Gouty Arthritis - Causes, Symptoms and Principles of Comprehensive Treatment
One of the types of joint diseases of a chronic nature is gouty arthritis.Pathology is caused by the accumulation of large amounts of uric acid, more specifically - the crystals of this acid are localized in the articular structures, damagingly affecting the periarticular tissues and hyaline cartilage.Table of contents: Causes of development of gouty arthritis Symptoms of gouty arthritis Diagnostic measures Treatment of gouty arthritis Recommended reading:
Causes of gouty arthritis
The most commonly diagnosed disease is diagnosed in males aged 40-50 years, butWomen gouty arthritis is rare and only after 60 years.Often, pathology is also found in men 25-50 years old - this age-related "spread" is associated with a direct connection of gouty arthritis and male hormones, which can either be actively developed or in normal quantity.That's why doctors include women in menopause at risk for gouty arthritis.Please note: is extremely rare, gouty arthritis is diagnosed in childhood - in this case it will be a genetic predisposition.
- genetic predisposition;
- violation of the diet - it is about excessive consumption of meat, sausages, coffee, chocolate.Earlier, gouty arthritis was generally called a disease of aristocrats according to the list of foods that should be consumed in limited quantities;
- for a long period of taking certain medicines for medical reasons or in an independent mode - for example, diuretics, anti-hypertensive drugs, cytostatics and others can provoke the development of the disease in question.
Gouty arthritis can also occur as a secondary disease - it is often diagnosed against a background of kidney disease, heart failure, hormonal background abnormalities.Note: the deposition of uric acid crystals can be absolutely asymptomatic for a long time, but even with a small "push" gouty arthritis will manifest itself very intensely.Such an "impetus" can be an infectious disease, suffered stress, severe physical exhaustion, forced starvation and other.
Symptoms of gouty arthritis
The disease under consideration passes three periods in its current, each of which has its own distinctive features.
Gouty arthritis is absolutely asymptomatic, the patient does not bother, no manifestations of any pathology are observed at all.During this period, the disease can be identified only when a laboratory blood test is performed - it shows a high content of uric acid.
This may be a primary manifestation of a gouty character, and another recurrence of a chronic form of pathology.
Gouty arthritis is already diagnosed, actively progressing, but differs by prolonged remissions with the disappearance of all the characteristic symptoms for the disease in question.In general, the clinical picture of gouty arthritis is pronounced, so doctors do not diagnose problems. The main symptoms are :
- acute pain in the joint of the thumb of the lower limb;
- swelling of the affected joint and skin hyperemia in this place;
- during painful joint movement, pain is greatly increased;
- body temperature rises in the absence of signs of colds or any chronic inflammatory / infectious diseases;
- around the joints begin to appear tofusi - a subcutaneous growth of whitish color;
- periodically appearing pain in other, small and large joints.
It is worth to clarify that gouty arthritis is characterized by the manifestation of the process - first of all the joint of the big toe on the left or right leg is affected, which is observed in 90% of cases.And if, during this period, no medical measures are taken, the progression of the pathological process under consideration is guaranteed.If the inflammatory process proceeds for a long time without proper treatment, then in the bones that directly adjoin the affected joint, "piercers" are formed.These are cavities that are filled with sodium monoaurate crystals.The next step in the progression of gouty arthritis is tofusi( subcutaneous growths), which strongly deform the leg and can lead to disability of the patient. Note: in women gouty arthritis proceeds much more easily, characteristic cavities with a cluster of sodium monomurate crystals and whitish subcutaneous growths are extremely rare.Incidentally, it is these factors that provoke erroneous diagnosis - doctors can confuse gouty arthritis and arthrosis. Acute attacks of the gouty process, which are always accompanied by severe pain in the affected joints, occur quite often - from 1 time per week to 1-2 times a month or a year.
To diagnose gouty arthritis, doctors prescribe the patient a full examination of the entire body.But first of all, the joint fluid is taken from the affected joint - it will reveal crystals of urate sodium.In some cases, the synovial fluid for laboratory testing is taken even from a healthy joint or from tofus - this is allowed within the diagnostic framework, the results will be accurate.At the same time, blood is taken for laboratory testing, and an increased amount of uric acid will be found in it.But even in combination with the presence of sodium urate crystals in the synovial( articular) fluid, this result does not give the right to immediately diagnose gouty arthritis.In many people, such survey results will only indicate a violation of purine metabolism.If the disease under consideration proceeds for a long period of time, it makes sense to appoint an X-ray examination - the characteristic changes in the joints will be noticeable.These include, for example, destruction of cartilage, "piercers", defects in the end sections of bones.
Treatment of arthritic arthritis
This disease is treated only by complex therapy - it is impossible to take medications and refuse to correct nutrition, a good effect is provided by traditional medicine.Unconditionally, only one thing - contacting a doctor with the first symptoms of gouty arthritis increases the chances of getting rid of the pathology at times.
In times of exacerbation of chronic gouty arthritis, it is advisable to undergo medical therapy. And doctors make the following prescriptions: :
- Non-steroidal anti-inflammatory drugs - ibuprofen( as substitutes may have nurofen or nurofen), indomethacin, rheumoxicam, movalis.The listed medicines are considered the most effective during acute attacks of gouty arthritis.And, at first the doctors prescribe them in the form of injections( the effect is faster and fuller), and then gradually transfer the patient to use the same drugs, but in a tablet form.
- Specific anti-inflammatory drug, used specifically for gout - colchicine.
- Ointments based on non-steroidal anti-inflammatory drugs - remisid, dip-rel, indomethacin.These ointments are designed to be applied to the skin over the affected inflammatory process of the joint.
- Compresses / lotions made from dimexide( 25% solution) or ordinary semi-alcohol solution( alcohol is diluted with water in a 1: 1 ratio).
- Physiotherapy.They are appointed against the background of the subside of an acute attack of gouty arthritis - magnetotherapy, laser therapy, paraffin baths and more.
But even if the disease in question is latent, or if the chronic process is in remission, then taking medication should never be stopped!Doctors simply make other appointments, adjust the therapy scheme - for example, prescribe medications that reduce the synthesis of urates.To get rid of any pathological process, you need to eliminate the cause - this also applies to gouty arthritis.This means that you need to get rid of excess uric acid in the body. For this purpose the following assignments are made:
- uricosim - it acts directly on the already formed urate crystals, destroying their structure;
- allopurinol - actively reduces the amount of uric acid released by the body.Doctors can prescribe and an analogue of this medicine - ziloric;
- probenecid - displays an excessive amount of uric acid crystals.
Allopurinol is the most important in the treatment of gouty arthritis - it is prescribed in the case of high levels of uric acid in the blood, with developing renal failure, in the case of already formed tophi.It is necessary to know that after taking this medication in the first 5-7 days, all the characteristic symptoms of gouty arthritis can be greatly aggravated and that is why it is advisable to take allopurinol simultaneously with anti-inflammatory nonsteroidal drugs.Please note: allopurinol is never used as an analgesic if an attack of gouty arthritis has occurred for the first time.During treatment with this medication, an allergic reaction may occur in the form of a skin rash. Probenecid and uricosym are never prescribed for progressive renal failure, too high a level of uric acid in the blood.Contraindication to the appointment of these groups of drugs is the previously diagnosed peptic ulcer of the stomach and / or duodenum. Please note: during treatment with all the above mentioned medicinal products, it is necessary to consume a large amount of water - at least 2.5 liters per day. Patients should understand that the treatment of gouty arthritis is to be continued, it will be necessary to follow the diet and monthly to take tests to monitor the level of uric acid in the body.If the dynamics of the disease in question is positive, then patients can supplement the basic therapy with therapeutic physical training, massages and physiotherapy procedures.
Diet for gouty arthritis
If the patient ignores the appointment of a nutritionist, breaks the diet and continues to consume large quantities of meat products, coffee, chocolate and other harmful products, even with specialized treatment results will not be. There are clear limitations and permissions in relation to products:
- Excluded completely from the diet for a minimum of 12 months:
- lamb meat and veal;
- by-products - liver, lungs, heart and others;
- herring, mackerel and sardines in any form - smoked, pickled, salted, fried;
- soups and broths on meat.
- It is necessary to limit the use:
- of poultry meat, ham, liver sausage;
- cod, sprat, pike perch, sprat;
- peas, beans, lentils, beans;
- cauliflower, radish, spinach, sorrel;
- coffee, beer and cocoa.
- You can safely enter any dairy products, including hard / soft cheese, into the daily menu:
- eggs of chicken and quail, goose and duck;
- nuts of absolutely all kinds;
- jelly and gelatin;
- vegetable soups( except for those prohibited for consumption);
- porridge of all varieties / species, except oatmeal;
- vegetable and butter.
Fish and meat in diagnosed gouty arthritis should be eaten only in boiled form and not more than 3 times a week.It is necessary to limit the use of salt, including in the form of marinades, pickles for preserving vegetables.It is very useful during the treatment of the inflammatory disease of the joints to use a decoction of rose hips, cranberry juice, lime tea, berry compotes - do not forget to just make sure that there are no diseases of the cardiovascular system.In general, when gouty arthritis should be fed on diet number 6, but only with some clarifications. The following is an exemplary patient menu :
- Breakfast is a curd with a jelly from fresh or canned fruit, coffee with lots of milk.The second breakfast is a glass of apple juice.
- Lunch - rice soup on vegetable broth, rye bread, a glass of compote from dried fruits.
- Snack - black tea( not tightly brewed), jujube, apple.
- Dinner - a glass of green tea, pancakes from potatoes.
- Breakfast - any porridge on milk( except oatmeal!), Rye bread, a glass of pineapple juice.
- The second breakfast is walnuts, a pear of any sort.
- Lunch - ragout of vegetables, rabbit stewed, a glass of compote.
- Snack - a glass of orange juice.
- Dinner - a glass of black tea with milk, a sandwich with hard cheese.
- Breakfast - cutlets from fresh carrots, sour cream, a glass of black tea.
- The second breakfast is one or two bananas.
- Lunch - borscht on vegetable broth with sour cream, a glass of decoction of rose hips.Dinner - pumpkin casserole, herbal tea. .
- Breakfast - sandwiches made from wheat bread with any kind of cheese, black tea.The second breakfast is a glass of cherry juice.
- Lunch - potatoes baked in the oven with trout, vegetable salad with vegetable oil, a glass of cranberry mors.
- Dinner - muesli with nuts of any sort, a glass of green tea.
Given only an approximate menu - it shows that the diet of a patient with diagnosed gouty arthritis, despite the limitations and exceptions, is quite diverse and can not be called inferior in any way.Although for many patients, even such a menu is very scarce, but it is impossible to violate the diet - this will exacerbate the disease in question.Please note: this diet should be strictly observed by patients within 12 months.Then follows a thorough examination of the patient's body and, with positive dynamics of gouty arthritis, some indulgences in nutrition can be resolved.
Treatment of gouty arthritis with folk remedies
Important: in any case can not be considered funds from the category of traditional medicine panacea - the inflammatory disease of the joints under consideration should be treated by medical personnel.But even official medicine recognizes and "gives good" to the use during the therapy of folk remedies.Naturally, patients should receive permission for such treatment from their doctor, exclude possible hypersensitivity and / or individual intolerance of some medicinal plants or products.
The juice of this vegetable is considered to be the most effective for removing salts from joints, but only if you use a freshly prepared product.Prepare the juice of a black radish quite easily - the vegetable is cleaned, rubbed on the grater and squeezed through the cheesecloth, but you can use a blender for grinding, and a juicer.The scheme of reception of a juice of a black radish at a gouty arthritis: the first day we accept 1 teaspoon of juice in 60 minutes after a meal once a day.Then daily, the dosage is increased and adjusted first to a tablespoon, and then to ½ cup for one dose.This mode of reception of juice from black radish allows to determine the absence / presence of side effects and not to harm your own body.Note: if against the background of eating black radish juice, pains are noted in the epigastric region, the liver( right), then the medication should either be stopped altogether or the daily dose significantly reduced.For the whole period of treatment, the considered national remedy from the diet completely excludes acidic and acute products. The course duration is individual, but it is necessary to use at least 3 liters of black radish juice.
A decoction of the flowers of this healing broth will help with an acute attack of pain in an affected arthritic arthritic joint, but you do not need to cook it in the usual way. And, compliance with the technology is a mandatory aspect of :
- first a saline solution is prepared - for 10 liters of hot water, 20 g of common salt;
- then in it to lower 100 g of flowers of a camomile chemist's and to boil on small fire of 10 minutes.
After the ready-made broth is cooled to a temperature that the skin can withstand and the bath is made on the diseased joint.
A decoction of unopened fir cones with seeds is prepared - one bump is poured with 500 ml of boiling water and infused for 6-8 hours.The broth is taken 3 times a day for half an hour before a meal.Such a decoction effectively cleans joints and in general the body from excess uric acid.The duration of this decoction is determined on an individual basis - folk healers recommend not to interrupt treatment until full recovery.
Such a familiar product in cooking, it turns out, perfectly helps to clean joints from sodium monoaurate crystals. Preparing the drug as follows :
- take no more than 5 grams of bay leaves and fill them with 1.5 glasses of water;
- Boil the medium over a low heat, with a slow boil for 10 minutes;
- remove the decoction from the cooker, wipe the dishes with a towel or scarf and press for 3 hours.
The resulting broth should be drunk within a day in small portions.
Someone is surprised by unusual folk remedies, someone actively uses them - it's a purely individual matter.Nothing harmful in the drugs listed below is not in the opinion of official medicine, but it is still necessary to get a consultation from a doctor.Fresh bacon Many people use bacon for the treatment of gouty arthritis - cut off a small piece of it and rub it into the area of the affected joint until the piece is reduced by 2-3 times. If bouts of joint pain are too frequent, then a piece of fat should be simply tied to the affected joint and left so for the night.As a rule, after such procedure in the morning there comes a considerable relief - the pain practically recedes.Traditional healers recommend in the treatment of the considered disease fat to eat millet porridge welded on the water - it promotes the excretion of salts from the joints.Butter Take in equal proportions butter( unsalted and preferably find a home-made product) and alcohol.The oil is heated in a water bath or a small fire to such an extent that the foam begins to appear on its surface.At this moment, the oil is removed from the fire, poured on top of the prepared alcohol and set it on fire.Only after the fire in the dishes with oil will burn, the ointment will be considered ready.Use it should be in moments of acute pain in the affected joint - it just rubbed into the skin until the pain subsides.Preserved ointment based on butter in a warm place and no more than 5 days.Mustard Mix in a container of 1 teaspoon of honey, mustard( already finished, not powder) and baking soda.Next, we steam off the limb, on which the diseased joint is and on this such steamed skin we apply the obtained remedy.We put polyethylene film on top, then wrap this place with something warm( scarf, scarf) - this compress should remain on the affected joint all night.The course of treatment with such compresses is 10-15 days.Fish It will take 2 kilograms of fish pruning - this amount should be divided into 10 bags equally and put everything in the freezer, having previously cleaned the ridge and all the bones from the product.Then each evening, take out one packet, unfreeze it and put on a sick leg directly with the fish, and on top - a warm sock.Such a strange compress should be done for 6-8 hours, and in the morning everything is removed and thrown away, the foot is thoroughly washed.It is believed that after 10 days of such daily fish compresses the pain in the affected arthritic arthritic joint disappears for a long time.Gouty arthritis is quite a complex disease, which is difficult to treat.But at the same time, doctors say that with careful observance of all recommendations and appointments of specialists, the disease under consideration either completely cures, or goes on to long-term remission. Tsygankova Yana Aleksandrovna, medical reviewer, therapeutist of the highest qualification category.