Exacerbation of gout

Gout is a subset of arthritis, the occurrence of which is associated with a failure of the metabolic purine metabolism, which occurs with the formation of uric acid crystals in the joints. An exacerbation of gout brings a painful pain to a person, accompanied by another pathological symptomatology. If the state of health worsens, the patient needs urgent medical help, which only specialists can provide him.

[1], [2], [3]

Causes of gout exacerbation

Depending on the catalyst that caused the attack (and the growth of uric acid in the blood), the disease under consideration is divided into primary and secondary pathologies. But experience shows that the source of hyperuricemia, which provokes the development of primary gout, remains largely undefined in most cases. One of the assumptions of modern physicians is the version of the complex imposition of hormonal and genetic factors that have worked on the basis of certain features and addictions of a person in nutrition.

The causes of exacerbation of gout secondary type are determined by such sources:

• Medicinal therapy. Long-term use of certain drugs can provoke the development of this pathological process. For example, such effects can be given by thiazide diuretics, aspirin, nicotinic acid, pyrazinamide,
• Overweight. As statistics show, in people with excess kilos this problem occurs three times more often than people with lean physique.
• Genetic predisposition of the patient. If in his family a close relative had such a problem. Every fifth patient with this diagnosis has a relative of the patient with gout.
• Excessive consumption of alcoholic beverages. They provoke an increase in the level of uric acid in the body of the drinker, which ultimately leads to the pathology considered in this article.
• Organ transplantation.
• Leukemia is a group of malignant diseases that damage cells that participate in the process of hematopoiesis.
• Psoriasis - presumably an autoimmune non-infectious pathology, affecting mainly the skin of the patient.
• Lymphoma is a cancer pathology that affects the human lymphatic system.

The age and sex of the patient can be included in the risk factor. Predominantly gout suffer men who have reached the age of forty. But this does not exclude the appearance of this disease in women, it's just that such cases are diagnosed much less often.

[4], [5],

Pathogenesis

To effectively treat the disease, doctors must understand its pathogenesis, only so you can count on a complete cure or transfer of the disease to the stage of remission. Otherwise, the therapy affects only the symptomatic indices of the disease, which can somewhat improve the patient's condition, but not solve the problem as a whole.

The basis of the problem is the growth of uric acid in the blood, which can be caused by various causes. Similarly, hyperuricemia is not a single symptom of gout, it is present in the symptoms of a fairly wide range of diseases.

Therefore, the pathogenesis of the disease considered in this article is based on the triumvirate of factors:

• The deposition in the tissue structures of uric acid compounds.
• Modified transfer of these compounds into crystalline structures.
• Inflammatory processes affecting the joint tissues of the human body, that is places of accumulation of substances forming into gouty granules (tofusi).

Failures in purine metabolism lead to activation of the process of formation of uric acid. The source of this phenomenon can be endogenous purines, produced directly by the patient's body, and exogenous purines that a person receives with food.

In an organism of almost all mammals, there is an enzyme such as uricase. It works on splitting uric acid and removing it from the body. If genetically or in the process of development in the patient's body the process of producing uricase was broken, then, accordingly, there is a failure in the destruction of the acid, which provokes its accumulation in the human body.

Symptoms of gout exacerbation

As practice shows, the considered disease physicians are divided on a stage having their own symptomatology:

• Asymptomatic hyperuricemia.
• Acute gouty arthritis.
• Monoarticular gout.
• Polyarticular gout.
• Intercritical gout.
• Chronic gout.

Symptoms of gout exacerbation, perhaps, have the most pronounced symptomatic color:

• High pain intensity, localized in the region of joints and adjacent tissues.
• Pain increases with any movement in the problem area. Sometimes even an insignificant load is unbearable. For example, a blanket, which the patient is hiding during rest.
• Mostly the painful syndrome permeates in the night and morning.
• Puffiness of the joint, in some cases, and adjacent tissues.
• The growth of temperature indicators locally in the place of injury.
• Hyperemia of the skin. The dermis becomes smooth and glossy.
• Chills and a slight increase in the temperature of the whole body are possible.
• Deterioration of the general condition of the body and appetite.

Predominantly, the symptomatology affects one joint.

First signs

Speaking directly about the disease, its first signs are manifested by the appearance and growth of a peculiar growth in the articular region. When the illness worsens, a person begins to feel growing pain in the place of the lesion. Sometimes on several painful attacks the aggravation can and will stop. And perhaps further development of pathology, in which gradually begins to manifest the entire spectrum of pathological symptoms.

[6], [7]

Effects

The essence of the question directly depends on those actions that were made or not made against the background of an exacerbation of gout. If timely measures have been taken to stop the attack, the consequences of exacerbation are represented by attenuation of the inflammatory process. Gradually, pain and all accompanying symptoms begin to disappear. Man eventually returns to the familiar life.

But not everything is as rosy as it seems at first glance. Over time, the destructive process progresses, involving new joints. The uric acid substances begin to accumulate, destroying them, but for the time being the disease does not manifest itself. Crystalline deposits (tofusi) grow and, under a certain confluence of circumstances, there is a new, but already more large-scale, exacerbation.

Places of primary accumulation are articular joints of the phalanges of the fingers and toes, knees, elbows, forearm, curls of the auricles and a number of others.

[8], [9], [10], [11]

Complications

With the proper conduct of therapeutic treatment, one can expect a sufficiently high standard of living. Timely treatment, prevention of disease and regular medical supervision - these are the three whales on which the normal life of a person with a history of gout is maintained.

But with improper care, ignoring the recommendations of a doctor or in case of a neglected disease, complications can occur. They are able to express such deviations in the patient's state of health:

• Transition of the disease into a chronic form.
• There is destruction of cartilage and bone tissue.
• Deformation of the joint apparatus.
• Immobilization of the joint.
• Practically constant incessant pain.
• Difficulties in walking.
• Appearance and increase in the size of tofus. In the absence of adequate therapy, they can achieve significant dimensional parameters (there are cases when the sizes approached the parameters of the golf ball). The growth of these bone formations leads to complete disability of the person.
• Up to 40% of patients with a diagnosis of gout have problems with the kidneys. This is a scroll and stones in the organ, nephrolithiasis, with a special neglect of the case - renal failure.
• With the prolonged course of the disease, pathological changes begin to affect the cardiovascular system, causing ischemic heart disease and cardiac dysfunction, as well as hypertensive manifestations.
• This process also affects the development of the patient's diabetes, cataracts, dry eye syndrome.
• Rarely, but there have been cases of complications affecting the respiratory system, that is, the appearance of deposits of uric acid crystals in the lung tissues.

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Diagnosis of gout exacerbation

Correctly diagnose the disease is capable only of an experienced qualified doctor. At the same time, he must have the necessary results of tests and other medical examinations, and the patient's examination by the doctor himself. Direct diagnosis of gout exacerbation consists of a number of studies:

1. Lab tests.
   • Analysis of synovial fluid.
   • Urinalysis.
   • A blood test to determine the level of uric acid.
2. Instrumental diagnostics.
   • Radiography.
   • Computer tomography (CT).
   • Magnetic resonance imaging (MRI).

3. Differential diagnosis - exclusion of other diseases with similar symptoms:
   • Pseudogout - a common inflammatory arthritis, characteristic of people aged. Primary pain syndrome appears in the knee, then in other joints, but, usually, it does not affect small joints (for example, on the fingers). The aggravation, mainly, overtakes in the autumn period or early spring.
   • Septic arthritis.
   • Infectious arthritis.
   • Rheumatoid arthritis. Severe inflammation, pain syndrome. The diagnosis is made only on the basis of detailed analyzes and studies.
   • Osteoarthritis, osteoarthritis.
   • Various infections.
   • Charcot's foot, neuropathic arthropathy. In the early term, the symptomatology of this disease is akin to gout: edema of the lower limb, hyperemia, cracks in bone tissue, displacement of blood vessels.
   • Bunion of the big toe.
   • A number of other pathologies.

[13], [14]

Analyzes

When establishing the diagnosis, a specialist must have a complete clinical picture of the disease. To do this, the patient is assigned laboratory tests. In this case, if there is a suspicion of gout, the patient is prescribed:

• Investigation of synovial fluid. This analysis is quite an informative and accurate method of diagnosing the disease in this article. The synovial fluid is essentially an articular lubricant that "envelops" the entire joint, forming a protective pouch. With the help of this analysis it is possible to diagnose the disease even during the period of remission. The method network is the taking of fluid from the articular sac by means of a puncture. The procedure is not so painful that even local anesthesia is applied. It is not applied disinhibiting and for other reason - it is capable to lower reliability of the received result. The taken liquid enters a specialized laboratory, where it is possible to recognize the presence (or absence) of monosodium urate crystals (MSU). Their presence and confirms the disease described in this article.
• Urinalysis. If a patient exhibits signs of hyperuricemia, even if it is a young man, then this analysis will establish the amount of uric acid in the urine. If this parameter is higher than the accepted standards, then the attending physician directs his patient to additional studies. After all, this indicator can speak of both gout and the formation of sand and stones in the kidney or bladder. The intake of the test fluid is carried out during the period of pain abatement, after the patient starts purine diet. During this period, the patient should not take even low-alcohol drinks and any pharmacological agents. These substances can change the veracity of the result.
• Blood test. This study is conducted to determine the level of uric acid in this liquid. If the parameter in question has a low level of the characteristic, then this diagnosis is immediately discarded as not well-founded. If the result is significantly higher than normal, it begins to go about hyperuricemia and, accordingly, the suspicion of gout. In this case, an analysis of concomitant symptoms is performed. But it is worth remembering that the presence of hyperuricemia is not necessarily a sign of the disease under consideration, but in the case of an exacerbation of gout, the level of uric acid is not always higher than normal. It can be within acceptable limits or even be somewhat lower. But still, as medical statistics show, in more than 80% of cases of a high urinary acid content in the urine, a diagnosis was confirmed-gout.

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Instrumental diagnostics

Do not do modern medicine and without additional research, produced with the help of specialized medical equipment. Instrumental diagnostics of the considered disease can be expressed in a number of techniques, but the most popular are:

• Radiography, which gives a complete picture of the state of bone tissue and the presence, as well as the degree, destruction and deformation of the joint. This technique allows you to identify and other related diseases. The X-ray image reflects the real state of the musculoskeletal system, the presence of tofus even before they are visible with an armed gaze.
• CT scan. This technique visualizes the processes occurring in the area of interest.

• Magnetic resonance imaging (MRI). The method is similar to the previous one. Allows you to view the joint in 3D measurement. At the same time, the produced photographic package makes it possible to use the obtained survey results more than once.
• Ultrasonic dopplerography is a survey conducted to investigate the state of blood flow in vessels invaded in the area of interest.

Differential diagnostics

Even with all the results of research and analysis on hand, after getting the full picture of the disease, only a qualified and experienced doctor can put the correct diagnosis. He carries out differential diagnosis, the essence of which is to exclude diagnoses that have such a symptomatology and confirmation of one.

Most often, people who are far from medicine confuse the diagnosis in this article with a pseudogout. The symptomatology of these diseases is very similar. Therefore, in order to differentiate the disease, physicochemical analysis of urate crystals is foreseen.

Assign an analysis that reveals an infectious disease of the body, resulting in diseases such as infectious arthritis, Lyme disease, fungal, bacterial, tubercular, septic, viral arthritis, osteomyelitis.

The doctor should also exclude such pathologies as rheumatoid arthritis, big toe bursitis, systemic vasculitis, Reiter's syndrome, Still's disease, Charcot's foot, neuropathic arthropathy and many other pathologies of similar symptoms.

[16], [17], [18]

Treatment of gout exacerbation

Once the diagnosis is established, the doctor can proceed with the appointment of a protocol for the therapy of the disease. Treatment of gout exacerbation is conditionally divided into two main stages. Primarily it is necessary to reduce the intensity of pathological symptoms. The second stage of the physician is being transfigured for the treatment of pathology or preventive measures, which makes it possible to withdraw the disease in question to the stage of remission, thus avoiding recurrence.

In a modern protocol for the treatment of gout, physicians inject soft drugs to at least partially protect the stomach from their effects. The most commonly used drugs are celecoxib, meloxicam or nimesulide, related to the pharmacological group of selective blockers.

Even before the recent acute attack, doctors were removed with drugs that have anti-inflammatory characteristics: diclofenac or indomethacin. But as further observations show, these drugs negatively affect the work of the kidneys and liver, which is unacceptable, especially in the case of gout diagnoses, in which these organs are already undergoing negative changes.

Sometimes colchicine is prescribed, but it does not enjoy such popularity as the drugs voiced above. This is due to its wide enough side effects and negative impact on the kidneys, digestive tract and liver.

But a number of patients do not need a medical correction, it is enough to limit themselves in the diet during an exacerbation, excluding from it food products that bring uric acid into the body. It will not be superfluous to watch your weight, not allowing the development of obesity.

When exacerbating the patient can be prescribed and drugs with anesthetic characteristics. It can be: no-spa, analgin, diclofenac, paracetamol, instant 400, aspirin, ketanov, nurofen, took, tramal and others.

Medications

As already mentioned above, the patient is prescribed such antidiagnostic drugs

As purinol, allopurinol alopron, aegis, allupol, sanfipurol and others.

The essence of drug therapy is a decrease in the level of uric acid in the patient's blood. And here allopurinol, an active antidotal drug, is highly effective.

It is prescribed in an amount that directly depends on the level of the uric acid medium. The minimum dosage of the drug is 100 mg, the maximum dosage is 800 mg. Usually, on average, this level is 200 to 400 mg daily, divided by one or two doses.

Monthly monitoring of the level of uric acid in the blood serum is necessary here.

Contraindications for this drug include increased sensitivity to the components of the drug, kidney failure, pregnancy and the period of feeding the newborn baby.

Non-steroidal anti-inflammatory drugs (NSAIDs) are entered in the protocol for the treatment of patients who do not have special health problems, since they have a significant effect on the work of the liver and organs of excretion. These include: ibuprofen (in low dosages), mothrin, naproxen, indomethacin, diclofenac, sulindac, ketoprofen, voltaren, dexibuprofen and a number of others.

Indomethacin - the strongest inhibitor of prostaglandin biosynthesis is usually taken after a meal in the amount of 25 mg two to three times a day. If necessary, this dosage can be increased to 100 - 150 mg daily, divided into three to four doses.

Contraindications of this pharmacological means include hypersensitivity to the components of the medicine, peptic ulcer disease of the digestive system, renal failure, bronchial asthma, pregnancy and the period of the newborn's breast-feeding.

Preparations of this pharmacological orientation are applied in a limited way, due to their negative impact on the functioning of the excretory system and the liver.

Anti-inflammatory and antirheumatic drug nimesulide is prescribed to adult patients in a dosage of 100 mg twice a day. For maximum effectiveness, it is recommended to drink after eating. Children who are not yet twelve years old, the drug is not prescribed, and the dosage of older teens is calculated by the formula of 5 mg per kilogram of the patient's weight, separated by two daily doses.

Contra-indications of nimesulide include the hypersensitivity of the patient's body to its components, significant malfunctions in the work of the kidneys and liver, the presence of internal gastric bleeding, ulcerous or erosive lesions of the stomach or duodenal mucosa (especially during the exacerbation period), as well as the period of pregnancy and lactation in a woman.

In the protocol of treatment can be introduced and uricolytic drugs that are designed to protect the kidneys of the patient from reabsorption of uric acid substances, which contributes to their better removal from the body.

Such medicines include, for example, sulfirpyrazone (anturane) and probenecid (benemid, probalan).

The starting dose of probenecid is 0.25 g two to three times a day for a month. Dosage is increased gradually. Thus the skilled expert knows, that to achieve greater efficiency it is possible having entered in the protocol of treatment together with probenecid and colchicine.

People suffering from gout, often have problems with blood pressure. Therefore, such a patient may be prescribed antihypertensive drugs.

Ointment for exacerbation of gout

When the symptoms of the attack increase, the blockade is first carried out. Then, therapy is carried out aimed at the recovery processes in bone and connective tissues. It can be prescribed with an exacerbation of gout ointment, which has anti-inflammatory, anti-snuff and analgesic characteristics. In this regard, ointment fullflex proved to be quite good.

Ointment should be rubbed into the affected joint tissues twice a day. It is recommended to do this immediately after a morning awakening and before going to bed. Apply the drug until the moment the inflammation is stopped and the pain symptomatology disappears.

To optimize the treatment, it is recommended to use full cream ointment, together with oral administration of full-flax capsules, against a background of proper nutrition.

Due to the fact that the medicinal product under consideration is manufactured on the basis of natural plant components, its contraindications are not so significant. These include only increased sensitivity or intolerance to at least one of the components of the drug, the tendency to allergic reactions, the period of pregnancy and lactation, the age of the patient to 14 years.

Often for the removal of pain and inflammation, other ointments are also used. For example, fastum gel, niflugel and others.

Alternative treatment of gout exacerbations

The experience of our ancestors allows us to use alternative treatment for the relief of many diseases. This fact applies to our problem.

One of the methods of treatment our ancestors considered purification of the body, including joints. For example, this procedure can be carried out with infusion from laurel sheets.

The medicine is being prepared the day before. 5 g of raw material is poured with half liters of boiling water, boiled for another five minutes and, overflowing into a thermos, is allowed to stand for the night. In the morning, the medicine should be drained and drunk in small sips throughout the day. Take this infusion should be two to three days, after which you need to make a week break. Then purification continues.

An excellent medicine in this pathology is the products of beekeeping. They are applied as ointments, on the basis of bee venom, so directly the bee stings themselves, which are made into the area of the affected joint. But this technique is suitable only for a patient who is not allergic to a bee product.

Will find its use and a recipe: three heads onions rinse and place in a liter of boiling water. Put on medium heat and cook until the bulbs begin to lose shape, falling apart. The composition should be allowed to cool slightly, after which it should be drained and taken 150 ml before each day's meal. The duration of onion therapy is at least two weeks. Broth not bad copes painful symptoms. If you have another attack, you can repeat this "medicine".

A significant place in the treatment of gout is given to various herbal tinctures and their broths - this is the basis of non-traditional methods of treatment.

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Herbal Treatment

Due to the fact that nature has presented us with a great many medicinal plants with diverse characteristics, herbal treatment for gout does not take a small part of the prescription heritage. Here we recall only a few of them.

• Romashkovo - salt baths. To prepare them, you must first prepare a decoction of 100 g of vegetable raw materials and a couple of liters of water. Then, dilute the liquid with another 8 liters of water, placing it in a basin. Add 200 grams of salt here (not bad, if it will be marine). Procedures are carried out by lowering the diseased joint into the prepared solution.
• You can do the same procedure, but taking for broth 50 g of chamomile and 50 g of elderberry black flowers. With such a decoction, you can make baths or apply compresses on its basis to the joint.
• Well-proven sequence that should be brewed in a water bath for a quarter of an hour, diluting a tablespoon of the plant with a glass of boiling water. Drink instead of tea.
• Effective and oat broth, cooked which will take some time. Glass of grain pour a liter of water and put in a container on the fire, bring to a boil and keep on fire until the volume of liquid is reduced by half. In this case, the fire should be small. Then set aside on the edge and allow to cool slightly. To strain. The resulting liquid is mixed with two glasses of whole milk. Bring to a boil again. Drink one glass of "medicine" three times a day.
• A tincture of lilac flowers is also suitable. The medicine is prepared as follows: take a container of dark glass, fill it completely with vegetable raw materials. After that, pour in alcohol or vodka. At 0.5 liter bottle of lilac flowers will take approximately 200 ml of alcohol. The vessel should be sealed and placed in a darkened place for seven days. The product must be shaken periodically. Tincture is taken before a meal of 20 - 30 droplets.

• Well-proven teas, brewed on leaves of cowberry or strawberry. Such a drink should be drunk for two to three months in a cup twice a day. In the season of berries, they can be eaten raw, not less than a glass a day.
• The root of ginger, taken in the form of tea, is an excellent anti-inflammatory drug. One or two teaspoons of grated food for a cup of boiling water, taken three times a day, to feel the surge of energy and prevent the development of the disease.

There are also many other recipes, but before being treated by alternative means, it is not superfluous to still seek advice from a specialist.

Homeopathy with exacerbation of gout

To date, homeopathy is gaining increasing popularity among people who adhere to the treatment of various diseases using alternative medicine methods.

With regard to the relief of the disease under consideration, homeopathic doctors are ready to offer a number of drugs that, if they do not allow the person to lead to a full recovery, will help to eliminate pathological symptoms, improving the patient's condition.

Urtica Urens - this homeopathic product cleans up the joints and many body systems quite well. Its basis is stinging nettle. The drug takes 5 drops, diluted with a small amount of water every two to three hours. Taking surplus uric acid, the medicine does not lessen the severity of the attack.

Benzoicum acidum is another preparation of homeopathy of a similar action. Its basis is benzoic acid, obtained from natural raw materials.

Kolhikum - removes puffiness and stops the inflammatory process. The basis of the drug is a medicinal plant.

Sarsaparilla - an anesthetic, which helps with pain symptoms during gout.

Ledum palustre - relieves inflammation of small joints of the foot and hands, tendons and heels. Helps to remove excess uric acid. The basis of the drug is the medicinal plant rosemary bog.

Urea pura - relief of acute manifestations of gout and gouty specimens. The basis of the drug is urea.

Urikum Acidum - allows softening gouty conglomerates of uric acid deposits. The drug is especially effective for gout, gouty eczema, rheumatism.

Operative treatment

But, as it is not regrettable it sounds, you can not always do just by adjusting the diet, medication or the recipe of alternative medicine. If the clinical picture of the disease is presented by tofus or tofusomi of large dimensions, the pathology area is infected, causing the patient a lot of discomfort (pain and difficulty in movement), this patient is shown surgical treatment.

If joint immobilization is aggravated by an infection, the situation is associated with a high risk of complications, which can only be prevented by performing an operation to remove uric acid from the joints adjacent to the joint with soft tissue. In some cases, this operation can affect the joint itself. The deformed organ can be a substitute for a prosthesis.

Diet with exacerbation of gout

If a person has a diagnosis of gout in a medical history, it is very important to eat properly, because a number of food products bring additional uric acid to the human body, which is already in excess, which only aggravates the pathological picture. Therefore, a diet with an exacerbation of gout is an integral element of treatment.

This patient needs to control the intake of excess purines into his body.

From the diet of such a patient must be excluded (or reduced to a minimum):

• Alcohol.
• Smoking (nicotine).
• Strong tea.
• By-products: liver, tongue, brains, kidneys.
• Reduce the consumption of meat, even low-fat varieties to 200-300 g per week.
• Daily intake of salt - no more than 5 g.
• Fatty varieties of fish.
• Spices and pickles.
• Strong coffee.
• Canned food and smoked meat.
• Any saturated broth.
• Mushrooms.
• Bean cultures.
• Fresh fruits and vegetables. Accepting only thermally processed products.
• Chocolate.
• Fresh buns.
• Caviar.
• Cocoa.
• Dried fruits.

Allowed to leave in the ration:

• Kashi and soups based on any cereals.
• Eggs.
• Dairy products.
• Allowed to accept only thermally processed vegetables and fruits.
• Milk in small quantities.
• Natural fresh juices, compotes, fruit drinks.
• Berries.
• Whole grains.
• Stale yesterday's bread.

Doctors recommend such patients for one or two days during the week, during which it is necessary to take only one kefir or cottage cheese with kefir. Allowed and apple unloading (or another mono-product).

Do not overeat (go for five to six meals a day) and fasting. The volume of one serving is not more than 200 ml.

If you eat according to diet and follow the doctor's other recommendations, then the exacerbation of the disease can be quickly stopped, and then generally put the disease into a state of remission.

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Prevention of gout exacerbations

Any disease or attack is better to prevent, than then to struggle with the arisen problem. To prevent relapse, it is necessary to prevent the disease. Doctors recommend:

• Watch your food, do not get carried away by eating foods with high purine content.
• Doing sports. It does not have to be a heavy load. It is enough to get by morning jogging, walking or light exercises, which would form a muscular corset. It will reduce the burden on the joints, having spent some of the effort on yourself.
• Do not heavily burden the joints.
• Drink a sufficient amount of liquid, which will allow the timely and complete removal of excess uric acid.
• Intensive twisting is forbidden.
• If the patient has sedentary work, it should be compensated by regular training.
• Watch the weight. Extra kilograms - this is an excessive burden on the musculoskeletal system.
• Avoid injury to the joints.
• Do not wear narrow and uncomfortable shoes. She traumatises the joints of the foot.
• The same applies to clothes.
• If the patient has gone through chemotherapy, then to prevent the prevention of uric acid deposits in the body, he is prescribed antihyperuricemia therapy. Mostly it is the reception of the drug allopurinol.

Forecast

As the statistics show, the prognosis is quite favorable. Practically all patients with this diagnosis suffer more from the symptoms of accompanying pathologies than from the directly considered disease, the exception is the period of exacerbation. But the sooner adequate measures are taken, the easier it will be for the patient to suffer an attack.

It is also known that such patients, in most cases, suffer from nephrolithiasis (stones and sand in the kidneys) or urolithiasis (a metabolic disorder that leads to the formation of urinary stones), as well as from kidney failure and it can cause a lethal outcome, and not considered in this article disease.

If you read this article, then, we hope, made the right conclusions that an exacerbation of gout can be completely avoided. When all the recommendations of the doctor are implemented, patients usually live happily to a very old age, while leading a quality, familiar life. For this purpose it is necessary to put a little bit of zeal: proper nutrition, active way of life, positive emotions and attention to one's organism guarantee this. But if the aggravation is still there, do not brush aside the problem, resorting to self-management. It will be right to seek the help of a qualified specialist who, after evaluating the clinical picture of the attack, will help to find the most effective and quickest solution to the problem. And we wish you good health and a full and rich life!

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