Musculoskeletal system >>>> Signs and treatment of gout

Signs and treatment of gout.

Gout signs.

At the very beginning of the development of gout, the symptoms of the disease resemble arthritis or polyarthritis, with localization atypical for these diseases in the joints of the hands, elbows, and the knee joint. First attack of gout, as a rule, makes itself felt in 60% of patients with gout with a lesion of the first metatarsophalangeal joint of the leg (joint of the big toe). There is a sharp pain in the joint (often at night), there is inflammation, swelling of the joint and hyperemia (redness) of the skin opposite the joint. Painful sensations impede movement in the joint, as a result of which the entire limb has to be kept at rest. The pains are excruciating, may be accompanied by fever, chills. A blood test will show increased ESR and leukocyte counts. After a week, the inflammatory processes gradually subside, the attack passes, the functions of the joint are restored. According to this scenario, an acute attack of gout can develop.

Prolonged gout attacks can last from several days to one and a half months. In the first years of the development of the disease in patients with gout, there are three characteristic clinical manifestations of the disease:

The joints are affected (each time the attacks are accompanied by the involvement of new joints in turn),
Topuses appear (tophuses (cones) grow, often the skin on them has ulcerations, secreting a thick liquid with urate crystals),
Other internal organs are affected (sodium urate crystals are found even in the thickness of the eyelids, the wings of the nose), the first signs of the development of urolithiasis appear .

The change in bone tissue deforms the joints and makes it difficult to move, with chronically flowing gout with the forced development of symptoms, patients lose their ability to work.

Treating gout.

Methods for the treatment of gout serve three purposes:

Relieve and / or prevent gout attacks,
They prevent hyperuricemia and slow down the deposition of sodium urate in tissues,
Promote the processes of resorption of urate salt deposits.

Treatment for gout attacks:

Colchicine is taken to relieve inflammation during a gout attack. It is a metabolic agent that regulates the exchange of uric acid.
Anti-inflammatory drugs pyrazolone (phenylbutazone, butadione, ketazone, rheopyrin) and indole (indomethacin, methindol) drugs.
In the absence of an effect from the above means, corticosteroids are used (they do not give a stable effect and can cause cortic dependence). In case of an acute attack and sharp, poorly tolerated pain, it is recommended to inject prednisolone into the joint.
Rest of the limbs during seizures.
In case of mild manifestations of gout disease (in the absence of tophus, rare attacks), etamide is used.
With long-term treatment of gout, uricodepressive drugs (allopurinol) are used, they reduce the synthesis of uric acid by inhibiting the enzyme xanthine oxidase.

With gout a diet is laid that excludes large doses of purine and protein compounds, alcoholic beverages, strong coffee, strong teas, fatty foods. Purine compounds are present in high doses in fatty fish, fatty meats, kidneys, liver, lungs, brain, veal, and yeast products. It is recommended to eat lean chicken (breast), low-fat dairy products, hard cheeses, vegetables (except for peas and cauliflower, sorrel, spinach) and fruit side dishes, drink plenty of water.