering drugs. The time it takes for the crystal deposits to dissolve is related to the duration of the disease, the total crystal load, and the uric acid level achieved. This paper presents a clinical case of a decrease in the size of tophi in a patient with severe tophus gout after replacing allopurinol with febuxostat and reaching target uric acid levels.

Gout is a systemic topical disease characterized by the deposition of sodium monourate crystals in various organs and tissues and the resulting inflammation in individuals with hyperuricemia caused by environmental and / or genetic factors [3]. It is generally known that the clinical manifestations of gout, such as acute gouty arthritis, chronic gouty arthropathy and the formation of tophi, develop due to the deposition of sodium monourate crystals in the articular, periarticular tissues and in the subcutaneous tissue.Considering that, in addition to the duration of the disease, the main factor in the formation of chronic tophus gout is the severity and persistence of hyperuricemia, timely diagnosis and use of drugs that reduce the level of uric acid in the blood serum are of great importance [7, 12]. The development of tofus gout, leading to disability of patients, can be avoided. Urate-lowering therapy is used to initially lower and control uric acid levels and to eliminate tissue deposition of crystals in patients with chronic gout.This is especially important in tofus gout to prevent further crystal deposition and resulting tissue damage.

Topuses are formed during the “natural” course of gout and the absence of adequate urate-lowering therapy on average 7-10 years after the onset of the disease, the frequency of their detection reaches 34% and increases in parallel with the duration of the disease, although sometimes they can be the first clinical manifestation of gout, preceding typical attacks arthritis [10, 15]. The deposition of sodium monourate in tissues suggests a slow epitaxial growth of crystals with the formation of crystal structures [9].Deposits of sodium monourate crystals are most often observed in the tissues of the joint, periarticular bursae, ligaments [5], however, the literature describes casuistic cases of deposition of urate deposits in the stomach wall [4], kidney tissues, in the myocardium and heart valves, as well as in the spine, leading to complete destruction of the vertebrae and the development of life-threatening neurological symptoms [2]. Histologically, tofus is a chalk-like (white in its central part) node, consisting of crystals of sodium monourate, proteins and mucopolysaccharides; deposits are surrounded by histiocytes, lymphocytic shaft, fibroblasts.When treated with formalin, sodium monourate crystals can dissolve, which may be the reason for the absence of crystals in the preparation during polarization microscopy.

Urate deposits cause constant low-level inflammation in tissues, an increase in inflammatory markers in synovial fluid, joint tissues and blood, ultimately leading to erosive-destructive joint damage and the formation of comorbidity [5]. Insufficient control of the level of uric acid in the blood serum leads to the involvement of more and more new joints in the inflammatory process, which, as a rule, is combined with the formation of intradermal and intraosseous tophi, which can open up, forming characteristic difficult-to-heal skin defects.In addition to physical and aesthetic anxiety, tophuses can cause functional impairment, reducing the quality of life of patients, their ability to work, often disabling patients [13].

When the level of uric acid in the blood serum is> 360 μmol / l, biological fluids are saturated with it, which leads to its crystallization in the form of monosodium salt if the super-saturation point is reached. Clinically, this is manifested by attacks of gouty arthritis, the formation of calculi in the kidneys, and the growth of tophus.On the contrary, persistent normouricemia correlates with the absence of acute arthritis attacks and dissolution of already existing crystals [8]. Thus, recent studies indicate the possibility of resorption of tophi, a decrease in their number and size with adequate urate-lowering therapy. Unfortunately, patients with gout, especially in the early years of the disease, tend to neglect dietary advice and the use of antihyperuricemic drugs. Thus, P. Primatesta and co-authors [11] in a retrospective study involving 177 637 patients with gout found that over the next year from the moment of diagnosis for treatment aimed at gouty arthritis, in 41.7% of cases, nonsteroidal anti-inflammatory drugs were used, and only 31.8% of patients received allopurinol, while 39% of patients received no medication for gout at all.

However, careful monitoring of the level of uric acid in the blood serum, adequate use of urate-lowering drugs (primarily allopurinol or febuxostat), modification of the way of life can lead to the reversal of tophuses, up to their complete disappearance. E. Pascual and co-authors [8] noted that with adequate antihyperuricemic therapy, sodium monourate crystals cease to be detected in the synovial fluid after 3–33 months from the start of treatment. In the EXCEL study (Febuxostat vs Allopurinol Comparative Extension Longterm Study), which compared two xanthine oxidase inhibitors, in addition to achieving normouricemia and complete disappearance in all patients of acute arthritis attacks after 40 months of treatment, resorption of tofuses was also noted when treated as with febuxostat ( 36–46% of patients) and allopurinol (in 29%) [6].Another study evaluated the evolution of tophi in 63 patients with severe tophus gout treated with allopurinol, benzbromarone and their combination until serum uric acid levels were lower than the tissue urate saturation threshold [10]. Researchers have demonstrated the rate of reduction of tophi depending on the average concentration of uric acid: at a level of uric acid of 6.1–7.0 mg / dl, the rate of reduction of tophi was 0.53 ± 0.59 mm / month; at the level of 5.1-6.0 mg / dl – 0.77 ± 0.41 mm / month; 4.1-5.0 mg / dl – 0.99 ± 0.50 mm / monthThe best results were obtained with strict control of the level of uric acid: at a serum concentration of ≤4.0 mg / dL, the resorption of tophi occurred at a rate of 1.52 ± 0.67 mm / month. Note that all patients showed complete resolution of the tophi after 64 months of therapy.

The time required to dissolve the crystal deposits is related to the duration of the disease, the total crystal load (the number and size of tophi) and the level of uric acid achieved [5]. For example, the majority (90%) of patients with gout duration <10 years showed complete resorption of tophi after 112 months of therapy (serum uric acid levels averaged 291 μmol / L (4.9 mg / dL)).Similar results were achieved only in 25% of patients with gout duration> 10 years [8]. This difference in performance is likely due to the total crystal load. At the same time, the rate of decrease in gouty tophi approximately doubles when the concentration of uric acid in the blood reaches 238 µmol / L (4 mg / dL) compared to 360 µmol / L (6 mg / dL) [10]. According to most of the current recommendations of the ACR, EULAR, 3E Initiative [7, 12], in chronic tophus gout, the target is the level of uric acid <5 mg / dL (<300 μmol / L); be individually lowered.

The main urate-lowering drugs widely used in real clinical practice are allopurinol and febuxostat (in Ukraine, febuxostat was registered in 2014 under the trade name Adenurik). Allopurinol is most often used in a fixed dose of 300 mg / day, but its maximum dose is 800 mg / day [14]. Unfortunately, in most patients, it cannot be achieved due to hypersensitivity reactions, liver damage and the development of renal failure, which often accompanies the tophus stage of gout.Febuxostat is a selective inhibitor of xanthine oxidase, can be actively used in renal failure, does not require dose adjustment in elderly patients, and also provides faster achievement of the target level of uric acid and tighter control of it compared to allopurinol [1].

In this regard, a clinical observation is of interest, illustrating the positive dynamics in the form of a significant decrease in tophi and the absence of exacerbations for 3 months when replacing long-term use of allopurinol with febuxostat.

Clinical observation. Patient K., 44 years old, a doctor, applied for a consultation at the Regional Clinical Hospital – Center for Emergency Medical Aid and Disaster Medicine in the city of Kharkiv, an outpatient department, with complaints of pain in the joints of the hands, feet, knees, ankle, elbow joints, morning stiffness up to 1 hour, multiple formations (tophus), deforming the joints of the hands and feet.

From the anamnesis: The total duration of the disease is about 12 years.In 2004, paroxysmal pain and swelling appeared in the joints of the lower extremities. After the examination, a diagnosis of gout was established. For 12 years, he constantly took allopurinol at a dose of 50 to 300 m / day, but the attacks of arthritis persisted and the target level of uric acid was not achieved. An attempt to increase the dose of allopurinol led to toxic reactions from the skin. The frequency and intensity of attacks increased with time, rounded formations with whitish contents appeared in the area of ​​the auricles, and subsequently in the area of ​​the hands.Since 2008, gouty kidney damage (interstitial nephritis and urolithiasis) has been noted in the form of proteinuria, increased levels of urea and creatinine. In 2010, he was operated on for urolithiasis. Since 2011, there has been a persistent increase in blood pressure, for which he takes losartan at a dose of 50 mg / day. The use of diuretics, acetylsalicylic acid, alcohol abuse is denied. Gout from relatives is not noted.

I went to see a rheumatologist due to severe pain syndrome in the area of ​​small joints of the hands, elbow, wrist, ankle joints, as well as due to significant deformation of the joints, significant functional limitations.

Objectively: the condition is relatively satisfactory. Moves with a limp due to pain in the knee and ankle joints. The skin is of a normal color. Multiple tophus in the area of ​​the auricles. No peripheral edema. Swelling, deflection and deformation of the joints of the hands and feet, their palpation is painful, the range of motion is limited. Multiple tophuses ranging in size from 1.0 x 0.5 to 4.0 x 5.0 cm in the area of ​​the joints of the hands, some of them with elements of local inflammation.Swelling of the elbow joints, tophus in the area of ​​the elbow joints. Swelling, defiguration of the knee, ankle joints, their palpation is painful, the range of motion is significantly limited. In the lungs – auscultatory vesicular breathing throughout. BH – 18 / min. Heart sounds – the sonority of the tones is reduced, the activity is rhythmic, the emphasis of the II tone on the aorta, heart rate 74 beats / min, blood pressure 150/100 mm Hg. Art. The abdomen is soft, increased in volume due to the subcutaneous fatty tissue. The liver is not palpable. Pasternatsky’s symptom is negative on both sides.Free urination.

At the time of the visit, the patient was taking 200 mg / day of allopurinol.

Complete blood count: hemoglobin 122 g / l, erythrocytes 4.9 · 10 / l, leukocytes 8.7 · 10 / l, ESR 32 mm / h, the formula has not been changed.

Biochemical blood test: C-reactive protein 24 mg / dL, uric acid 6.9 mg / dL (411 μmol / L), rheumatoid factor negative, urea 7.8 mmol / L, creatinine 108 mmol / L, liver function tests unchanged, blood glucose 8.6 mmol / l.

Glomerular filtration rate (according to the CKD-EPI formula): 72 ml / min / 1.73 m, which corresponds to chronic kidney disease (CKD) stage II.

X-ray of the hands in frontal projection with the capture of the wrist joints revealed gross disturbances in the structure of the joints with multiple articular-periarticular tophi (Fig. 1).

Fig. 1.

X-ray of the hands in frontal projection of patient K., 44 years old

On the radiograph of the hands in frontal projection, the manifestations of local osteoporosis are determined; in the bones of the wrist, more clearly in the left hand, multiple areas of enlightenment are visualized – a symptom of a “punch” (tophus) of various diameters, the largest with a diameter of 8–9 mm; the X-ray joint spaces of the second metacarpophalangeal joint of the left hand, the second, third, and fifth metacarpophalangeal joints of the right hand are sharply narrowed with the presence of cysts and massive spherical soft periarticular joints at the level of the second metacarpophalangeal joint of the left hand and the fifth metacarpophalangeal joint of the right hand tissues (periarticular tophuses) with the presence of small deposits of calcium deposits in them.At the level of the articular ends of the above-described metacarpophalangeal joints, areas of enlightenment are determined – a symptom of a “punch” (tophus), occupying> ⅓ of the articular surface, as well as massive marginal bone growths. Severe deformity with subluxation at the level of the proximal interphalangeal joint of the second finger of the right hand with destruction of the epiphyses of the adjacent bones, multiple areas of enlightenment (tophi) and a pronounced increase in X-ray density in the enlarged periarticular soft tissues (gouty articular-periarticular tophi).Similar changes are also noted to a lesser extent at the level of the proximal and distal interphalangeal joints II, III fingers of the left hand and II – IV fingers of the right hand.

Conclusion: X-ray signs correspond to gouty polyarthritis of the hands, stage III, with multiple erosions of the articular surfaces of the bones of the wrist, hand and phalanges, articular-peri-articular tophi, deposition of calcium deposits in the periarticular soft tissues and at the level of articular cartilage, osteolysis of the finger epiphysis of the proximal gland II the right hand with the development of subluxation in the proximal interphalangeal joint of the second finger of the right hand.

Ultrasound examination of the kidneys: the right kidney is 9 x 4.5 cm, the left one is 9.6 x 4.8 cm. The contours are wavy, the parenchyma is 1.6 cm, the echogenicity is increased. The gaps of the calyces on the right are up to 0.7 cm, the slit pelvis is up to 1.7 cm. In all segments of both kidneys, there are multiple hyperechoic structures 0.5–0.8–1.3 cm with an acoustic shadow.

The course of gout was assessed as severe, given the early onset of gout (at 32 years of age), frequent exacerbations (> 4 times a year), polyarticular lesions of the joints of both the lower and upper extremities, and the presence of multiple massive tophi.

The patient was diagnosed as follows:

Gout, mixed type, severe course. Chronic tofus gout with damage to the joints of the upper and lower extremities, stage III, functional insufficiency of the joints of the I – II degree. Topuses of the auricle, massive topuses of the elbow joints, the area of ​​the joints of the hands and feet. CKD ІІ stage . Gouty nephropathy (interstitial nephritis, urolithiasis).

Due to the lack of reaching the target level of uric acid, continuing exacerbations of gouty arthritis, the presence of multiple large tofuses, kidney damage, the patient was recommended to discontinue allopurinol and start taking febuxostat 80 mg / day under the control of uric acid once every 2 weeks with dose titration up to 120 mg / day until the target uric acid level of 5 mg / dL (300 μmol / L) is reached and possibly lower.Anti-inflammatory therapy included the use of diclofenac sodium at a dose of 100 mg / day in combination with proton pump inhibitors. Correction of lifestyle and gastronomic preferences is recommended. The dose of losartan was increased to 100 mg / day under blood pressure control.

After 3 months, the patient came to the clinic for a second consultation and correction of treatment. On examination, a significant decrease in the size of tophuses of all localizations was noted. According to the patient, attacks of exacerbation of arthritis did not bother, the intensity of pain syndrome significantly decreased, and physical activity improved.This made it possible to reduce the dose of diclofenac to 50 mg / day, as well as to take it occasionally. At the time of examination, the patient continued to take febuxostat at a dose of 120 mg / day. Laboratory examination revealed a decrease in ESR to 18 mm / h, C-reactive protein – 6 mg / dL, creatinine – 98 μmol / L, urea – 6.7 mmol / L. The target uric acid level of 292 μmol / L (4.9 mg / dL) has been reached.

There was a decrease in tofuses on the auricles, however, the greatest dynamics (Fig. 2-4) was found on the hands.

Fig. 2.

View of the hands of patient K. at the initial visit to a rheumatologist

Fig. 3.

View of patient K.’s hands after 3 months of active urate-lowering therapy and reaching the target uric acid level

Fig. 4.

Assessment of the size of tophi 3 months after active urate-lowering therapy

At the initial examination, the tophus in the region of the proximal interphalangeal joint of the second finger of the right hand was 3.9 x 2.4 cm (width and height), was inflamed, tense and painful on palpation; after 3 months of adequate urate-lowering therapy, its size decreased and amounted to 3.4 x 2.0 cm, there were no signs of inflammation and soreness.The size of the tophus of the distal interphalangeal joint of the right hand before treatment was 1.7 x 1.4 cm; after 3 months of therapy – 1.4 x 1.2 cm. The volume of the right hand at the level of the metacarpophalangeal joints before treatment was 24.8 cm, after 3 months of therapy – 24.1 cm; left hand before treatment – 24.2 cm, after 3 months – 23.7 cm. Significant positive dynamics of reduction in size affected all tofuses of the hands.

This observation, in our opinion, clearly demonstrates the results of correctly selected therapy and high patient adherence to the doctor’s prescriptions, which made it possible to achieve the target level of uric acid, as well as significant clinical improvement.And although the size of the tofuses is still impressive, the response to treatment, the positive dynamics in the first 3 months of therapy and the patient’s adherence to further adequate urate-lowering therapy allow us to draw optimistic conclusions.

Despite the fact that the diagnosis and treatment of gout is now quite well developed, the medical community has been presented with recommendations for the early diagnosis and management of patients with gout [7], still note major shortcomings in their organization and implementation.The existing arsenal of medicines allows not only to effectively and quickly stop an acute gout attack, but also to carry out effective treatment in the interictal period, preventing the development of complications. However, despite all the evidence, a number of reasons interfere with this process. The described clinical case made it possible to identify several factors that led to the formation of severe tofus gout in patient K .:

1. Insufficient awareness of a wide range of doctors regarding the characteristics of the course of the disease and new, most effective methods of treatment and drugs, with the need for dynamic monitoring of patients, quick response and flexible prescription of drugs depending on the clinical situation.

2. Incorrect use of urate-lowering drugs (inadequate dose, duration of use, untimely administration of urate-lowering drugs, their use in high doses at the time of an acute attack, lack of focus on achieving target values ​​of uric acid). So, patient K. for a long time used allopurinol in inadequate doses without focusing on the level of uric acid and achieving a clinical effect.

3. Wide availability of non-prescription dispensing of non-steroidal anti-inflammatory drugs, rapid relief of the first attack, as a result of which the patient remains out of sight of the rheumatologist; the lack of prevention of exacerbations leads to the fact that patients seek medical help already at the stage of tofus gout.

4. Low adherence of patients to the systematic use of urate-lowering drugs in the interictal period. And although this paragraph does not apply to the presented patient (the patient persistently continued to take allopurinol without clinical and laboratory effect), many patients interrupt the prescribed treatment in the interictal period of intermittent gout.

5. Lack of accounting for concomitant therapy, long-term use of drugs that cause hyperuricemia (thiazide and loop diuretics, acetylsalicylic acid, riboxin, etc.)etc.).

Thus, recent studies, as well as the developed recommendations for the management of gout, allow achieving the most daring goals in treatment, namely: resorption of gouty tophi with prolonged, persistent, adequate urate-lowering therapy. Intensive urate-lowering drug therapy may be helpful in patients with severe sequelae of tophus arthritis.

References

• 1.Barskova V.G., Ilinykh E.V., Nasonov E.L. (2011) Febuxostat is a new drug in the treatment of gout. Scientific-practical. rheumatol., 2: 52–58.
• 2. Eliseev M.S. (2016) Lesions of the spine in gout. Rus. honey. zh., 24 (2): 85–89.
• 3. Nasonova V.A., Barskova V.G. (2004) Early diagnosis and treatment of gout is a scientifically substantiated requirement to improve the work and life prognosis of patients. Scientific-practical. rheumatol., 1: 5-7.
• 4.Nasonova V.A., Zakharova M.M., Barskova V.G. et al. (2004) Detection of sodium monourate crystals in biopsies of the gastric mucosa in patients with gout. Therapist. arch., 76 (6): 47–51.
• 5. Andrés M., Sivera F., Pascual E. (2014) Rapid Crystal Dissolution in Gout. Is It Feasible and Advisable? Int. J. Clin. Rheumatol., 9 (4): 395-401.
• 6. Becker M.A., Schumacher H.R., MacDonald P.A. et al. (2009) Clinical efficacy and safety of successful long term urate lowering with febuxostat or allopurinol in subjects with gout.J. Rheumatol. 36 (6): 1273-1282.
• 7. Khanna D., Fitzgerald J.D., Khanna P.P. et al. (2012) 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res. 64 (10): 1431-1446.
• 8. Pascual E., Sivera F. (2007) Time required for disappearance of urate crystals from synovial fluid after successful hypouricaemic treatment relates to the duration of gout.Ann. Rheum. Dis., 66 (8): 1056-1058.
• 9. Pascual E., Ordoñez S. (1998) Orderly arrayed deposit of urate crystals in gout suggest epitaxial formation (letter). Ann. Rheum. Dis., 57: 255.
• 10. Perez Ruiz F., Calabozo M., Pijoan J.I. et al. (2002) Effect of urate-lowering therapy on the velocity of size reduction of tophi in chronic gout. Arthritis Rheum., 47 (4): 356-360.
• 11. Primatesta P., Plana E., Rothenbacher D. (2011) Gout treatment and comorbidities: a retrospective cohort study in a large US managed care population.BMC Musculoskelet Disord., 12: 103-107.
• 12. Richette P., Doherty M., Pascual E. (2016) 2016 Updated EULAR evidence-based recommendations for the management of gout. Ann. Rheum. Dis (doi: 10.1136 / annrheumdis –209707).
• 13. Roddy E., Zhang W., Doherty M. (2007) Is gout associated with reduced quality of life? A case-control study. Rheumatology (Oxford) 46: 1441-1444.
• 14. Stamp L., Taylor W., Jones P. et al. (2011) Starting dose, but not maximum dose, is a risk factor for allopurinol hypersensitivity syndrome: a proposed normogram fro safe starting dosing of allopurinol.Arthritis Rheum., 63 (10): S1012-1018.
• 15. Wernick R, Winkler C, Campbell S. (1992) Tophi as the initial manifestation of gout. Report of six cases and review of the literature. Arch. Intern. Med. 152: 873-876.

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folk remedy for gout on the joint of the leg

folk remedy for gout on the joint of the leg

Initially, joint damage leads to discomfort in movement. A person becomes constrained during standard actions, cannot carry out previous physical activities. Over time, the inflammatory syndrome intensifies, developing into a full-fledged pathology.

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What is gout ?.Gout is a type of rheumatic disease that affects the joints. The disease progresses against the background of impaired metabolism and an increase in uric acid in the body, which is the final metabolite of cellular activity. Uric acid. Gout is a fairly common joint disease associated with metabolic disorders. Pathology occurs most often in elderly people who consume large amounts of purines with food. These substances cannot be fully excreted by the kidneys, which leads.When choosing folk remedies for gout, preference is given to those that remove uric acid from the body. Clay is often used to treat gout on the feet. A compress is applied to the affected joint for 2-3 hours. To do this, the powder is diluted in warm water until it becomes sour cream. With a disease of gout – treatment with folk remedies significantly helps in therapy. Gout is a metabolic disorder in which uric acid salts are deposited in the joints of the legs and arms. Gout is a chronic disease with acute attacks of pain and inflammation in the joints caused by.No less effective is a gout balm made from butter and vodka. 3. Required: 100 g of vodka and fresh butter. Exposure to the joint with heat and cold. The effectiveness of this folk remedy for the treatment of gout for the first time. It is impossible to completely recover from gout on the toes or other areas, but by following the tips listed below, you can get rid of bouts of pain. Folk remedies with. Review of methods of treating gout with folk remedies, methods of relieving an attack.Compositions according to folk recipes are effective enough, but not enough to get rid of gout on the legs or arms forever. In case of violation of the diet or refusal of a maintenance dose. Gout on the feet: home treatment with folk remedies. Traditional healers recommend for gout of the joints of the legs. Gout – home treatment with folk remedies, causes and symptoms of the disease. Treatment of joints with folk remedies at home. Traditional medicine for gout. What to do in case of exacerbation of gout?The most effective folk remedies for gout on the legs. The affected joint should be provided with rest, during treatment, refrain from physical activity. The first few days of the disease, bed rest is observed.

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To control the quality of the product, as well as to avoid unnecessary markups, the manufacturer decided to independently sell the product.This is a forced measure, when purchasing a gel at a pharmacy, the patient may encounter a fake. The manufacturer does not hide the list of active ingredients. At the same time, he sent the results of clinical trials to open access. The official website of the manufacturer provides the most complete information. At the same time, you can familiarize yourself with the electronic documents for the medicine, which will help you understand whether this is a divorce or not. Sustafast successfully completed the research, thanks to which he was released for free sale.Natural ingredients have virtually no side effects. Preparations based on artificial substances cause discomfort after use in the form of dizziness, nausea, pain in the stomach or liver, deterioration of the heart rate, etc. Sustafast does not negatively affect the state of the body, therefore, such symptoms do not occur. Possible side effects include:

Diet with a high uric acid content

Nephrolithiasis, or kidney stones, is a common urological disease in which kidney stones form.The causes of nephrolithiasis are not fully understood. The main importance in the development of the disease is attached to a change in the colloidal-mineral balance of urine, its pH, concentration, and composition.
The formation of uric acid stones (urates) in the urinary tract occurs when an increased content of uric acid in the blood is combined with a constant acidic reaction of urine in the urinary tract. At the heart of the disease is, first of all, a violation of purine metabolism. Due to such a violation in the body, an excess of the end product of the exchange of purines – uric acid occurs.The intake of purines with food actively contributes to the development of the disease. That is why it is very important to follow the dietary advice of your doctor. When treating, first of all, the doctor recommends excluding from the diet all foods rich in puric and uric acids – mainly meat and fish. The diet for urate urolithiasis is close to the diet for gout, but in a softened version.
If there is a violation of the metabolism of not only uric acid, but also oxalic acid, the formation of stones of a mixed type occurs – urate-oxalate.In this case, it is also necessary to exclude foods high in oxalic acid from the diet and limit foods containing ascorbic acid.
It should be remembered that only a specialist can advise the most optimal diet, as well as medical treatment, since it is necessary to take into account the type and chemical composition of kidney stones.

Recommendations for nutrition with urate stones in the kidneys
Recommended diet with the exception of strong meat broths, smoked meats with limited meat, cheese, honey, alcoholic beverages.The following products are allowed:

• Boiled lean meat, fish, poultry, no more than 3 times a week. After boiling, meat and fish can be used to prepare various dishes (stew, bake).
• Dairy products: milk, fermented milk drinks, cottage cheese, sour cream, cheese.
• Eggs: no more than one egg per day in any processing.
• Fats: butter, cow, ghee and vegetable oils.
• Cereals in any dish, in moderation.
• Bread and flour products: wheat and rye, from second grade flour, bran can be included.
• Vegetables in sufficient quantities in any processing.
• Vegetarian soups (borsch, cabbage soup, vegetable, potato, dairy, fruit soups, with the addition of cereals, okroshka, beetroot soup).
• Cold snacks: salads from fresh and pickled vegetables, fruits, vinaigrette, vegetable caviar, squash, eggplant.
• Fruits, sweet dishes, fruits and berries in any processing, dried fruits, milk jelly and creams, marmalade, jam.
• Sauces: vegetable, sour cream, dairy.
• Spices: citric acid, vanillin, cinnamon.
• Drinks: tea, weak coffee with milk, fruit drinks, juices, decoctions of wild rose and wheat bran, dried fruit compotes.

Diet recommendations for urate-oxalate stones in the kidneys
It is necessary to avoid foods that cause increased excretion of oxalates in the urine (cocoa, chocolate, spinach, legumes), limit the consumption of fats, sugar, potatoes, tomatoes.
Shown are alkaline waters of the resorts of Truskavets, Zheleznovodsk.
The following products are accepted:

• Meat, poultry, fish in moderation, preferably in boiled form, including boiled sausages (dairy, dietary), sausages, eggs in any processing, salads from boiled meat and fish.
• Milk, kefir, cottage cheese, sour cream (except for situations with an increase in the level of calcium in the urine, with a high urine pH, with exacerbation of pyelonephritis).
• Fats: butter and vegetable oils, unsalted lard.
• Groats: buckwheat, oatmeal, pearl barley, millet; pasta; soups from them.
• Bread: wheat, rye, flour products, especially coarsely ground with the inclusion of wheat bran.
• Vegetables and fruits: cucumbers, cabbage, peas, eggplants, turnips, pumpkin, lentils, apricots, bananas.
• Soups, sauces.
• Cold vegetable snacks, squash and eggplant caviar.
• Compotes, jelly, mousse.
• Tea, weak coffee with milk, decoctions of dried fruits, rose hips, wheat bran, fruit drinks, kvass.

In addition to changing the diet, it is necessary to increase the amount of fluid consumed to 2.5-3 liters per day and take B vitamins and magnesium.
Even single, heavy meals of purine-rich meat and fish foods and alcoholic beverages are prohibited.

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