Gout Symptoms

Joint Pain, Inflammation, and Other Symptoms

Gout, considered one of the most painful forms of inflammatory arthritis, has inflicted pain on humanity for thousands of years—from Egyptian royalty to the English aristocracy. In fact, excruciating pain and inflammation—typically in your big toe—are the classic symptoms of a gout attack. Today, gout is the most common inflammatory arthropathy in the United States, where it affects approximately 4% of adults.

Rest assured, most people with gout will experience only one acute gout attack in their life. With an acute gout attack, symptoms will go away within a few days, and you may never have another attack again.

But for some people, gout can be a progressive condition. These people can have frequent gout attacks, and the attacks generally last longer than the initial attack. People with frequent gout attacks can go on to develop chronic gout, and these people will most likely experience joint damage. They’ll have to take medications long-term to prevent gout attacks.

Although everyone is different, and it’s difficult to predict when a gout attack will occur, it’s important to be aware of the warning signs of a gout attack, especially when you have chronic gout. This article will address how to recognize an acute gout attack, and it will also cover common chronic gout symptoms.

Common Symptoms of a Gout Attack
As mentioned above, pain and inflammation are the most common symptoms of a gout attack. Gout-related pain is sometimes described as sharp, throbbing, and crushing. The pain usually occurs without warning—it can wake you up in the middle of the night, or you might notice it first thing in the morning.

When you have a gout attack, the pain is constant, and the severity of the pain can fluctuate throughout the attack. Although attacks usually last about 3 to 5 days, the pain is most severe within the first 24 hours after the attack begins. After the pain goes away, you may notice some discomfort in the affected joint. This discomfort can last from a few days to a few weeks.

In addition to the pain, you may also notice that the affected joint is stiff, swollen, warm, red, and very tender. Those are signs of inflammation.

In addition to pain and inflammation, there are some other signs and symptoms of a gout attack you should look for.

• Only 1 joint is affected: Your first gout attack generally affects only 1 joint (most often in the big toe, ankle, or knee), but other joints can be affected, too. You can also develop gout in the insteps of the feet, heels, elbows, wrists, and fingers. If you have more than 1 gout attack, the joint that’s affected typically doesn’t change. For example, if you have a gout attack in your toe, the next time you have an attack, it will likely be in that same toe. However, as you’ll read about later on, if gout becomes chronic, more joints can become involved.
• Fever: Some people have a fever during a gout attack.

Not everyone who has a gout attack will have all of these symptoms. You may have just a couple of symptoms.

How to Recognize Chronic Gout
Again, it’s still possible to experience gout attacks with chronic gout. When you have chronic gout, you can have flares—a period of time when your symptoms intensify. Therefore, you need to be able to recognize the signs of a gout attack and work hard to prevent attacks.

In general, your doctor can make a chronic gout diagnosis if you experience 2 or more acute gout attacks within a 12-month period. Remember, pain and inflammation aren’t constant when you have chronic gout, but both symptoms do flare when you have a gout attack.

Additionally, your doctor will look at your uric acid levels. Extremely high levels of uric acid (greater than 12 mg/dL) may help your doctor with a chronic gout diagnosis. (In general, uric acid levels should be about 4 to 5 mg/dL). High levels of uric acid can also cause uric acid crystals to collect in your kidneys, which can lead to kidney stones—another chronic gout symptom.

Another sign of chronic gout is tophi. Tophi are chalky deposits of uric acid that look like little lumps under the skin of the affected joint. They usually develop only after you’ve had gout for several years.

Furthermore, multiple joints can be involved with chronic gout, and these joints can become damaged over time if gout is left untreated. Range of motion can also decrease in these joints. Your doctor can spot the first signs of joint abnormalities in imaging tests such as x-rays.

What to Do If You Have Gout Symptoms
If you develop gout symptoms such as sudden, excruciating pain in one of your joints, call your doctor. Although an acute gout attack will go away on its own even if you don’t treat it, gout that’s left untreated can eventually lead to more severe pain and joint damage. Recognizing the signs and symptoms of a gout attack can help you prevent future attacks.

Updated on: 11/05/20

Gout Causes

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.

Continued

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.

Continued

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.

Signs Your Chronic Gout Is Getting Worse

When you have gout, your blood has too much uric acid, a substance your body makes when it breaks down food. Over time, the uric acid forms into crystals, which collect around joints. You may not have symptoms at first. But if the area gets inflamed, a gout attack happens, with swelling, redness, and intense pain.

When Gout Becomes a Long-Term Problem

When uric acid levels in your blood stay too high, more and more crystals form around your joints. It can turn into a long-term condition, leading to painful and damaged joints.

Gout will happen differently for everyone. But signs that it may be getting worse include:

• Flares happen more often and last longer. Over time, the inflammation causes lasting damage to bone and cartilage.
• Flare-ups in other parts of your body. About half of people with gout have their first attack in the joint at the base of the big toe. When gout gets worse, it can affect other joints, including the ankle and knee.
• Bumps form under the skin. Uric acid crystals may start to collect in soft tissue, forming lumps called tophi. They often appear on the hands, fingers, elbows, and ears, but they can show up almost anywhere on the body.
• Kidney problems. Your kidneys normally get rid of uric acid in your body. But too much of it can also damage the organs. Kidney problems linked with gout — and signs that gout is getting worse — include gouty kidney, kidney stones, and kidney failure.

What You Can Do

If you think your condition is getting worse, talk to your doctor. They will give you medicine to keep your uric acid levels low and to try to prevent future attacks and complications.

Allopurinol (Aloprim, Lopurin, Zyloprim) treats chronic gout by lowering the uric acid produced in your body.

Febuxostat (Uloric) also lowers uric acid production but would be used with caution if you are at risk for heart or blood vessel disease.

Once you start taking these medicines, you’ll need to take them for life so that your uric acid stays at the right levels.

Probenecid and lesinurad (Zurampic) help the body get rid of more uric acid in your urine. Pegloticase (Krystexxa) and rasburicase (Elitek) can break down uric acid into a substance that your body can get rid of. They are only for very severe gout that doesn’t get better with usual treatments.

Scientists are also testing new treatments for chronic gout. At the same time, researchers are getting a better understanding of how the body makes and breaks down uric acid. Insights from this research could lead to new treatments in the future.

10 Questions About Managing Gout

Gout is a disease that can flare without warning. Asking your doctor these 10 questions can help you better manage the condition.

Why do I have gout?

Gout is caused by deposits of sharp, needle-like crystals of uric acid in the joints that create inflammation, redness, and heat around the joint, along with extreme pain. Uric acid comes from two main sources: internally from the destruction of old or damaged body cells and externally from foods, such as red meat and seafood, that contain a lot of a substance called purines.

A number of factors can increase your chances of getting gout, including genetics, gender, age, weight, and medical conditions, including hypertension. Some medications, like diuretics, can also cause gouts.

Your doctor may feel that some combination of these factors has put you at high risk, or that your diet has contributed to the problem.

What other medical conditions are linked to gout?

High uric acid levels are linked to hypertension, diabetes, high cholesterol levels, and obesity. Treating these conditions may improve gout.

How long will a gout attack last and how often will I get one?

An acute gout attack may last from three to 10 days, with or without medication. Some people have only one attack in their lifetime, but without treatment or a drastic change in your diet and risk factors, attacks may eventually happen several times a year.

What are my gout medication options?

For an acute gout attack, medications are given simply to reduce pain and inflammation; they do not affect uric acid levels. The options include non-steroidal anti-inflammatory drugs (NSAIDs), oral corticosteroids, and colchicine, depending on what is tolerated best. If only one joint is affected, a corticosteroid may be directly injected into the joint to reduce inflammation and pain.

After the attack subsides, many (but not all) people will need ongoing treatment designed to keep uric acid levels in a normal range to prevent further attacks.

“The guide to treating someone,” says Chaim Putterman, MD, chief of rheumatology at Albert Einstein College of Medicine, New York City, “is the number and severity of attacks.” This means you may not need long-term medication if you’ve only had one attack. Long-term treatment either lowers the body’s production of uric acid or speeds up its excretion. Either approach can level out uric acid concentrations in the body.

Why do I have to continue to take my medication if my gout is better?

There can be low-lying inflammation between attacks, and crystal deposits can increase in size and eventually become hard and damage the joint. The medications help prevent this. “It’s important to know that gout is a disease of uric acid, so you need to maintain low levels by taking medication every day,” says Dr. Putterman.

Are there side effects to my gout medications?

Medications for both acute gout attacks and long-term control of uric acid control can have side effects. Medications that abruptly change uric acid levels can actually bring on a gout attack (or make a current attack worse) while uric acid levels are fluctuating. For this reason, attempts to lower uric acid levels are often postponed until the painful, acute attack has subsided.

NSAIDs can cause stomach irritation, and corticosteroids, when used short-term for a gout attack, can cause insomnia, stomach irritation, and difficulty controlling blood sugars in the person with diabetes. Colchicine (Colcrys), used primarily for acute attacks, tends to cause gastrointestinal side effects, particularly diarrhea. Because of possible side effects you should record all problems and work with your doctor to find the best medication regimen.

I took medication a long time ago and it did nothing — does this mean nothing will work for me?

“Some patients may have been taking medications years ago and had side effects, so they don’t go to their doctor because they think they have nothing to offer,” Putterman says. “This has changed because there are new gout medications.”

Which medications can interfere with the ones I have to take for gout?

Taking allopurinol (Zyloprim), which decreases uric acid levels, with certain other medications is dangerous, says Putterman. So you need to tell your doctor about everything you are taking, including supplements and over-the-counter drugs.

Some diuretics can worsen gout and should be replaced with another medication. Some medications needed after an organ transplant or for cancer treatment can react adversely with gout-controlling therapy. Low-dose aspirin may lead to uric acid retention and high uric acid levels. However, high-dose aspirin may actually lower uric acid levels, but should never be taken without your doctor’s approval because of potential side effects.

How should I change my diet?

“Most of the uric acid we generate is endogenous [from our own body] — it doesn’t come from outside sources,” explains Putterman. This means that one of the main causes of gout (and flare-ups) is being overweight, as there are more cells to be broken down. Weight loss will decrease uric acid levels.

Eating large amounts of certain foods containing high levels of purines, substances that are broken down to uric acid, can increase the chance of a gout attack. They include meat such as bacon, veal, and organ meats (often found in gravy, meat bouillon, and meat broth) and seafood such as haddock, trout, herring, and scallops.

People who consume reasonably high levels of low-fat dairy products have been shown to have a lower number of gout attacks. Coffee consumption, both caffeinated and decaf, also seems to decrease the risk of gout attacks.

There are many dietary supplements that claim to “cure” gout, yet “nothing that is sufficient for the patient with established gout has been found to completely eradicate this disorder,” says Putterman.

Do I need to give up alcohol?

There is a known link between gout attacks and alcohol, especially beer, which is high in the purines that cause increased uric acid levels. Putterman is aware that eliminating alcohol completely can be difficult for some patients and suggests moderation. It’s better to spread out intake over the course of your week rather than drink heavily on any given night, a scenario that’s more likely to cause a gout flare.

There are a number of ways to help control gout. Work with your doctor to get the answers you need and explore all of your options for both lifestyle modifications and medications.

Managing a Gout Flare – Arthritis Foundation

Take medicine you have on hand

Start treatment immediately with over-the-counter ibuprofen (Motrin, Advil) or naproxen (Aleve), but never take aspirin, which can worsen a flare. If you have had a flare before and your doctor has prescribed an anti-inflammatory medication to take in the event of another, take your prescribed medication as your doctor directed. If you are already taking a uric acid-lowering drug to reduce the risk of flares, continue to take that drug.

Ice down

Applying an ice pack to the painful joint may help ease pain and inflammation. Wrap a pack (a bag of crushed ice or frozen peas will also do) in a dish cloth and apply to the area for 20- to 30-minutes at a stretch several times a day.

Call your doctor. Let your doctor know what is going on right away. She may prescribe a new medication, or have you come to the office for a joint fluid test (to confirm the gout diagnosis) or an injection of a corticosteroid to start relieving inflammation quickly. Getting treatment within the first 24 hours of the start of a flare can lessen its length and severity.

Drink plenty of fluids

Staying hydrated helps flush out uric acid (the cause of your joint pain) and prevent kidney stones, another possible problem associated with high uric acid levels. Aim for eight to 16 cups of fluids a day, at least half of them water.

Avoid alcohol.

Although it may be tempting to have a drink to relax when you’re in pain, it’s important to avoid alcohol, especially beer, which contains high levels of purines. The body creates uric acid when it metabolizes purines. Furthermore, alcohol inhibits the excretion of uric acid from your body.

Get a cane

Walking with a cane during an acute gou flare can help keep pressure off your painful joint.

Elevate your foot, if affected

Raising your foot with pillows so it’s higher than your chest may help lessen swelling.

Create gout-friendly socks

Cut the big toe out of cheap socks or cut the toe section off completely so you can have warm feet without toe pain.

Chill out

Try to relax if you can; stress can aggravate gout. Watch a movie, talk to a friend, read a book or listen to music.

Revamp the menu

Stop eating troublesome high-purine foods, such as shellfish, red meat, sweetbreads and gravies.

Gout Symptoms and Diagnosis | Johns Hopkins Arthritis Center

Arthritis / Acute Gout Attack

 

Gout is a form of arthritis, hence it causes pain and discomfort in the joints. A typical gout attack is characterized by the sudden onset of severe pain, swelling, warmth, and redness of a joint. The clinical presentation of acute gouty arthritis is not subtle with very few mimics other than a bacterial infection.

The joint most commonly involved in gout is the first metatarsophalangeal joint (the big toe), and is called podagra. Any joint may be involved in a gout attack (and it may be more than one) with the most frequent sites being in the feet, ankles, knees, and elbows.

An acute gout attack will generally reach its peak 12-24 hours after onset, and then will slowly begin to resolve even without treatment. Full recovery from a gout attack (without treatment) takes approximately 7-14 days.

An accurate and colorful discription of a gout attack was elegantly written in 1683 by Dr. Thomas Sydenham who was himself a sufferer of gout:

The victim goes to bed and sleeps in good health. About 2 o’clock in the morning, he is awakened by a severe pain in the great toe; more rarely in the heel, ankle or instep. This pain is like that of a dislocation, and yet the parts feel as if cold water were poured over them. Then follows chills and shiver and a little fever. The pain which at first moderate becomes more intense. With its intensity the chills and shivers increase. After a time this comes to a full height, accommodating itself to the bones and ligaments of the tarsus and metatarsus. Now it is a violent stretching and tearing of the ligaments– now it is a gnawing pain and now a pressure and tightening. So exquisite and lively meanwhile is the feeling of the part affected, that it cannot bear the weight of bedclothes nor the jar of a person walking in the room.

Chronic Tophaceous Gout

Some patients only experience acute gout attacks which may be limited to 1-2 times per year (or even 1-2 times in lifetime). However, for some patients, gout can be a chronic, relapsing problem with multiple severe attacks that occur at short intervals and without complete resolution of inflammation between attacks. This form of gout, called chronic gout, can cause significant joint destruction and deformity and may be confused with other forms of chronic inflammatory arthritis such as rheumatoid arthritis. Frequently, uric acid tophi (hard, uric acid deposits under the skin) are present and contribute to bone and cartilage destruction. Tophi are diagnostic for chronic tophaceous gout. Tophi can be found around joints, in the olecranon bursa, or at the pinna of the ear. With treatment, tophi can be dissolved and will completely disappear over time.

Tophi at helix of ear.Large tophaceous deposits surrounding joints.

Asymptomatic Hyperuricemia

It is important to recognize that although almost uniformly all patients with gout have hyperuricemia (high levels of uric acid in the blood)…all patients with hyperuricemia do not have gout. Although most patients will have elevated levels of uric acid in the blood for many years before having their first gout attack, there is no current recommendation for treatment during this period in the absence of clinical signs or symptoms of gout. This is termed ‘asymptomatic hyperuricemia’. The risk of a gout attack increases with increasing uric acid levels, but many patients will have attacks with “normal” levels of uric acid and some will never have an attack despite very high levels of uric acid.

Diagnosis of Gout

A diagnosis of gout can be made with the documentation of the presence of uric acid crystals in synovial fluid or from a tophaceous deposit. In the setting of an acute gout attack, aspiration of joint fluid (by using a needle to draw fluid out of the swollen joint) and examination of the fluid under polarized light can yield the definitive diagnostic finding of needle shaped negatively-birefringent uric acid crystals (yellow when parallel to the axis of polarization). Intracellular crystals within a neutrophil are characteristic during an acute attack.

As the clincal features of acute gout and a septic joint (bacterial infection) can be very similar, arthrocentesis is important to rule out infection by sending the joint fluid for culture in these circumstances. Importantly, gout and infection can co-exist in the same joint (they are not mutually exclusive) and consideration should be made for sending joint fluid for culture even in a patient with an established history of gout if they are at risk for infection.

Tophi can be aspirated or the tophaceous material expressed and examined under polarize microscopy as well to confirm a diagnosis of chronic tophaceous gout.

Serum uric acid concentrations may be supportive of a diagnosis of gout, but alone the presence of hyperuricemia or normal uric acid concentrations do not confirm or rule out the diagnosis of gout as frequently uric acid levels may be normal during an acute gout attack.

Gout symptoms & treatments – Illnesses & conditions

Treatment for gout includes pain relief to help you cope with a gout attack, as well as medication and lifestyle changes to prevent further attacks.

Pain relief for a gout attack

What to do during an attack

You should:

• take any medication you’ve been prescribed as early as possible after you notice an attack (see below) – this should start to have an effect within two or three days
• rest and raise the limb
• avoid knocking or damaging the affected joint
• keep the joint cool – remove surrounding clothing and apply an ice pack, such as a bag of frozen peas wrapped in a towel
• ensure you’re well hydrated

Apply the ice pack to your joint for around 20 minutes. Don’t apply ice directly to your skin and don’t apply it for more than 20 minutes at a time because this could damage the skin.

If necessary, you can keep reapplying an ice pack to your skin during an attack, but you should wait until your skin has returned to a normal temperature first.

NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) are usually recommended as the first treatment for gout. They work by reducing pain and inflammation during an attack.

NSAIDs used to treat gout include naproxen, diclofenac and etoricoxib.

If you’ve been prescribed NSAIDs, it’s a good idea to have them with you at all times so you can use them at the first sign of a gout attack. Continue to take your medication throughout the attack and for 48 hours afterwards.

Your GP may also prescribe a medication called a proton pump inhibitor (PPI), to take alongside your NSAID. This reduces the risk of the NSAID causing indigestion, stomach ulcers and bleeding from the stomach.

Colchicine

If you’re unable to take NSAIDs or if NSAIDs are ineffective, a medicine called colchicine can be used instead.

Colchicine reduces some of the swelling and pain associated with a gout attack.

It’s best to have it with you at all times so you can use it at the first sign of a gout attack. Your GP will tell you how long to take it for and how often.

When taken in high doses, side effects of colchicine include feeling sick, abdominal (tummy) pain and diarrhoea.

Corticosteroids

Corticosteroids are sometimes used to treat severe cases of gout if other treatments don’t work or you’re unable to take an NSAID or colchicine.

A short course of steroid tablets often provides relief, but they can’t be used long-term in high doses as they cause side effects, including: 

• weight gain
• thinning of the bones (osteoporosis)
• easy bruising
• muscle weakness

Corticosteroids can also be given by injection to provide rapid pain relief. This can be either into a muscle, a vein or directly into the affected joint. 

Medication and lifestyle changes to prevent further attacks

You can reduce your chances of having further gout attacks by taking medication and making lifestyle changes to reduce the level of uric acid in your body.

Medication

Medication to reduce uric acid levels – known as urate-lowering therapy (ULT) – is usually recommended if you have recurrent attacks of gout or you have complications of gout.

Most people with gout will eventually need to have ULT, so you may want to discuss the advantages and disadvantages of this treatment with your doctor as soon as you’ve been diagnosed with gout.

They should explain that while ULT can significantly reduce your risk of having further attacks, the medication needs to be taken on a daily basis for the rest of your life and there’s a small risk of side effects.

If you decide to start ULT, a medicine called allopurinol is usually tried first. If this isn’t suitable or doesn’t work, other medications may be used instead. These medications are described below.

Allopurinol

Allopurinol helps reduce the production of uric acid. It can help prevent gout attacks, although it won’t help relieve symptoms during an attack.

Allopurinol is a tablet taken once a day. When you first start taking it, your dose will be adjusted to make sure the level of uric acid in your blood is low enough. Regular blood tests will be needed to monitor this until the most effective dose is found.

Allopurinol can sometimes cause a gout attack soon after you start taking it and it can take up to a year or two before no further attacks occur. It’s important to persevere with treatment even if you do have attacks during this time.

To help relieve attacks, your doctor will prescribe one of the pain relieving medications described above to take alongside your allopurinol at first.

Most people taking allopurinol won’t experience any significant side effects. However, side effects can include:

• a rash – this is usually mild and goes away on its own, but it can be a sign of an allergy; if you develop a rash, stop taking the medication immediately and contact your GP for advice
• indigestion
• headaches
• diarrhoea

Febuxostat

Like allopurinol, febuxostat is a medication taken once a day that reduces the body’s production of uric acid. It’s often used if allopurinol isn’t suitable or causes troublesome side effects.

As with allopurinol, febuxostat can make your symptoms worse when you first start taking it. Your doctor will initially prescribe one of the pain relieving medications described in case you experience attacks.

Side effects of febuxostat can include:

• diarrhoea
• feeling sick
• headaches
• a rash

Other medications

Less commonly used ULT medications include benzbromarone and sulfinpyrazone.

These types of medication tend to only be used if people are unable to take allopurinol or febuxostat. They need to be prescribed under the supervision of a specialist.

Lifestyle changes

Certain lifestyle changes can also help reduce your risk of experiencing further attacks of gout, including:

• avoiding foods containing high levels of purine (the chemical involved in the production of uric acid), such as red meat, offal, oily fish, seafood and foods containing yeast extract.
• avoiding sugary drinks and snacks – these are associated with an increased risk of gout
• maintaining a healthy weight – follow a balanced diet; don’t crash diet or try high-protein, low-carbohydrate diets
• taking regular exercise – try activities that don’t put too much strain on your joints, such as swimming
• drinking plenty of water – keeping yourself well hydrated will reduce the risk of crystals forming in your joints
• cutting down on alcohol – avoid beer and spirits in particular and don’t binge drink

There’s some evidence to suggest that taking regular vitamin C supplements can reduce gout attacks, although the effect may only be small. Talk to your GP first if you’re thinking about taking vitamin C supplements, as they aren’t suitable or safe for everyone.

90,000 Gout (gouty arthritis) | Medical center Your Health

Gout (gouty arthritis) is an metabolic pathology of the body, in which the exchange of purines (uric acid derivatives) is affected, which leads to excessive deposition of uric acid salts in some tissues of the body.

It is as a result of these deposits that dysfunctions of organs and tissues are formed.The joints, kidneys and some other organs (bones, ligaments, liver) are especially affected.

Gout has been known for a long time, proceeds with periods of remission and gouty attacks, more often affects middle-aged men, women suffer no more than 1-2% of all cases of gout.

Reasons

The basis of gout is a genetically inherited defect in the metabolic processes of uric acid, a defect in enzymes that help its utilization and excretion, as well as defects in the system of internal synthesis of purine substances.

In addition to genetic reasons, risk factors and external influences that predispose to the development of gout are no less important for the development of gout:

• Increased intake of purine bases from food with abuse of meat products,
• obesity and overweight,
• alcoholism, excessive drinking,
• bad habits, inactivity.

Development of secondary gout is possible

• against the background of tumor processes with changes in purine metabolism,
• against the background of increased breakdown of body proteins,
• in the treatment of thiazide diuretics (dichlothiazide, polythiazide),
• when using cytostatics (doxorubicin, fluorouracil, hydroxyurea, cyclophosphamide).

Gout attacks can be triggered by stress reactions to alcohol, citrus fruits, viral infections, physical or mental stress, trauma and hypothermia, bruises, pressure fluctuations, and medication.

Views

Most often, with gout, the kidneys and joints are affected, therefore,

can be distinguished

• gouty arthritis
• gouty kidney disease.

There are also three types of gouty disorders, based on the level of uric acid in the urine:

• metabolic form with the highest amount of uric acid.
• renal form, moderate amount of uric acid with increased salts,
• mixed form – a lot of uric acid and its salts, which give crystals.

Symptoms of gout

Gout is a chronic and progressive disease, it can occur in three successive stages –

• acute arthritis of gouty origin,
• stage of interictal gout,
• Tofus chronic stage of gout.

Gouty arthritis occurs suddenly: at night or in the morning, there are burning, throbbing or tearing pains of one or more joints, usually on the legs and their lesion is asymmetrical.

Quite often, the joint of the big toe is affected first.

The lesion usually affects the foot or ankle, knees, finger joints, elbows. There may be swelling of the veins around the joint, fever, and chills.

Due to severe pain and swelling, movement of the joint is almost impossible.During the day, the pain subsides somewhat, and by night it reappears, which leads to neurosis and irritability.

After 3-4 days the pain subsides, the joint acquires a cyanotic hue, the edema gradually subsides.

During attacks, blood tests change – inflammation is detected in the blood with accelerated ESR, high leukocytes and an increase in proteins of the acute phase of inflammation.

Attacks can occur at different times – from once every six months to several years. As gout progresses, the frequency of attacks increases, they become longer and less severe, but more and more joints are involved in the process.

Chronic gout

Chronic gout forms areas of tofuses – these are nodular accumulations of salts in tissues approximately 5-7 years after the onset of the disease.

Topuses appear inside the auricles, in the area of ​​the joints of the hands and feet, elbows, knees, their sizes can be from a couple of millimeters to a pea or more. As the progression progresses, the joints change, their deformations, curvatures, limitation of mobility and pain during movement occur.

In addition to the joints, the kidneys are affected. The changes are stronger, the higher the level of uric acid and urate in the urine, and the longer the illness.

There is a so-called urate nephropathy with inflammation of kidney tissue, excretion of salts, deposition of sand and stones and the formation of urolithiasis.

There are periods of renal colic with back pain, nausea and vomiting, and secondary pyelonephritis may also develop, with fever, leukocytes in the urine, symptoms of dysuria and a general serious condition.

Urates can be deposited not only in the renal pelvis, but also in the kidney tissue, its cortex and medulla, this leads to a gradual atrophy of kidney function and the development of renal failure.

There may be lesions of the tendons with the deposition of salts in them, while developing redness and swelling in the tendon area, severe pain and problematic movements.

The risk of developing coronary heart disease is also higher; some patients develop severe obesity.

Diagnostics

The basis of the diagnosis is typical attacks of gout with joint damage.Complementing the data of blood tests with signs of acute inflammation, urine tests with high levels of urates and uric acid, creatinine, in the punctate from the joint, the detection of urate salts.

In acute gout

For primary diagnosis, a study of the joint fluid is required. With gout attacks, it is transparent, its viscosity is reduced, leukocytes in it are up to 75%, uric acid crystals are found.

With prolonged gout

Mandatory X-ray with detection of certain signs in the clinic:

• maximum inflammation on the first day,
• multiple attacks of arthritis,
• damage to one joint,
• joint redness,
• inflammation in the first joint of the big toe,
• Tofus suspected,
• increase in the level of urate in blood and urine,
• Typical signs of joint damage on x-rays.

Treatment

The same symptoms can be signs of different diseases, and the disease may not proceed according to the textbook. Do not try to heal yourself – consult your doctor.

Rest and cool wraps are very important in the treatment of acute gouty arthritis.

An important place is occupied by colchicine, prescribed 0.5 mg every hour until arthritis subsides, or until side effects (vomiting, diarrhea) appear, but not less than 6-8 mg / day.

For the treatment of an acute attack of gout, colchicine is used for no more than a day.

Indomethacin, ibuprofen, naproxen, piroxicam are usually used in large doses and in a short course (2-3 days). Special care should be taken in case of concomitant liver and kidney diseases, especially in elderly patients.

Treatment with anti-gout drugs is carried out with primary gout for life, with secondary – depending on the elimination of the situation that provokes the development of gout.

With a reduced excretion of urates, preserved renal function and the absence of urinary stones, it is possible to use allopurinol + benzbromarone, used 1 tablet 1 r. / Day, probenecid.

The generally recognized uricostatic (i.e., blocking the production of urates) drug is considered allopurinol.

Allopurinol is prescribed at a starting dose of 100 mg / day. followed by a gradual increase in the dose to 300 mg / day. in 3-4 weeks.

With an increased excretion of uric acid in the urine and / or gouty kidney damage, preference is given to allopurinol.

Diet for gout

Foods to be excluded:

• alcoholic beverages (especially beer),
• internal organs of animals (liver, kidneys).

Foodstuffs whose consumption should be limited:

• fish (caviar, Baltic herring, sardines, etc.; larger fish is acceptable in the diet),
• crustaceans,
• meat (veal, pork, poultry, broths),
• some vegetables (peas, beans, mushrooms, cauliflower, asparagus, spinach).

Foods that can be consumed without restrictions:

• cereals (bread, cereals, bran),
• dairy products (milk, sour cream, cheese),
• all fruits and fruit juices,
• fats (butter, margarine, cooking oil),
• coffee, tea,
• chocolate,
• most vegetables (potatoes, lettuce, cabbage, tomatoes, cucumbers, pumpkin, onions, carrots, beets, radishes, celery),
• sugar (but: causes weight gain!),
• spices.

Forecast

Gout is a chronic progressive disease that cannot be completely cured, but the disease can be brought into a state of long-term remission.

Attacks usually heal in 2-4 weeks, but can occur every six months or more often, so taking drugs that lower the level of uric acid and its salts can even be lifelong.

Source: diagnos.ru

90,000 disease of aristocrats.How it appears and how to treat it

This disease is a “time bomb” in the human body. With gout, uric acid salts are deposited in various tissues. The joints most often suffer from gout, where acute inflammation with severe pain develops. The joints become deformed, which leads to a significant decrease in the quality of life.

This old disease was known back in the days of Hippocrates. Gout is also called “disease of kings” or “disease of abundance.” It was thought to be linked to being overweight, eating meat and drinking alcohol.Now three out of a thousand people suffer from gout. Most often it affects men over the age of 40, in women it mainly manifests itself after menopause.

Why gout develops

The main reason for the development of gout is a violation of the metabolism of uric acid, which everyone has in the blood and is the end product of the cleavage of nucleic acids – purines. From the liver, it enters the bloodstream and is excreted from the body by the kidneys. If uric acid is present in the body in normal concentration, then it is not an enemy: it promotes the elimination of free radicals that provoke the appearance of cancerous tumors, as well as the protection of blood vessels.But if too much uric acid is formed, or its normal amount is formed, but not enough is excreted, that is, it becomes too much in the blood (hyperuricemia), serious problems begin.

Hyperuricia develops with the consumption of large amounts of red meat, especially offal, some types of fish, cocoa, tea, chocolate, peas, lentils, alcohol, especially beer; with some autoimmune and oncological diseases.

Inhibition of the excretion of uric acid in the urine is more often associated with kidney disease.But with alcohol abuse, both mechanisms are triggered: the synthesis of uric acid increases, while its excretion from the body decreases.

Excess uric acid is converted into tiny crystals that are deposited in various tissues of the body, causing inflammation, primarily in the cartilage of various joints, which leads to the development of gouty arthritis. If these salts are deposited in the subcutaneous tissue, peculiar whitish nodules of the size of lentils and more are formed, which are called tofuses.They are most often found on the earlobe, hands, feet, around the joints. If uric acid crystals affect the kidney tissue, such a formidable disease as gouty nephropathy may develop, and possibly urolithiasis with severe painful attacks of renal colic.

Acute gouty arthritis

The main clinical manifestation of gout visible to the eye is acute gouty arthritis, or gouty attack: one of the most painful conditions in rheumatology.Most often, the first attack of gout begins after a heavy meal with alcohol at night or in the early morning hours. In the classic case, this is an acute inflammation of the joint of the big toe: where the phalanx attaches to the foot. But any joint can fall prey to gout – usually one on one side. A sharp pain begins in the affected joint, which intensifies when touched. The joint swells, reddens and becomes hot, classic pain relievers like analgin do not help the patient.Trying to take a warm foot bath only adds to the suffering. All this is accompanied by chills, a rise in temperature, sometimes up to forty degrees.

The cause of pain in gouty attack is not mechanical – sharp crystals, but chemical – irritating substances. On these “inflammatory substances”, they are called inflammatory mediators, immune cells penetrate into the joint, which begin to destroy the joint’s own structures, mistaking them for “attack of foreign agents”.

The attack lasts from three to seven days and in the early stages of the disease ends with complete healing, even if nothing is done.A distinctive feature of gout is the sudden onset of an attack and a rapid rebound. No other arthritis appears so unexpectedly and does not disappear after a week. A person can forget about it, but after a few months everything repeats again, but now the attack lasts two to three weeks. And the longer the duration of the disease, the shorter the intervals between attacks, and the longer the attacks themselves.

Gout is dangerous because over time it can lead to complete damage to the musculoskeletal system.In addition, with gout, blood pressure rises, which contributes to the development of various cardiovascular diseases. Urolithiasis, and especially nephropathy, can lead to kidney failure. In case of violation of purine metabolism, a violation of fat metabolism occurs in parallel, therefore it is noted that most gouty people are obese people.

As a rule, all patients go to their GP. Less often, in case of joint damage, – to the surgeon. These doctors, if necessary, consult such patients with a rheumatologist, since gout belongs to the group of rheumatic diseases.Patients with severe joint lesions are referred for consultation to arthrologists – specialists in joint pathology.

We make a diagnosis

The diagnosis of “Gout” is established in the presence of characteristic attacks, confirmed by clinical and instrumental studies:

1. An extensive blood test – signs of inflammation are found.
2. Biochemical blood test – an increase in uric acid, and signs of concomitant diseases may also be revealed: diabetes mellitus, liver disease, renal failure and others.
3. Study of joint fluid. This procedure can be quite unpleasant, but it is precisely as a result of articular puncture that the doctor will be able to obtain with sufficient accuracy the answer to the question: what actually happened? Articular puncture greatly facilitates the patient’s condition, because, firstly, excess fluid is removed from the joint, causing a feeling of pressure from the inside and containing a large amount of “inflammatory substances”. Secondly, in the absence of contraindications, a medicine is injected into the articular cavity, which quickly removes signs of inflammation.The resulting liquid is sent to a laboratory for analysis. If crystals of sodium monourate of characteristic size and shape are found, the diagnosis is confirmed.
4. Tofus content analysis. When there are soft formations available for examination and taking of material, similar to vesicles or warts, usually the rheumatologist tries to obtain their contents for analysis. When viewed with the naked eye, what is released from tofus vaguely resembles cottage cheese, and microscopy reveals the same crystals as in the joint fluid.
5. Radiography. A radiologist can answer the following questions: Are we dealing with gout? If so, how far did the disease go?
6. Ultrasound examination of joints. In the case of gout, this is much less informative than radiography.

While the ultrasound doctor will only be able to determine whether arthritis really takes place, how much fluid is in the joint and whether we can take it for analysis.

Treatment of gout

It is customary to separate non-drug and drug treatment.

Non-drug treatment includes diet therapy, use of orthopedic aids and joint relief, and lifestyle adjustments. Medicines are prescribed by a doctor depending on the type of gout: it is associated with an increased synthesis of uric acid or with a decrease in its release.

Two main directions: reducing pain during the period of gouty attack and reducing the risk or completely preventing new attacks by reducing the deposition of salts – urates. To achieve these goals, anti-inflammatory drugs and drugs are used against an increase in the concentration of uric acid in the blood.The attending physician selects them, self-medication is unacceptable.

If the attack took you by surprise:

• Complete rest. Keep the affected joint elevated and at rest.
• If the affected joint allows you to touch it, try applying an ice pack to it – this will have a softening and analgesic effect.
• Drink plenty of water. A large amount of fluids, up to two liters per day, will help speed up the elimination of uric acid from your body.

Lifestyle of a patient with gout

After the pain syndrome is eliminated, the doctor must make sure that the level of uric acid remains safe for the patient and that the drugs are selected correctly.For this purpose, a regular determination of the level of uric acid is carried out using a biochemical blood test. At the beginning of treatment, this should be done every two to four weeks, then every six months.

It is necessary to lead a healthy lifestyle, to move more; drink less alcohol, give up tobacco; walk in comfortable shoes; watch out for food, so as not to be among the “fat people”.

Gout, if it is not provoked and not started, but see a doctor in time, is a fairly controlled disease.Almost all patients with gout live to old age, suffering more from concomitant diseases than from joint pain.

DIET

No therapy will help with gout if the person does not follow a diet. It is necessary to exclude foods rich in purine bases from the diet. These include all by-products: liver, kidneys, brains, tongue; meat of young animals; fatty meats and fish, canned food, smoked meats, sausages, sprats, sardines.

Allowed only 200-300 grams of lean boiled meat per week.Since during cooking half of the purine bases pass into broth, the patient should not drink fish and meat decoctions. Vegetarian soups can be recommended from the first courses. The meat is chicken or duck. “Lean” types of fish are allowed: cod, pollock – no more than three times a week. It is also necessary to limit the consumption of table salt to six to seven grams per day, sugar, sweets, flour dishes, cocoa and chocolate, exclude coffee and strong tea from your diet.

But fermented milk products poor in purines – kefir, fermented baked milk, yogurt, eggs, potatoes, bread and cereals can be eaten without restriction.You need to eat more vegetables, berries and fruits, of which citrus fruits are preferable – they have a pronounced alkalizing effect.

All patients are recommended to spend fasting days once a week. There are a lot of options: vegetable, fruit, cottage cheese. On any fasting day, the amount of liquid you drink should not be less than one and a half liters.

If gout is associated with obesity, which is very common, a low-calorie diet should be followed. But beware of unusual diets that have a notorious reputation for causing gout attacks.Such diets, including fasting, cause a violation of the integrity of cells and the release of uric acid, which can negatively affect both the general condition of the patient and the work of the kidneys and heart.

Gout_part 1_Disease of Kings or Queen of Diseases? – “Mother and Child

“Gout” in translation from Greek means “a trap on the foot.” Gout has been mentioned since the time of Hippocrates (2,500 years ago, in the 5th century BC), when he first described syndrome of acute pain in the area of ​​the big toe , which he actually called “gout “.By the end of the 20th century, gout began to be considered as a disease of the accumulation of uric acid salts in the structure of the joints, subcutaneous tissue, bones and kidneys

“Gout” in translation from Greek means “a trap on the foot.” Gout has been mentioned since the time of Hippocrates (2,500 years ago, in the 5th century BC), when he first described syndrome of acute pain in the area of ​​the big toe , which he actually called “gout “.By the end of the 20th century, gout had come to be regarded as a disease of the accumulation of uric acid salts in the structure of the joints, subcutaneous tissue, bones and kidneys .

Disease of kings, geniuses?

For a long time, gout has been called “the disease of kings or the queen of diseases”, “the master’s ailment” and was even considered a sign of genius. Many famous people who left their mark in world history suffered from gout. These were people of genius: Isaac Newton, Albert Einstein, Charles Darwin, Peter I, Leo Tolstoy, Michelangelo, Leonardo da Vinci, Alexander the Great.In N.A. Nekrasov’s poem “Who Lives Well in Russia?” on behalf of the author, the following lines sound: “Leave me, Lord, my honorable illness. According to her I am a nobleman. ”

Relatively recently, it became known that uric acid is similar in structure to caffeine and has a caffeine-like effect, that is, it stimulates mental activity. People with outstanding mental ability have elevated levels of uric acid, even if they do not have gout. There are many assumptions on this score, but the exact mechanism of this phenomenon cannot yet be explained by world science.Thus, all patients diagnosed with gout have a chance to become somewhat brilliant. The only trouble is that with gout, the joints are damaged with severe pain and dysfunction, damage to the kidneys and other organs.

Currently, gout is one of the most common joint diseases in people over 40, more often in men. Men get gout 9-10 times more often than women. The peak incidence is observed in men aged 40-50 years, and in women over the age of 60 years.This is due to the fact that the female sex hormones estrogens have a beneficial effect on the metabolism of purines and have a good uricosuric effect (well excreted uric acid in the urine).

The clinical picture of gout and why the “disease of kings” is dangerous.

The appearance of a gout patient is very characteristic, which is reflected in many illustrations. This is, as a rule, a middle-aged man, good-natured, overweight (overweight or obese), suffering, in addition, arterial hypertension (increased blood pressure), abusing alcohol and meat food.

Gout develops either with excessive formation of uric acid in the body, or with insufficient excretion of uric acid by the kidneys, or by a combined mechanism. In 90% of cases, gout begins with arthritis of the first toe. The clinical picture of gout is very characteristic. The attack usually begins at night or early in the morning and is accompanied by severe pain in the specified joint, swelling and redness. The pain syndrome is constant throughout the day, the pain does not stop at rest, intensifies at night, with the slightest movement, light touch (the so-called “bed sheet” pain).The patient is unable to move due to pain. At the same time, the body temperature often rises even to sufficiently high numbers. The first attack can last from several hours to several days. At the onset of the disease, acute arthritis can be stopped on its own, with repeated attacks, as a rule, treatment is required.

The disease proceeds in waves, that is, periods of exacerbation alternate with “light” intervals. A gout attack can be triggered by physical exertion, trauma, stress, a violation of diet (alcohol, meat, fish and other foods that increase the level of uric acid in the blood), fasting, overheating or hypothermia.

With repeated attacks of gouty arthritis, that is, with chronic gout, other joints (knee, ankle, joints of the hands and feet, elbow, much less often – shoulder, hip, temporomandibular) may be affected, tofuses (accumulations of monosodium uric acid salt) appear … Topuses are localized in soft tissues in the area of ​​the affected joints, ears and bones, which leads to destruction (destruction) of the joints. Also, tophuses can be localized on the eyelids, tongue, larynx, in the heart (causing conduction disturbances and dysfunction of the valve apparatus), in the kidneys.In some cases, subcutaneous tophuses can reach large sizes, ulcerate with the separation of a tiny white mass, and there may be cases of local inflammation (including purulent).

In all patients with gout, periodically or constantly in the blood, an increased level of uric acid (hyperuricemia) is determined, which is a mandatory criterion for the diagnosis of this disease. During acute arthritis, the normal level of uric acid is often found in the blood.An assessment of this indicator in dynamics is required during a re-examination.

A poor prognostic sign is kidney damage with gout. It could be nephrolithiasis (presence of kidney stones). In most cases, stones are based on uric acid salts (sodium monourate). Only in 10–20% of patients, calcium oxalates or calcium phosphate are found in the stones. Also, with gout, urate nephropathy can develop, which is characterized by the deposition of sodium monourate in the kidney tissue.This variant of kidney damage is associated with a high risk of developing severe renal failure.

Asymptomatic hyperuricemia and risk groups for gout.

Often we have to deal with hyperuricemia in people who have never suffered attacks of acute arthritis. This is asymptomatic hyperuricemia, a clinical syndrome distinct from gout, which in most cases is part of the metabolic syndrome manifested by obesity, type 2 diabetes (or increased fasting blood glucose), increased blood cholesterol levels, vascular atherosclerosis, coronary heart disease, and hypertension.All of these conditions can increase the risk of developing gout, which often occurs after long-term asymptomatic hyperuricemia.

The development of gouty arthritis is often associated with excessive consumption of protein foods (meat, fish, offal, legumes, etc.), alcohol, taking certain medications (diuretics, aspirin and its derivatives, cyclosporine), lead intoxication. Also important is a hereditary predisposition to impaired purine metabolism (in this case, gout can occur at a young age, there are cases of the disease in relatives).Gouty arthritis can provoke trauma, exercise. Of great importance for the development of hyperuricemia and gout are kidney diseases, accompanied by chronic renal failure.

Treatment of gout is directed, , firstly, at stopping a gouty attack. Further, in the interictal period, when all symptoms of arthritis are absent, treatment is needed to normalize the level of uric acid in the blood (diet, medications, medical supervision), which prevents the progression of the disease and reduces the risk of complications.Chronic tofus gout, nephropathy is the result of insufficient treatment of gout, both during acute episodes and especially in the interictal period.

It should be noted that such patients should be treated and monitored by a rheumatologist who uses an integrated approach to treatment, not limited only to symptomatic measures during an attack.

90,000 Gout.Diagnostics and treatment

Gout – inflammation of the joints due to impaired metabolism of uric acid in the body. That is, more uric acid is produced than is excreted from the body, or uric acid is retained in the body. And this leads to an increase in its level in the blood and crystallization in the joints. Most often, crystals of uric acid salts accumulate in the joints of the big toe and joints of the feet. Less commonly, the knees, ankles and heels are affected, and even less often the joints of the fingers, elbows and wrists.The formation of crystals in the renal tissue and renal tubules is possible.

Reasons

Gout is often referred to as a lifestyle disease. Alcohol abuse, especially beer and wine, smoking and physical inactivity contribute to the development of the disease. An increase in uric acid levels is also associated with excessive consumption of foods containing purines (the substances from which uric acid is formed). Especially dangerous in large quantities are meat products (beef, pork, veal, lamb) fried and grilled.Do not get carried away with smoked and canned foods, mushrooms, coffee and cocoa, confectionery, legumes. Gout is a systemic disease. And it can be both the cause of other diseases, and the consequence of such. Diseases such as diabetes, obesity, atherosclerosis, hypertension, psoriasis, and kidney disease can contribute to the development of gout. The risk group includes people who take diuretics for a long time. Gout is hereditary.

Symptoms

Gout is felt by sudden and severe pain in the joints of the legs. Attacks can be triggered by minor trauma, eating a lot of protein foods or alcohol, overwork or emotional stress. Intense pain often appears at night, and lasts about a day, and then it turns into a long and aching pain. The affected joints swell, the skin around them turns red, stretches, and becomes warm. The slightest touch of the joints is extremely painful. If the joints of the legs are affected, it is difficult to walk. Dense subcutaneous nodules may form in the toes, knees, elbows, and the skin of the ears.General malaise, fever and chills are possible. Without treatment, the inflammatory process affects other joints , the damage can become irreversible, gradually deformity of the joints occurs. In this case, the toes can be deformed overnight. Gout can lead to chronic renal failure, hypertension, and vascular damage to the heart and kidneys. Therefore, at the first symptoms of the disease, you must consult a doctor.

Analyzes

In the medical laboratory “Synevo” you can quickly diagnose gout.

Required analyzes:

Additionally, it is recommended to carry out an examination of the kidneys to determine functional disorders and the presence of stones.

You can get tested for gout at any point of Sinevo in Minsk, Gomel, Brest, Grodno, Vitebsk, Mogilev, Bobruisk, Baranovichi, Soligorsk, Slutsk, Polotsk, Novopolotsk, Svetlana, Orsha, Llobin , Borisov, Rechitsa, Mozyr, Smorgon.

Remember that gout cannot be cured, but you can control it with a balanced lifestyle and proper nutrition. It is necessary to give up the use of grape wines, beer, colored carbonated drinks, smoking, to minimize the use of foods that increase the level of uric acid. Eat more fruits, vegetables, and low-fat dairy products. Drink plenty of clean drinking water (2-3 liters per day). Maintain a healthy weight and an active lifestyle. Be healthy!

Health care facility “Gorky Central District Hospital”

Gout has been known since ancient times and in different periods had such names as “disease of kings”, “pirate disease”, “pansky’s ailment”.Even A.S. Pushkin describes this disease in his work “Eugene Onegin”

I had gout at forty,

Drank, ate, missed, got fat, grew weak …

Gout – is a systemic disease associated with impaired purine metabolism, characterized by an increase in the content of uric acid in the blood ( hyperuricemia ), deposition of urate in the articular or periarticular tissues and the development of inflammation in connection with this.

There is a primary and secondary form of gout.Secondary occurs against the background of other diseases: kidney disease, against the background of increased protein breakdown, etc.

Causes of primary hyperuricemia:

1. Excess urate formation
2. Reduced urate excretion
3. Mixed Violations

Risk factors for gout:

1. Male
2. Old age

• Addiction to eating meat, alcohol

1. Physical overload
2. Hypothermia
3. Reducing the excretion of uric acid by the kidneys

• Heredity

The following stages of gout are distinguished:

1. Asymptomatic hyperuricemia – characterized by an increase in uric acid in the blood without any clinical manifestations
2. Acute gouty arthritis – a classic acute attack can be described as the occurrence of intense pain in the area of ​​the 1st metatarsophalangeal joint, often occurring at night. Over time, the intensity of pain only increases, reaching a maximum on the first day, and can be so strong that even a touch of the sheet will be unbearable for the patient. More often provoked by physical exertion, emotional stress, trauma, alcohol consumption, a sharp change in diet (overeating, starvation)
3. The interictal period is the so-called period of apparent well-being, the period between two acute attacks of gout. Its duration is individual and can last from several months to several years.With the progression of the disease, the duration of interictal periods is sharply reduced.
4. Chronic tofus gout may manifest

– by the formation of tophus in various organs and tissues

– the development of chronic gouty arthritis

– kidney damage by the type of nephrolithiasis or urate nephropathy

If hyperuricemia is not promptly treated, gouty arthritis may form tofuses that disrupt the function of the joint. Topuses – an accumulation of crystals of uric acid salts, located in various organs and tissues, arising after 5-7 years from the onset of the disease. The most common localization of cartilage is the subchondral bone, inside the auricles, superficially in the area of ​​the joints of the hands and feet, elbows, knees, in the kidneys and skin. Tofus sizes can be from a few millimeters to a pea or more. The skin over the tophi can ulcerate, which is accompanied by the release of the contents in the form of a pasty white mass.

Chronic gouty arthritis joint damage with persistent involvement of 2-3 joints or many joints in the process, lasting more than 3 months, against which there are attacks of typical acute gouty arthritis.

In chronic arthritis, not only the joints of the lower, but also the upper limbs are affected. Such localization is more often combined with osteoarthritis of the distal and proximal interphalangeal joints, with the development of Heberden’s and Bouchard’s nodules.

Kidney damage can be of two types: nephrolithiasis or urate nephropathy.

The main symptoms of gouty nephropathy are:

– acute lower back pain. Pain is a consequence of the movement of stones in the renal pelvis. Crystals damage the epithelium of the renal pelvis, leading to the development of inflammation.

– hematuria (detection of blood in urine)

– renal colic. Sudden onset of severe lower back pain for no apparent reason

– the emergence of tofus-like formations in the kidneys, which in the future can lead to chronic renal failure

Principles of non-pharmacological treatment of acute gouty arthritis:

1. Complete rest
2. Elevated position of the diseased limb
3. In case of acute inflammation – cold, when the pain subsides – warming compress
4. Abundant drink – 2-2.5 liters per day (alkaline solutions, mineral waters, diluted lemon juice, compotes, jelly)
5. Dairy-vegetable diet

Principles of drug therapy

1. Application of NSAID
2. The use of colchicine, used in the presence of contraindications for the appointment of NSAIDs
3. The use of glucocorticosteroids

Principles for the treatment of chronic tophus gout antihyperuricemic drugs are used, combined into two groups: uricodepressants – inhibit the formation of uric acid, uricosurics – enhances its excretion from the body through the kidneys.

The representatives of the first group used in the Republic of Belarus include allopurinol.

Indications for antihyperuricemic therapy:

1. Increase in seizures up to 2 or more times a year
2. Chronic tofus gout

Basic rules of therapy:

– treatment must be permanent

– You cannot start therapy during an acute attack

– for the prevention of acute attacks, it is necessary to start treatment with small doses of allopurinol under the control of uric acid levels every 2 weeks until normouricemia is reached.

90,000 information for patients – clinic “Dobrobut”

The main symptoms of gout, treatment and prevention

Gout is a joint disease characterized by metabolic disorders and salt deposition. The main symptom of gout is an attack of gouty arthritis. The disease belongs to the oldest pathologies described by Hippocrates. At the time, it was called the “disease of kings.”Most often men are affected after 40 years. Signs of gout in women are rarely diagnosed.

Provoking factors:

• genetic predisposition;

90,019 male sex and age over 40;

90,019 moderate to severe obesity;

• uncontrolled intake of medications;
• Excessive consumption of alcohol and fatty foods.

The main cause of gout is an increased sustained level of uric acid.During the development of the disease, uric acid crystals are deposited in the joints, which leads to their partial or complete destruction.

Pain with gout of joints – clinical manifestations

Depending on the development of the disease, gout is divided into an asymptomatic stage and acute gouty arthritis. In the first case, the accumulation of uric acid crystals in the joints does not manifest itself in any way. This condition lasts for years and only in 20% of patients can lead to the occurrence of real gout.

Clinical manifestations of acute gouty arthritis:

• presence of edema in the joint area;
• redness of the joint;
• acute pain in joint gout arising at night (or in the morning);
• subfebrile increase in body temperature;
• deterioration in general condition, apathy, loss of appetite.

In the initial period, pain occurs, as a rule, in one joint (big toe or hand), but over time the pathology “captures” the adjacent joints.Attacks of acute gouty arthritis can last from several days to several weeks. Without timely diagnosis and qualified treatment, the symptoms of the disease begin to appear more and more often. A gradual reduction in the time between attacks is an alarming symptom that signals the transition of the disease into a chronic form. The doctor will tell you how to relieve exacerbation of gout quickly and effectively at a personal appointment.

Manifestations of gout in men

Gout is a chronic disease that is almost impossible to cure.The disease can develop rapidly or be sluggish. In this case, everything depends on the general condition of the patient and his way of life.

As noted above, men are diagnosed with gout three times more often than women. The disease affects representatives of the strong half after 40 years. A rheumatologist deals with the treatment of gout in men. After diagnostic measures, taking anamnesis and examining the patient, the doctor will prescribe a course of drug therapy and monitor its implementation.

On our website Dobrobut.com you can sign up for a consultation and get an answer to the question “gout – what kind of disease and which doctor to go to”.

Treatment for gout

For treatment to be most beneficial, lifestyle changes and dietary choices are essential. High-quality diagnostics and strict adherence to the rheumatologist’s prescriptions allows you to take control of the disease and minimize acute attacks. In addition, taking medications for gout attacks on time can help avoid serious complications.More details about the possible consequences of the disease will be discussed in the next section.

Drug therapy for gout of the thumb is aimed at reducing the level of uric acid in the body and relieving inflammation with acute pain syndrome. In the first case, the doctor may prescribe the following drugs: allopurinol, orotic acid, thiopurinol, hepatocatazal, or miluritis. To solve the second problem, non-steroidal anti-inflammatory drugs are most often prescribed: diclofenac, butadione, indomethacin and naproxen.

Thumb Gout: How to Prevent an Attack

The following guidelines will help prevent attacks of acute gouty arthritis.

Preventive measures:

• regular exercise of a complex of physiotherapy exercises;
• daily consumption of at least 2 liters of water;

90,019 refusal from carbonated drinks and powdered juices;

• Strict adherence to a diet for gout and high uric acid;
• strict control over the use of aspirin;
• control of the level of uric acid in the body;
• Periodic fixation of the diseased joint in an elevated state;
• refusal from fatty and smoked foods.

Your doctor will tell you what foods you should not eat for gout during your consultation. We also recommend that you study the recipes of traditional medicine that will help prolong the period of remission.

Symptoms of gout and possible complications

Tofuses are nodules that form under the skin in the area of ​​an inflamed joint. They can appear in the area of ​​the fingers, toes, elbows, and the Achilles tendon. Over time, these nodules begin to eat away at the bone from the inside out.

Deformity of the big toe. Without proper treatment, gout can lead to a pathological process in the nearby joints (knee, ankle). Read on to learn how to treat gout on your feet at home.

In severe stages, phlebitis may develop. Also, urolithiasis is a common complication of gout.

How to treat gout at home

The main treatment for the disease is drug therapy and diet.Traditional medicine, physiotherapy exercises and physiotherapy are auxiliary methods prescribed, as a rule, during the period of remission.

Taking into account the causes of gout in the hands and the results of laboratory tests, the doctor will prescribe a medication course of treatment with the obligatory use of auxiliary therapy.

If you have any questions and need a personal consultation from a specialist, please contact our clinic. The consultation is carried out by doctors with many years of experience. You can make an appointment on the website and at the above numbers.

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90,000 how to relieve pain, symptoms and treatment, at home

Is it possible to quickly relieve gout pain? Gout (other Greek

literally – a foot trap) is a chronic pathology associated with metabolic disorders, in which the content of uric acid in all fluids and tissues of the body is increased, as a result of which the acid accumulates in the form of crystals.The disease belongs to the category of metabolic disorders, has a paroxysmal nature. An increase in it in the blood is called hyperuricemia.

Gout has been known since antiquity and was first described by Hippocrates. Its frequency today is 0.3%, men suffer from it 2-7 times more often. The peak of the disease occurs at the age of 40-50 years.

After menopause in women in the absence of estrogen, gout is typical for them.

The dependence of gout on the nature of food was noted during the war, when the incidence of gout was sharply reduced due to the lack of meat.

Clinical manifestations of gout are mainly in 2 types – gouty arthritis and nephrolithiasis with urate in the kidneys. The accumulation of uric acid in the joints is expressed in the appearance of tofus – bumps under the skin that contain uric acid. These gouty nodes disrupt joints.

Etiology of the phenomenon

Excessive urate levels are the main cause of gout. This picture can only arise as a result of 2 reasons:

• uric acid intake is so increased that healthy kidneys do not have time to excrete it;
• this is exactly the moment when a person has addictions in food and does not abstain at the same time.

2 reason – the acid is supplied in moderation, but the kidneys themselves are sick and cannot cope with the task of excretion.

Urata choose places where the blood supply is less and are deposited exactly there, because it is easier for crystals to strengthen here: cartilage, joints and tendons.

They also like to be deposited in the kidneys, then the patient develops an ICD, but with gout, such patients have few attacks of renal colic. A provocative role is also played by:

• addiction to red meat;
• fatty foods;

90,019 legumes;

• coffee;
• alcohol;
• hereditary predisposition;

90,019 obesity;

• physical inactivity;
• liver and kidney pathology;
• insignificant water consumption.

Symptomatic manifestations

It should be noted right away that it is not possible to completely cure gout today, but the disease can be curbed.

For a long time, the pathology proceeds without symptoms, then suddenly an attack of acute pain in the joint occurs, more often at night. Patients characterize these pains as gnawing, everting.

The joint turns red, swelling appears, the joint and the surrounding tissue begin to burn. General hyperthermia can reach 40 ° C.Symptoms develop within an hour.

Silence is not synonymous with recovery. With each attack, the remission time will be reduced. The joint is gradually destroyed, adjacent joints are affected.

Gouty nodes that appear over time – an indicator that the body is actively fighting salt deposits, trying to destroy them with the help of leukocytes, perceives salts as a foreign body.

Arrival to the affected area of ​​leukocytes and is expressed in inflammation, the tissues become edematous.Inflamed tophuses burst, and white dust appears – this is nothing more than uric acid crystals. Usually 1 joint is affected.

Chronic course is characterized by:

• the appearance of arthritis in the small and medium joints of the limbs, pressing sensations in them;
• ICD;

90,019 tofus in joints, eyelids and auricles.

Often on the first toe, an ugly lump, a swelling, appears on the first toe, which interferes with shoes. The area of ​​the diseased joint is purple-cyanotic, swollen, sensitive even to light touch.

In the kidneys, urate crystals are capable of damaging their tubules. This leads to the appearance of inflammation in them – glomerulonephritis, pyelonephritis and nephritis.

The course of such inflammations is imperceptible, but they can quickly lead to acute renal failure.

Seizure assistance

How to relieve gout pain on the legs? Even with the implementation of all the recommendations during an attack, it is impossible to relieve pain instantly. But it is possible to alleviate the condition by shortening the time of pain. How long does a gout attack last? It usually lasts from a few hours to a week.

To begin with, the patient is prescribed bed rest and complete rest of the leg. The legs should be raised with a pillow above the level of the head.

What to do in case of a gout attack? In case of unbearable pain, the affected joint can be covered with ice for half an hour. At night, a compress with Vishnevsky ointment or Dimexidum is required. Drinking alkaline drinks – oatmeal and other jelly, mineral or plain water with lemon, milk. Other food is excluded for a while. With healthy kidneys, the volume of water consumed is 3 liters.

It is impossible to immediately remove an acute gout attack, but it is possible to reduce inflammation and edema by using NSAIDs for 2 weeks – Butadion, Metindol, Ibuprofen, Diclofenac, Indomethacin, Naproxen, etc.

Drinking alkaline waters during exacerbations plays an important role: it normalizes metabolism and well excretes purines in the urine. Purines are just those substances that come with food or are formed in the body, they are the precursors of uric acid.

Waters must be alkaline and with organic substances – Narzan, Essentuki and Borjomi.

Read more: Treatment of gout with Ibuprofen

Principles of Treatment

Treatment of an acute attack of gout should pursue 2 goals: to stop the attack of pain and to prevent exacerbations. To do this, it is necessary to reduce the level of uric acid in the blood and relieve inflammation. For this purpose, the complex of treatment includes diet, drugs, physiotherapy, exercise therapy, massage, folk remedies.

• Orotic acid;
• Allopurinol;
• Milurite;
• Benzobromarone;
• Febuxostat;
• Probenecid;
• Pegloticase;
• Hepatocatazal;
• Thiopurinol.

They are used to prevent attacks and acid dissolution, to reduce its synthesis. The course of administration is long, the choice of the drug is determined by the doctor.

Rapid relief of pain in gout is carried out by taking Colchicine, GCS – Hydrocortisone, Metipred, Prednisolone (can be injected into the joint). They can quickly remove leg edema, they quickly remove leg pain, swelling and swelling with redness. The effect is noticeable already in the first day of use. Therefore, their total course does not exceed 2 weeks.

Local treatment is also mandatory – compresses with Dimexide, Diklak ointment or Diclobene, you can make applications. Chondroprotectors are prescribed to improve the general condition of the joints, for a period of at least 3 months or more: Teraflex, Dona. Vitamins and calcium preparations – Calcemin, Calcium-Complivit, etc.

Treatment without drugs is impossible, they are an obligatory component.

Physiotherapy

• electrophoresis with novocaine and bischofite;
• wave treatment;
• paraffin;
• UHF;
• laser and balneotherapy.

Gout injection in the joint

Exercise therapy and massage are used to improve the condition of cartilage tissue, restore its motor function. Moderate physical activity improves joint mobility and prevents leg pain, small joints of the limb are developed, which are affected most rapidly. Physical activity is not indicated only in an acute attack.

Alternative treatment

1. Teas made of linden, rose hips, hawthorns, thyme, oregano, bluehead flowers.
2. Warm baths of chamomile, calendula, immortelle.
3. Compresses from fir and garlic oil, wheat flour and yeast.
4. Rubs from tincture of mullein flowers.
5. Ointment made from badger fat, juniper and bay leaf, ointment based on flowers and chestnut bark.

Garlic oil and chestnut tincture are also taken internally.

Medicines

Removal of excess and normalization of uric acid levels – stops seizures by 90%.Of the medicines used:

1. Allopurinol – inhibits the synthesis of uric acid. By doing this, it reduces its concentration in the body. In addition, it gradually dissolves excess uric acid in the kidneys and joints. It is still the # 1 drug in the treatment of gout.
2. Febuxostat (Uloric, Adenuric) – selectively inhibits xanthine oxidase, interfering with the synthesis of uric acid. The results of its use are such that after 3 months of the course, it completely dissolves urate crystals in the joints and prevents them from accumulating again.His big plus is that kidney pathologies are not a hindrance for him.
3. Pegloticase (Pegloticase, Krystexxa) – medicine for infusion, contains enzymes for dissolving urinary salts. It is used in case of severe course of the process to stabilize it.
4. Probenecid (Santuril, Benemid) – its peculiarity is not that it reduces the synthesis of uric acid, but that it prevents it from being reabsorbed in the renal tubules. Therefore, she comes out with urine. Applicable only in remission.
5. Fulllex is prescribed as pain relievers: it will help relieve acute pain quickly, but not for long. Has anti-inflammatory and anti-edema effects. It is applied topically and internally.
6. Colchicine – relieves pain very well, and the relief of a gout attack is carried out with it. Reduces urate, preventing it from falling into crystals. Contains autumn crocus. It prevents leukocytes from moving to the site of inflammation. Used as an emergency aid. In the first 12 hours of an attack, 2 tablets are drunk at once, with an interval of another 1 hour, in the future – according to the doctor’s scheme.

What can you do at home?

How to relieve gout pain? If the patient has an attack at home, you need to ensure the rest of the injured leg:

1. Create an elevation for her from the pillow.
2. Apply ice to the inflamed area: several times a day for up to half an hour, until the pain passes.
3. Give more to drink – up to 1.5 liters of alkaline mineral water or plain salted water per day. It is good to use herbal teas.

Fullflex – can be used as a first aid tool.Gout pain at home can be removed with applications of Dimexidum and Novocaine, taken in equal proportions. Instead of Dimexidum, you can use vodka in the form of a compress at night.

GCS – very well relieve inflammation and edema, but they suppress the immune system, so doctors try to use them while outweighing the benefits of risk.

NSAIDs – have anti-inflammatory, but slower, not immunosuppressive, action, they are used more often and without much fear.Diclofenac and Ibuprofen are usually prescribed.

Recent American studies have shown that fat men who love sausages and sausages are predisposed to gout. A direct link between gout and calcium and vitamin C deficiency has been revealed: after 40 years, they are always in short supply.

Preventive measures

Prevention requirements are quite simple: proper diet and moderate physical activity. Physical education should be given at least 30 minutes a day, it can be any active movement from dancing to swimming.

The norm of water drunk per day is not less than 2 liters. Monitor the level of uric acid in the body: not higher than 60 mg / l. It is necessary to exclude offal and fatty sausages, meat, smoked meats, legumes, sorrel, xanthines – coffee, tea, chocolate. But you can eat low-fat milk, eggs, cereals, cheese, fruits and vegetables: they do not contain purines. For a diet, table number 6 is suitable.

Avoid any injury to joints and tight shoes, gout loves to affect damaged areas.

From this article you will learn about a gout attack: what factors provoke it, characteristic symptoms on the leg.How long does an attack last, how is it treated, how to relieve pain, what to do at home.

The author of the article: Stoyanova Victoria, doctor of the 2nd category, head of the laboratory at the diagnostic and treatment center (2015–2016).

Date of publication of the article: 01.06.2019

Gout attack: how to relieve pain, symptoms and treatment, at home

From this article you will learn about a gout attack: what factors provoke it, characteristic symptoms on the leg. How long does an attack last, how is it treated, how to relieve pain, what to do at home.

The accumulation of uric acid crystals in the joints leads to the development of gouty attacks with intense pain syndrome.

Gouty attack associated with:

• damage to soft tissues and cartilage of the joint,
• the development of acute inflammation (for example, with arthritis),
• limitation of movement in the joint.

Gouty attacks often affect men over the age of 40 with errors in the diet – overeating meat food, alcohol abuse.

Gout is a chronic disease, frequent attacks lead to disability due to dysfunction of the joints and the development of its immobility (ankylosis).

A rheumatologist is responsible for the observation and treatment of the disease. In the event of the initial onset of an attack, it is necessary to contact a therapist to clarify the diagnosis and referral for a consultation with a narrow specialist who will advise how to relieve a gout attack.

Causes of an attack

Most often, exacerbation occurs at night.It can occur for no apparent reason.

However, the risk of developing it increases after consumption:

• alcohol,
• large amounts of food containing many purines – red meat, chocolate, cocoa, tea, coffee,

90,019 products containing an excess of oxalic acid – sorrel, spinach, rhubarb, radish, eggplant, asparagus, green onions, beets.

Depending on how often attacks occur, several grades of gout are distinguished:

Grade Seizure frequency, number of affected joints

Mild	1-2 times a year 1 or 2 joints
Medium	Once every 3-4 months From 2 to 4 joints
Heavy	1 time in 3 months and more often 4 joints – serious pathological changes even outside exacerbations

Typical Symptoms

Most of the disease affects the metatarsophalangeal joint of the big toe.The first attack will be precisely with the defeat of this joint.

However, over time, the pathology can spread to other joints (subtalar, interphalangeal, ankle, knee).

Exacerbation occurs suddenly, often at night. It is manifested by the following signs in the area of ​​the diseased joint:

1. Severe unbearable pain.
2. Swelling.
3. Puffiness.
4. Skin redness.

An acute attack can last up to 10 days without treatment.With proper therapy, it lasts less than 3-7 days.

Diagnostics

If the attack has developed for the first time, then the person may not yet know what the matter is.

When contacting a doctor, you will need to describe in detail your symptoms, as well as undergo an examination:

• general blood test – due to the development of inflammation, the level of leukocytes increases,
• biochemical blood test – with gouty disease, the level of fibrin, uric acid, sialic acids, gamma and alpha-2-globulins increases),
• X-ray – will help detect pathological processes in the joint,
• puncture of the joint followed by microscopic analysis of the synovial fluid – allows you to identify crystals of sodium urate in it.

How to relieve a gout attack

What to do if the joint on the leg is swollen, how to relieve gout pain? First aid is to see a doctor immediately.

Due to the fact that an exacerbation most often finds a person at night, it is best to call an ambulance.

Symptoms and treatment of acute gout are interrelated. Therapeutic measures are aimed at getting rid of pain, swelling and inflammation.

Complex treatment consists of:

• drug intake,
• physiotherapy,
• diets,
• bed rest,

90,019 folk remedies.

1. Medicines

Drug treatment includes:

1. Colchicine is a drug specifically designed to treat gout. It effectively relieves inflammation by acting directly on the mechanisms of its occurrence. The agent inhibits granulocytes – immune cells that try to fight in the joint with urate crystals, thereby provoking an inflammatory process.
2. Non-steroidal anti-inflammatory drugs (NSAIDs) – relieve inflammation by blocking cyclooxygenase, an enzyme that is involved in the development of the inflammatory process.They also have an analgesic effect.

   Preparations from this group are available in tablets and injections. To relieve a gout attack, Meloxicam, Diclofenac are used.

NSAIDs that contain salicylates (Aspirin, Diflunisal) are contraindicated, as they can only aggravate the situation.

3. Corticosteroids are hormonal drugs with powerful anti-inflammatory effects. With gout, their use in the form of ointments, creams, gels is effective. (Flucinar, Betamethasone).

Injections into the joint are used in extreme cases – when other methods have not helped to relieve inflammation.

4. Preparations for local use – ointments with NSAIDs in the composition (Voltaren, Fastum-gel), Finalgon, Fulflex and others. They help relieve pain and swelling.

2. Physiotherapy

Among physiotherapeutic procedures the following applies:

• UHF – the effect on the body of a high-frequency magnetic field to increase blood and lymph flow, activate the immune system, relieve inflammation,
• ultraviolet irradiation – the use of ultraviolet rays to enhance blood flow, normalize metabolism in cells, stimulate immunity,
• electrophoresis with potassium and lithium – administration of medicinal substances using electric current to improve tissue nutrition,
• impulse currents – treatment with current impulses to eliminate pain, inflammation, improve blood flow,
• compresses with Dimexidum – the drug is placed in gauze folded 4 times, the compress is applied to the sore joint for 20-30 minutes daily for 10-15 days.

The course of treatment lasts until recovery, and the procedures will continue for 2 days after.

3. Diet

To quickly relieve inflammation, you need to drink plenty of water (1.5-2 liters per day, if there is no renal or heart failure). It is advisable to drink alkaline mineral water, as it will help normalize the acid-base balance in the body (Borzhomi, Essentuki No. 4 and 17, Luzhanskaya). You can also drink any other beverages except coffee, tea and cocoa.

What you can and should eat Foods that aggravate metabolic problems in gout should be avoided

Vegetables: fresh, stewed, boiled	Fatty fish
Vegetable soups	Red meat
Porridge	Sorrel
Fruit	Spinach
Chocolate
Rhubarb
Eggplant
Radish
Beet
Asparagus
Smoked products
Canned food
Alcohol (especially red wine) is absolutely contraindicated

The same diet is recommended during periods of remission.

4. Bed rest

Rest is recommended for the patient. The sore leg (most often the joint becomes inflamed on the leg) should not be heavily loaded. It is advisable to put a pillow or roller under it while lying down so that it is on a hill. This will help relieve swelling.

5. Folk remedies

It is better not to try to treat a gouty attack on your own at home – the exacerbation will pass, but the disease itself will remain.

Home remedies are used to complement traditional methods.Effective for relieving pain and swelling:

1. Propolis compresses. Grind 50 g of propolis, place in a thermos and pour 0.5 liters of boiling water. Leave to infuse for a day. Moisten the cheesecloth folded several times in the prepared tincture and apply to the sore joint. Keep the compress for 15-20 minutes. Do it 2 times a day. Propolis helps relieve inflammation, swelling and pain.
2. Chamomile baths. Pour 50 g of the plant with 5 liters of hot water. Wait for it to brew. Wait until the water is at room temperature, as it is strictly forbidden to heat the sore joint.Place your foot in the bath and hold it there for 20 minutes. Chamomile has anti-inflammatory effects.
3. Broth from a string. Pour 20 g of plant materials with 1 glass of water. Put on fire, bring to a boil and keep for another 15 minutes. Drink 1 tbsp. l. 3 times a day after meals. The sequence relieves inflammation and helps to normalize metabolism.

Before using any folk remedy, consult your doctor.

Prevention of further exacerbations

To avoid seizures, follow these rules:

• Stick to your diet,
• give up alcohol completely,
• Remember to take the medication prescribed by your doctor for the permanent treatment of gout.

Forecast

The more frequent the exacerbations, the worse the prognosis.

Severe gout can be fatal, since joint inflammation on its background is only one of the manifestations. Uric acid derivatives in the form of crystals are deposited on internal organs, which leads to complications from the cardiovascular and excretory systems.

Because of gout, acute left ventricular failure, myocardial infarction, chronic renal failure can develop.All of these pathologies can become fatal.

In order to prevent such a severe, life-threatening stage of gout, it is necessary to treat attacks on time, and also strictly follow all the rules recommended by the doctor during periods of remission.

Mild gout has a better prognosis. If you start treatment at the first attack, you can achieve a stable remission for years.

Acute gout what to do

For acute pain, it is recommended to take an ibuprofen or naproxen tablet.This will help tame the pain syndrome a little.

In case of severe pain, in no case should salicylic acid-based medications be used. They promote uric acid retention.

Treatment of a gout attack is primarily aimed at reducing pain and removing excess uric acid from the body.

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

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

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

How to relieve a gout attack?

Rheumatologists recommend relieving acute attacks of gout with the help of special anti-inflammatory drugs. They should always be at hand for a person suffering from these manifestations. Diclofenac and Indomethacin have excellent action.

They are used in the same way.At one time, you can drink 1-2 tablets, the frequency of taking no more than 4 times a day. The drugs should be used until the condition improves.

How to remove the further course of a gout attack, every person who faces this problem should know.

Medication can relieve acute pain, but this is not enough. It is necessary to calm the inflammatory process and remove excess acid from the body.

A person should immediately sit down on proper nutrition and exclude foods rich in purines.In no case should you drink alcohol. Every day you need to drink 5-6 glasses of water.

This will contribute to the speedy elimination of lactic acid from the body.

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

How to relieve a gout attack at home?

If an acute attack begins, the affected joint must be provided with complete rest. Excessive movement will only aggravate the situation and complement the picture with unpleasant symptoms.

It is recommended to place the diseased limb on a slight elevation. If there is a pronounced inflammatory reaction, a warming compress will help.

How to remove a gout attack at home is a must for every person suffering from this disease.

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

Medicines will help to relieve pain. Antihistamines and antikinin drugs play a special role. Anti-inflammatory drugs will also help.

However, taking the medication does not guarantee a lightning-fast disappearance of the attack. The main symptoms disappear within 12 hours. If the effect after taking the drugs is not observed, preference is given to glucocorticoids.

They are able to relieve inflammation, but one should not expect a lasting effect from them.

It is advisable to treat the place for stopping with a 50% solution of Dimexide. It will relieve inflammation and soothe pain. Applications based on Analgin, Novocaine and Indomethacin are suitable.

Medicines

During the elimination of an acute attack of gout, medications play an important role.

It is not recommended to select medicines on your own, this issue is decided by the attending physician based on the patient’s condition.To stop an attack, medications from different categories are used.

The following agents help to reduce the level of uric acid in the body: Allopurinol, Febuxostat and Pegloticase.

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

Alternative treatment

Folk remedies have a pronounced effect. No wonder they were widely used in ancient times.For gout, alternative treatment has also proven itself. After all, it is not so easy to stop an attack with medications alone. It is necessary to use folk remedies as ancillary measures.

• Recipe number 1. Chamomile decoction. It will relieve the inflammatory process and alleviate the general condition of a person. To prepare an effective remedy, you need to take chamomile flowers and pour boiling water over them. The resulting medicine is used in the form of baths, so the ingredients must be taken in sufficient quantities.So, chamomile flowers – 100 grams per 10 liters of water. To improve the effect, add 20 grams of salt. All ingredients are mixed together. When the solution is infused, it can be used in the form of a bath.
• Recipe number 2. Ordinary spruce cones have a wonderful effect. Their action is aimed at cleaning the joints from the excess content of lactic acid in them. To prepare the product, you need to take a cone with seeds and pour 1.5 cups of boiling water. Everything is left overnight. The resulting tincture is taken internally 30 minutes before meals, 3 times a day.Use until relieved.
• Recipe number 3. Bay leaves will help cleanse the joints. You should take 5 leaves and pour them with 1.5 cups of boiling water. All this must be boiled for 5 minutes. It is not recommended to open the cover during this process. The bay leaf contains essential oils, as a result of boiling, they can disappear. The resulting broth should be wrapped in a towel and left for 3 hours. Then use it during the day.
• Recipe number 4.Boiled rice has a beneficial effect on the joints. You need to take 2 tablespoons of the main ingredient and rinse under water. Then pour into a 500 ml jar and fill with water. The rice should stand overnight. In the morning, it is removed, washed, and the procedure is repeated again. You need to do this 4 times. Only then can the rice be eaten, but you should not add oil and salt to it.

Herbal Treatment

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

• Pharmacy chamomile. From a decoction of this plant, you can prepare an excellent bath. It will relieve the inflammatory process and alleviate the general condition of a person. For cooking, you need to take 100 chamomile and 10 liters of water.

• Chamomile and elderberry. Together, these plants will help relieve pain. Mix the ingredients in equal parts, then pour boiling water over.The resulting mixture is heated, but at the same time it cannot be boiled. The remedy is used not only for an acute attack of gout, but also for headaches and back pains.
• The sequence. If you regularly use the infusion from the series, you can get rid of many ailments. This plant can replace tea. You need to brew it in boiled water for 15 minutes. The result is a beautiful and delicious golden drink. During cooking, you need to follow the sequence.
• Common lilac.The glass bottle must be filled with lilac flowers. At the same time, they should not be compacted. Then everything is poured with 200 ml of vodka or alcohol. It is necessary to insist the remedy for a week, while constantly shaking it. The resulting tincture is taken 20-30 drops 3 times a day with food.

It should be noted that treatment with folk remedies must be accompanied by walking and moderate physical activity.

Homeopathy

Gout is an acute illness characterized by severe pain.They arise as a result of the deposition of urate crystals in the joints. The affected areas appear reddened and shiny. The disease can affect the joints in the upper and lower extremities. Homeopathy will help to fight gout competently.

At the onset of an acute attack, ACONITE 30 is preferred. This remedy will help to suppress unpleasant symptoms. In the chronic course of the disease, AMMON will help. PHOS. 30. If the painful joint cannot be touched, ARNICA 30 will provide immediate assistance.With typical manifestations, you cannot do without BELLADONNA 30.

If there is severe swelling, use BRYONIA 30. Sharp pain and the inability to touch the sore joint will help eliminate COLCHICUM 30. If you have tofuses, you cannot do without GUAIACUM 30.

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

An experienced homeopathic physician should provide detailed information on medications and treatment regimens.It is not recommended to use the funds on your own.

Surgical treatment

Surgery for gout is rarely used. This process is unnecessary.

However, surgical treatment may be required if a person has large tofuses. As a rule, they interfere with normal life.

Their location on the limbs, in particular on the legs, does not allow normal wearing of shoes. In general, tofuses bring a lot of inconvenience.

Formations do not dissolve on their own. Often, the process captures the periarticular tissues. Most often, the skin suffers, as a result of which fistulas develop. In this case, the removal of deposits is recommended. Everything is carried out through surgical intervention. However, removing tophus does not guarantee that it will not reappear in the future.

Tophus are not able to dissolve under the influence of special drugs. If they are not eliminated in a timely manner, there is a risk of limiting the mobility of the joint.Gradually, tofuses lead to deformation, and then to complete destruction of the cartilage. In this case, the person becomes disabled.

Exacerbation of gout: treatment, how to quickly relieve an attack, pain medications to relieve symptoms

How to relieve an acute attack?

Patients suffering from long-term disorders of uric acid metabolism know that with the next increase in uncomfortable sensations, it is necessary to relieve an attack of gout as quickly as possible. Otherwise, the need for hospitalization of a person is not excluded.

Treatment for gout during an exacerbation can be carried out in different ways. There are specialized medicines that reduce the severity of pain syndrome, folk remedies that are popular among patients who want to minimize the effect of synthetic substances on the body.

Rest for the affected joint and local exposure to cold will additionally help to quickly relieve gout pain. To achieve the maximum therapeutic result, it is recommended to combine both natural and traditional synthetic medicines.

Medicines

According to modern protocols for the provision of specialized patient care, exacerbations of gout are treated primarily with medication. Randomized trials prove that the use of drugs helps to eliminate severe pain and stabilize the patient’s condition.

Non-steroidal anti-inflammatory drugs (NSAIDs) remain the basic group of tablets and solutions for drug treatment of gout. The mechanism of action is based on the inhibition of cyclooxygenase (COX-1 and COX-2).The result is a decrease in the synthesis of pro-inflammatory substances that aggravate the patient’s well-being.

Through the use of injections and tablets for gout, pain can be quickly eliminated. Additionally, the severity of edema, redness of the affected joint is reduced.

Used drugs from the NSAID group:

• Sodium Diclofenac.
• Etoricoxib.
• Lornoxicam.
• Meloxicam.
• Ketorolac.

The relief of a gout attack with the help of these drugs is recommended by the European and American Association of Rheumatology.In 80-85% of cases, the improvement of the patient’s condition occurs after the first dose of the drug.

It is important to remember that the treatment of gout during an exacerbation is best done with injectable forms of drugs. The reason is better absorption, faster effect and lack of mechanical contact with the affected joint.

Gout pain relief is also achieved with the help of Colchicine. The drug belongs to alkaloids. The mechanism of action is based on a pronounced decrease in the rate of migration of leukocytes to the focus of inflammation.

Due to this effect, an acute attack of gout quickly passes into the stage of regression and remission.

Colchicine additionally inhibits the absorption of microparticles of puric acid by phagocytes, breaking one of the key links of the pathological process.

Treatment of exacerbations of gout allows the use of painkillers. Narcotics are used. Indication – severe pain, significantly disrupting the general condition of the patient. Pain relievers for gout on the legs are prescribed with caution.The reason is the risk of developing addiction. The use of this group of drugs lasts 3-5 days.

Recommended pain relievers for gout:

The choice of pain relievers for gout is carried out only by a doctor. It is impossible to buy narcotic analgesics on your own in a pharmacy without a special prescription from a doctor.

In the treatment of an acute attack of gout, there is a place for glucocorticosteroids (GCS). Steroid drugs are used when the groups of medicines described above are ineffective.The powerful anti-inflammatory property of GCS ensures the rapid achievement of the desired result. Prednisolone and its derivatives are good at removing pain and other clinical manifestations of impaired purine metabolism.

If indicated, the doctor may additionally prescribe the following medications:

• Benzbromarone to reduce the concentration of uric acid in the blood.
• Losartan for the correction of blood pressure.
• Fenofibrate to prevent the progression of atherosclerosis.
• Omeprazole to reduce the acidity of gastric contents.

The selection of drug therapy is carried out exclusively by the doctor. Otherwise, the disease progresses and gives the patient a lot of discomfort.

Folk remedies

Before using non-traditional remedies, you must always remember that an acute attack of gout is a sharp pain that prevents a person from moving and even thinking.

Any folk remedies are focused on long-term use with a gradual increase in the therapeutic result.Therefore, in 90% of cases, pain relief for gout, carried out by natural remedies, is ineffective, except in cases where the patient is ready to endure acute sensations before the onset of non-traditional drugs.

Possible recipes:

• Valerian tincture with cologne. It is necessary to mix the contents of two vials of the herbal preparation with 1 bubble of aromatic liquid. The agent is infused in a dark place for 48 hours. The cotton wool moistened with the mixture is applied to the affected joint and bandaged.We remove the described bandage after 4-5 hours. The general course of treatment is up to 14 days.
• Salt compress. To create a folk remedy, you need to mix half a kilogram of kitchen salt with one liter of warm water. To give stability to the structure of the drug, another 200 g of petroleum jelly is added to it. After thorough mixing, the specified agent is applied to the affected joint and kept for 1-2 hours.
• Contrast for feet. Cold and hot water will help relieve acute gout pain.Any cereal is poured into two identical vessels. Boiling water is poured into one container, cold water into the other. The sore leg must be alternately lowered into the vessels for 5 minutes.

Despite the existence of various methods of non-traditional healing, it must be remembered that traditional medicine does not provide a truly high-quality elimination of the problem.