Acute pain occurs suddenly – at night or in the morning – with a throbbing or tearing character, affecting one or more joints, most often in the lower extremities. Often the big toe joint is affected first.
This pain cannot be ignored. Due to the severe pain and swelling, movements in the affected joint become almost impossible. During the day, the pain decreases slightly, but in the evening it intensifies again, which can lead to nervousness and irritability. If these symptoms are familiar to you, you probably suffer from gout .
Let's take a closer look at what this disease is and how to deal with it.
What is gout?
Подаграта е ревматологично заболяване, причинено от натрупването на кристали на пикочната киселина (урати) в ставите, а по-късно и в бъбреците. Клиничната картина на подаграта се характеризира с повтарящи се и прогресиращи пристъпи на артрит, придружени от силна болка и образуване на тофуси – подагрозни възли, които водят до деформация на ставите.
The disease most often affects the feet, ankles, knees, finger joints and elbows. It is possible to observe swelling of the veins around the affected joint, an increase in temperature and a feeling of chills. Attacks can occur with different frequency - from once every six months to several years. As the disease progresses, the frequency of attacks increases, they become longer and less acute, but more and more joints are involved in the process.
When does gout occur?
The main factor leading to gout is the amount of uric acid that accumulates in the blood. Uric acid is formed during the breakdown of purine compounds, which are found in certain foods - meat, seafood, beer and various smoked products.
Normally, the body eliminates uric acid through the kidneys and urine. However, in some cases, it accumulates in excessive amounts, making it difficult for the kidneys to filter it. Sometimes kidney disease can disrupt this process even with a balanced diet.
When uric acid is not excreted effectively, it begins to build up in the body, forming sharp, needle-like crystals in the joints and surrounding tissues. It is these crystals that cause pain, swelling, and chronic inflammation.
Why does gout occur?
There are several criteria that increase the risk of developing gout:
✔️Unhealthy diet - excessive consumption of alcohol (especially beer), smoked meats, certain types of fish, peas, lentils, offal (hearts, stomachs, offal), red meat and sweet carbonated drinks.
✔️ Heredity – if there are cases of gout in your family, the likelihood of developing the disease as you age is significantly higher.
✔️ Gender and age – women suffer from gout much less often than men and usually develop it during menopause, when the body begins to produce more uric acid. In men, the disease usually manifests itself between the ages of 30 and 50.
✔️ Overweight - the higher the body weight, the greater the risk of uric acid accumulation in the body.
Secondary gout and stages of disease development
It is possible to develop secondary gout , which can be triggered by:
✔️ Oncological diseases - during treatment with cytostatics, such as doxorubicin, fluorouracil, cyclophosphamide.
✔️ Increased breakdown of body proteins.
✔️ Thiazide diuretic therapy (such as dichlothiazide, polythiazide) in patients with hypertension.
✔️ Certain chronic diseases – diabetes, kidney and cardiovascular diseases, which can also lead to increased levels of uric acid in the blood.
Stages of development of gout
There are four main stages in the development of the disease:
1️⃣ Asymptomatic hyperuricemia – elevated levels of uric acid in the blood, but without the formation of crystal deposits and without symptoms.
2️⃣ Asymptomatic hyperuricemia with salt deposits – the presence of urate crystals in the joints, but without symptoms or a history of gout (without attacks of arthritis).
3️⃣ Acute gouty arthritis – presence of crystal deposits in the joint structures with an active inflammatory process (acute attack) or in the interval period between attacks when there is no active arthritis.
4️⃣ Chronic gout – characterized by constant accumulation of crystals, chronic arthritis, erosive changes (visible through X-rays and other imaging methods) and functional disorders of the joints.
Chronic gout
Chronic gout leads to the formation of tophi – nodular accumulations of uric acid crystals in the tissues. They begin to form approximately 5-7 years after the onset of the disease. Tophi can appear in the auricle, around the joints of the hands and feet, elbows and knees. Their size varies from a few millimeters to the size of a pea or even larger.
As the disease progresses, the joints become deformed, leading to distortions, limited mobility, and pain when moving. In addition, in some cases, the tendons can be affected, where salts are also deposited. This causes redness, swelling, severe pain, and significant difficulty in movement.
Treatment
In the stage of asymptomatic hyperuricemia, drug therapy is not required. Instead, it is recommended to maintain a healthy lifestyle, including weight control in the presence of obesity. Maintaining a balanced diet is key - it is necessary to limit purines of animal origin, reduce the consumption of alcohol (especially beer) and sweetened beverages.
To maintain normal uric acid levels, increased intake of low-fat dairy products is recommended. It is also possible to use biologically active substances that help remove excess uric acid from the body.
In acute gouty arthritis, it is important to rest the affected joint. Cooling compresses are recommended to help reduce inflammation and relieve pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used for treatment, which are usually administered in higher doses for a short period of 2-3 days. In elderly patients or with concomitant liver and kidney diseases, the use of NSAIDs should be carefully evaluated to avoid unwanted side effects.
What medications treat gout?
Treatment with anti-gout medications for primary gout is lifelong, while for secondary gout it depends on the possibility of eliminating the causes that cause the disease. These medications include colchicine and allopurinol, which are prescribed strictly by a doctor based on the results of tests and uric acid levels in the blood.
How is gout treated with folk medicine?
In periods without exacerbation, various natural complexes that help reduce uric acid levels can be an effective additional therapy. Products such as „Antipurin“, „Burdok-C“ „Fitoren“ help remove uric acid salts, normalize mineral balance and support kidney function.
Nutritional recommendations: What to eat with gout and which foods to avoid
For better health, it is advisable to avoid fried meat, offal (such as liver, kidneys, lungs and brain), smoked meats, canned meat and fish, highly salted fish, hot spices, and all spices except vinegar and bay leaves. It is also a good idea to abstain from chocolate, cocoa, coffee, strong tea and alcoholic beverages.
Limit your consumption of sausages, cooked fish, bacon, mushrooms, legumes (such as beans, peas, and lentils), pickles, and some vegetables such as spinach, sorrel, cauliflower, and radishes.
On the other hand, you can safely consume vegetables such as potatoes, tomatoes, cucumbers, carrots, beets, and onions, as well as fruits, especially citrus fruits.
Following these recommendations will help you maintain a balanced and healthy diet.
Can we heal?
Gout is a chronic progressive disease that cannot be completely cured, but can be brought into a state of prolonged remission. Attacks usually resolve within 2-4 weeks, but may occur once every six months or more frequently. Therefore, taking uratoponizirovannyh drugs that reduce the level of uric acid and its salts may need to be lifelong.