Gout (Arthritis podagricheskiy)

Description of gout

Gout voznikaet, when uric acid crystals accumulate in the joints. This leads to inflammation of the joints. If crystals grow in the kidneys, This may cause stones kidney.

Causes Gout

Gout usually occurs in the presence of high levels of uric acid in the blood (hyperuricemia). But gout can sometimes appear at a normal level of uric acid.

The liver metabolizes uric acid, and it is excreted by the kidneys through urine. The level of uric acid increases, where:

• Produces too much uric acid;
• Uric acid is excreted partially.

When you have gout and hyperuricemia organism does not display enough uric acid.

Risk factors

All causes of hyperuricemia are risk factors for gout. Factors, that increase the likelihood of gout:

• Obesity, sudden weight gain, or quick weight loss;
• Age: senior 40 years;
• Paul: male;
• The presence of family members with gout;
• Receiving diuretics, such as hydrochlorothiazide;
• Some medications, such as aspirin;
• The high content of purines in foods (uric acid is formed by cleavage of purines):
  • Liver and other meats from the internal organs;
  • Dried beans and peas;
  • Anchovies;
  • Sauces;
• Food, that includes drinks with high-fructose, such as drinks sweetened with sugar and orange juice;
• Alcohol consumption, especially drunkenness;
• Some types of cancer and cancer treatment (eg, receiving cytotoxic drugs);
• Medications (eg, anticonvulsants, anti-rejection medications transplanted organs);
• Dehydration;
• Hypercholesterolemia;
• Kidney disease.

Symptoms of gout

Symptoms include:

Acute gouty arthritis

• The sudden appearance of severe pain in the joint had, usually, starting with the big toe;
• Red, hot, swollen, and very sensitive joints;
• Increasing pain during 24-36 hours after the onset of symptoms.

Retsidivnыy podagricheskiy arthritis

For most people,, gout patients this type of attack usually occurs once in two years. At the same time to gouty attack symptoms there, or they are minor. This attack may affect many different joints. With recurrent gout, tophi can form – chalky deposits of uric acid, which usually occur in the elbows and earlobes.

Diagnosis of gout

The doctor asks about the symptoms and medical history, performs a physical exam. For the analysis of uric acid in the sample is taken from the patient's joint. Other tests may include:

• Blood and urine tests, to measure the level of uric acid in the blood, and to assess renal function;
• X-ray examination – to take a picture of structures inside the body, especially bones; It is used to verify the destruction of joints.

Treatment of gout

Treatment depends on, whether acute or recurrent gout.

Acute gouty arthritis

Generally, the sooner treatment begins at an acute attack, the more effective it is. Treatment depends on the:

• Symptoms;
• The amounts of the affected joints;
• Previous treatment;
• Overall health.

General measures

The room is warm heating pad or ice on the affected joint can relieve pain.

Medications

• Nonsteroidal anti-inflammatory drugs (NSAIDs), eg:
• Indomethacin;
• Ibuprofen;
• Naproxen;
• Corticosteroids – used if NSAIDs are not effective or not recommended;
• The study found, that the use of corticosteroids in conjunction with paracetamol (acetaminophen) brings less adverse effects, than the NSAID together with acetaminophen.
• Colchicine – It is used to prevent gout attacks, but it is rarely used for the treatment of acute attacks. Attention: This drug has many side effects, however it is rarely used in early attack.

Retsidivnaya gout

General measures

• Consumption of a diet low in purine;
• Avoiding alcohol;
• In the presence of excess weight you need to lose weight gradually. Rapid weight loss can cause a gout attack;
• We need to ask the doctor, drugs which increase the level of uric acid;
• It is necessary to drink plenty of fluids.

Medications

If you have recurrent gouty arthritis or first attack of hyperuricemia, They can be assigned to medication:

• To reduce production of uric acid (allopurinol);
• To increase the excretion of uric acid by the kidneys (probenecid or sulfinpyrazone).

In some cases, it can also be used low dose colchicine, for the prevention of recurrent gout attacks.

Prevention of gout

To reduce the likelihood Gout is necessary:

• Consume foods low purines;
• Limit consumption alcohol;
• Drink plenty liquids;
• Lose weight gradually;
• Talk to your doctor about the risk of occurrence high blood pressure heart attacks. These disorders connected gout.