Urinary gout

Gout in Latin sounds like arthritis urica. This disease is caused by a malfunction during the exchange and withdrawal of purine in the body, which leads to an increase in the level of uric acid in the intercellular fluid and blood flow. Due to this, this disease has another name - urinary gout, the essence of which, as well as methods of its cupping, we will try to consider in this article.

Causes of urinary gout

Predominantly considered in this article, the disease is a disease of a strong half of humanity, although women are not insured from it. In most cases, it is diagnosed after forty to fifty years, but there are cases of earlier diagnosis. The causes of urinary gout are quite numerous, let's name only the main ones.

• During this period, there is a decrease in the amount of estrogens in the body, which leads to a violation of metabolic processes, including purines.
• Hereditary predisposition to this disease.
• Injuries to the joint.
• Addiction to alcoholic beverages.
• Obesity. The more extra pounds, the more difficult the problem and the higher the risk of pathology.
• Irrational nutrition.
• Organ transplantation.
• Hypodinamy.
• Subcooling.
• Long-term use of a number of drugs.
• Frequent diets with a sharp change in diet.

[1], [2], [3], [4]

Pathogenesis

In order to effectively deal with the problem that has arisen, it is necessary to know the pathogenesis of the disease that has been encountered. This is the only way to expect a complete cure or transfer of the disease to the stage of remission. If the pathogenesis is not clear, the specialist can only affect the symptom, which will 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 patient's body. As studies show, it is often enough to establish a catalyst that provoked the development of this disease is impossible.

But the mechanism of disease progression can be traced. Uric acid is produced by purine liver. Then through the bloodstream it spreads through the body. The main organ of its excretion from the body is the kidneys, which together with urine produce the substance of interest to us.

A smaller amount of uric acid is adsorbed into the intestine, where intestinal bacteria work with it.

The indicators of uric acid in the blood in a healthy person are no more than 6.8 mg / dl. If this indicator is higher, the doctor denotes this state of the body as hyperuricemia.

With the increased content of this element in the blood of a person, the formation on their basis of needle crystals of a salt called monosodium urate (MSU) begins. The higher the level of uric acid, the higher the risk of formation of such conglomerates.

Postponed in the joints of these compounds, cause the inflammatory process, accompanied by the appearance and other pathological symptoms.

Symptoms of urinary gout

The manifestations of the considered disease can respond with such a pathological deviation:

• Pain localized in the joints and adjacent tissues.
• Pain symptomatology is enhanced with any movement in the problem area. Mostly this discomfort increases during the night and morning.
• Swelling of the affected area.
• The growth of temperature indicators locally in the place of injury.
• Hyperemia of the skin at the site of the affected joint. The dermis becomes smooth and glossy.
• A chill may appear and a slight increase in body temperature may be observed.
• Deterioration of the general condition of the body and appetite.
• If the pathology is neglected, the growths appearing and continue to grow localized in the affected joint.
• Possible immobilization of the element of the musculoskeletal system.

In most cases, the symptoms of urinary gout affect one joint, but options are possible.

First signs

Usually the first signs of the disease that begin to disturb a person is the formation, manifestation and growth of nodular formations (tofusov), the appearance in the joint of uncomfortable sensations, edema.

Consequences and complications

If you do not maintain the level of uric acid in the norm, allowing it a long excess, you can get the formation of acicular salt crystals. The consequences of their proliferation - the formation of conglomerates, which contribute to the manifestation of the inflammatory process and the pathological symptom described above.

A non-stopable excess of uric acid leads the patient to aggravate the situation. Complications of this pathology can be described as follows:

• The deposits of tofus, causing an intolerable pain, which is amplified by any, even a slight touch.
• Transition of the disease into a chronic form.
• Defeat of blood vessels. Primarily it affects the heart and kidneys.
• Destruction of the tissue structure of the sore spot.
• Hyperemia, the appearance of the effect of the "glass surface".
• Deformation of the joint apparatus.
• Gradually the motor activity of the joint is reduced to "no".
• Increase the size of tofus.
• The proliferation of connective tissue fibers.
• Sclerotic changes in the human body.
• The growth of blood pressure.
• Changes in the work of the kidneys.
• This process also affects the development of the patient's diabetes, cataracts, dry eye syndrome.

Frequent cases, when concomitant diseases of this pathology are nephrosclerosis, glomerulonephritis, pyelonephritis, as well as renal dysfunction. With less frequency, but still possible to observe complications affecting the respiratory system, sciatica, pharyngitis, allergies, lumbago.

However, if the therapeutic treatment is carried out in a timely and correct manner, one can expect a sufficiently high standard of living.

[5], [6], [7], [8], [9]

Diagnosis of urinary gout

It is possible to diagnose the disease correctly, having on hand a complete picture of the pathology that is obtained after a general examination of the patient. Direct diagnosis of urinary gout consists of a series of studies:

1. Clarification of anamnesis of the patient.
2. Visual examination of the patient. Presence of tophi.
3. Lab tests.
   • Analysis of synovial fluid.
   • Urinalysis.
   • A blood test to determine the level of uric acid.
4. Instrumental diagnostics.
   • Radiography.
   • Ultrasound examination.
   • Magnetic resonance imaging (MRI) and / or computed tomography (CT).
5. Differential diagnosis - exclusion of other diseases that have a similar symptomatology.

[10], [11], [12]

Analyzes

Do not do without establishing a diagnosis without laboratory tests that allow you to assess the level of uric acid in the organs and systems of the patient and the severity of the damage to which the organism underwent pathology. Required tests such as:

• General and biochemical blood tests will allow to evaluate the blood formula, its quantitative components, including the uric acid parameters. The presence of an inflammatory process in the body.
• General and biochemical studies of urine.
• Conducting an analysis of synovial articular fluid and the contents of tofus (if uric acid crystals are found, hence the diagnosis of gout is confirmed).

Laboratory research is quite informative. They allow to recognize, evaluate and trace the process of formation and utilization of uric acid.

[13], [14], [15], [16], [17], [18], [19]

Instrumental diagnostics

Do not dispense with modern medicine without the help of medical equipment. Instrumental diagnosis of the disease of interest to us can be recognized by a number of medical techniques. The most popular are:

• Radiography, which allows to assess the condition of bones, connective tissues and other components of the joint, as well as the degree of destruction and their deformation. An x-ray photograph reveals tofusi, ranging from 0.5 mm to 3 cm in diameter, and other associated diseases.
• Ultrasonic dopplerography is a survey conducted to investigate the state of blood flow in vessels invaded in the area of interest. Such a study is especially informative during the period of exacerbation of the disease.
• CT scan. This technique visualizes the processes that take place 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.
• If the clinic of the disease is lubricated, the patient is assigned a scintigraphy with pyrophosphate of technetium. A special substance is injected into the blood of the patient - a marker that selectively settles in places of urate concentration, which allows, by subsequent scanning, to confirm or deny the diagnosis.

Instrumental diagnostics is prescribed to virtually all patients who have complaints about the pathologies of the joints.

Differential diagnostics

Diagnosis of gout sometimes causes difficulty even for an experienced skilled doctor. Therefore, differential diagnosis is the analysis of as many diverse surveys and analysis results as possible. This is the only way to obtain a complete picture of the pathology and differentiate the disease from other pathologies with similar symptoms.

An analysis of the patient's anamnesis and the results of the examination makes it possible to diagnose not only the gout itself, but also the stage of destruction on which it is located. After all, on the basis of this, one can talk about adequate, effective treatment or preventive measures that can maintain the patient's body condition within the framework of remission.

The specialist should be able to assess the clinic of the disease. The main criterion in this is the staging of pathology. Mainly, if the patient has already consulted a doctor with complaints, the patient is diagnosed with one of three stages of the disease:

• Hyperuricemia, deposition in the elements of the locomotor system of urates. At this stage of pathology, the patient's body is able to be for many years without showing itself symptomatically. But in medicine, there are cases when the disease still manifested itself even without an increase in the level of uric acid in the body.
• Accumulation of urate in tissue structures. Urates are crystalline neoplasms, which, even if present in small numbers, are capable of causing discomfort to a person. It is with their appearance that pathological symptoms gradually begin to appear and grow.
• Exacerbation of the process, caused by the inflammatory process, flowing in the tissues. At this level, the patient leaves, only if the accumulation conglomerates become significant. They not only injure neighboring tissues, but also cause resistance from the affected organism.

The main burden of this disease, in addition to the musculoskeletal system, lies on the kidneys. But this fact is found after several years of the course of the disease.

[20], [21], [22], [23]

Treatment of urinary gout

Modern opportunities allow a patient with gout to offer a number of diverse methods of coping with the problem. In this case, they can relate to both traditional classical medicine and non-traditional methods. Treatment of urinary gout can take place using the following methods:

• Drug therapy.
• Physiotherapy treatment.
• Operative treatment.
• Homiopathy.
• Massages and therapeutic gymnastics.
• Aromatherapy.
• Use of prescriptions of alternative medicine.

It should only be remembered that any therapy should be agreed with the attending physician. Otherwise, the patient risks only aggravate the situation, which will be much more difficult to cut. And the consequences of self-treatment can lead the patient's body to irreversible processes.

Medications for gout and increased uric acid

Once the diagnosis is established, the doctor can proceed with the appointment of a protocol for the therapy of the disease. Medicines for gout and increased uric acid are conventionally divided into two main stages. Primarily prescribed drugs that reduce the intensity of pathological symptoms. The second point of the attending physician transgresses to therapy of pathology or preventive measures that will help to bring the considered disease into the stage of remission, which will avoid relapse.

In the treatment protocol prescribe drugs of several pharmacological groups.

Non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed primarily during the period of exacerbation to relieve the severity of the process. In the role of such drugs can be used: butadione, mothrin, ketoprofen, dexibuprofen, rheopyrin, sulindac, indomethacin, naproxen, diclofenac, voltaren, and several others

Indomethacin - the strongest inhibitor of prostaglandin biosynthesis, which possesses antipyretic and analgesic characteristics, is usually taken after a meal in the amount of 25 mg two to three times a day. If the therapeutic effectiveness of treatment is not observed, 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.

Glucocorticosteroid (hormonal) drugs, steroid hormones, synthesized by the adrenal cortex. Powerful anti-shock, anti-allergic and anti-inflammatory characteristics. But it is necessary to prescribe them very carefully, since these drugs also show immunosuppressive characteristics that reduce the protective forces of the organism, increasing the probability of infectious diseases of the patient's body, worsen the coagulability of the blood.

Most commonly used drugs such as prednisolone, hydrocortisone, methylprednisolone, dexamethasone, betamethasone and others.

It is recommended to apply prednisolone ointment on the damaged joint with a small amount, rubbing lightly into the skin one to three times throughout the day. The duration of therapy is determined by the doctor, based on the effectiveness of the result.

Contraindications of this pharmacological agent include individual intolerance to the components of the drug, herpes, ulcer disease of the mucous organs of digestion, kidney failure, Cushing's syndrome, bronchial asthma, bacterial, fungal or viral skin pathologies, common or rosacea, pregnancy and lactation.

Mandatory antidotal drugs: allopurinol, urodan, colchicum-dispersant, allomaron, colchicine and others.

Drugs that excrete uric acid

It should also be noted that the protocol of treatment includes drugs that remove uric acid from the body. They allow to reduce its level, which contributes to the acceleration of the treatment process and the soonest improvement of the patient's condition. To such medicines carry: probenecid, allopurinol, blemarin, sulfinpyrazone and their analogues.

Effectively reduces the level of uric acid in the blood of the patient allopurinol - an active anti-gouty drug.

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.

[24], [25], [26], [27], [28]

Alternative treatment

The experience of our ancestors allows us to use alternative treatment to get rid of many pathologies. This judgment also applies to our problem.

Numerous alternative recipes are able to relieve such a patient of pain, lead to regression of the inflammatory process and effectively fight the accumulation of uric acid in the blood. But it is worth noting that treatment with alternative medicine methods does not lead to complete recovery. They are able to reduce the severity of symptoms or support the patient's body in a state of remission.

In this case, they can be used only with the permission of the doctor, since some of them can negatively affect the action of a number of drugs, reducing their effectiveness. Alternative medicine is a secondary, supportive, auxiliary treatment of the disease.

Here are a number of recipes that allow us to obtain a positive dynamics of treatment.

• Compresses from turnips. This root vegetable should be boiled or baked until tender. Mash. In the resulting consistency, you can enter a couple of tablespoons of sunflower or any other vegetable oil. "Medicine" is placed on the affected area of the skin. Top with a cloth. If the integrity of the skin is broken at the joint site, such applications are prohibited.

• 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.
• Ten-minute baths with such a composition have proved to be very good: drop by drop to introduce such aromatic oils as rosemary (or pine), juniper, tea tree (or naioli tree), kayaputovoy. After the bath, one of the same oils needs to do a small massage of the heated area.
• Similar baths can be taken and a combination of oils of grapes and lavender, taking a drop.
• In this situation, you can drink apple broth. Remove the apple from seeds and peel, chop and pour boiling water. Let stand for half an hour, drain, and drink a couple of cups between meals. Before the next use, the broth should be heated in a water bath. Take in a warm form.

Herbal Treatment

Nature has endowed us with a great many plants with medicinal properties. Herbal treatment helps to solve the problem in this article. But the only difference is that they can not bring the therapy to the full recovery of the patient, but will be able to improve his condition, especially during the period of exacerbation. Ready to voice only a few recipes from the numerous medical list.

• High popping effect shows poplar buds, crushed and combined with vaseline (ratio 1: 4). Obtained ointment should be one - two times a day to smear a sick joint. This will ease the pain and relieve the aggravation.
• A perfect anti-inflammatory drug - tea from the root of ginger. 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.
• A couple of teaspoons of herb-St. John's wort, steaming a liter of freshly boiled water. Wrap up and leave it for two to three hours. To reduce the level of uric acid in the blood and as an anesthetic, this medicine should be taken three times a day for 50 ml. The duration of such therapy can be several months.
• Effective and celery root, which is taken in the amount of one tablespoon and placed in a half-liter of boiling water. Two hours of infusion and the broth is ready. It should be drunk three to four times a day for 30 minutes before a meal. Properties are similar to the previous recipe.
• Suitable and baths of chamomile broth.

Homeopathy

Modern homeopathy is not a "guessing on the coffee grounds", but research and production of non-traditional medicine products, put on an industrial basis.

As applied to the treatment of the disease under consideration in this article, homeopathic physicians are ready to offer a whole list of medicines that, if not allow to lead a person to a full recovery, will help to eliminate pathological symptoms, improving the patient's condition.

When diagnosing gout, homeopaths can recommend such homeopathic preparations as:

• Bryonia Alba (Bryonia Alba) - well established in the removal of inflammation in the tissues of the joint, as well as in the case of limiting its mobility.
• Kolhikum - removes puffiness and stops the inflammatory process. The basis of the drug is a medicinal plant.
• Formic acid - perfectly removes the pain syndrome with rheumatism and gout, acts warmly on the joint tissues, normalizes the pressure.
• Potassium carbonate is an effective analgesic.
• Lithium Carb - perfectly removes joint pain, burning sensation.
• Urea pura (Urea pura) - relief of acute manifestations of gout and gouty specimens. The drug is based on urea.

Drugs of alternative medicine are designed to stimulate the body's own healing power of the patient.

Operative treatment

But with a number of clinical pictures, doctors can not do without more radical measures. If the size of tofusov is significant, and it interferes with the movement of the joint, causing unbearable pain to a person, or the disease has gone so far that deformation of the musculoskeletal system and destruction of tissues are observed, physicians come to the decision to perform a surgical intervention.

In such a situation, surgical treatment can be an excision of pathological formation or its removal together with the affected joint with subsequent prosthetics.

Prevention

Any disease or attack is better to prevent, than then to struggle with the arisen problem. To prevent recurrence of gout, it is necessary to prevent this disease. Specialists studying this problem recommend:

• You need to carefully review your diet. On the table of such a patient there should be a minimum amount of products rich in purine.
• Insignificant sports loads: morning warm-up, easy jogging or walking. The complex of exercises should form a muscular corset. It will help reduce the pressure on the joints by touching some of the stress on yourself.
• If the patient has sedentary work, it should be compensated by regular training.
• It is necessary to take a sufficient amount of liquid, which will ensure the normal excretion of uric acid from the patient's body. This is about 2.5 - 3 liters of fluid per day.
• Remove heavy loads and intense twisting.
• It is necessary to normalize your weight, not allowing extra pounds. After all, this is an additional load on the support system.
• Avoid injury.
• Do not wear a 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.
• It should be regularly for several minutes to massage all joints.
• It is necessary to avoid long-term use of a number of drugs, especially those belonging to the pharmacological group of thiazide diuretics and cytostatics.
• Reduce the intake of alcoholic beverages and nicotine to a minimum. Especially it concerns beer and wine.
• Do not supercool the body.
• Try to lead a calm, stress-free lifestyle.
• Avoid acute infections.

Forecast

Medical statistics show that the prognosis is quite favorable. The vast majority of people with this diagnosis mostly suffer from pathological symptoms of accompanying diseases than directly from gout. An exception is the period of exacerbation. But the sooner effective measures are taken, the easier the patient suffers the attacks, and the sooner the remission period begins.

As all the same statistics show, many patients diagnosed with gout suffer from urolithiasis (metabolic disorders leading to the formation of urinary stones) and / or nephrolithiasis (stones and sand in the kidneys). In more severe cases, it is possible to observe renal failure and it is precisely this that can lead to death, but not the disease considered in this article.

"Take care of your health in youth!" This winged phrase, perhaps, like no other characterizes the essence of the problem. If a person has a healthy lifestyle since childhood, following proper nutrition, the probability of developing the disease in this article is minimal. And even if it happened that the urinary gout is still diagnosed, such a person to stop the attack and keep the disease in a state of remission is much easier. But another category of patients should not give up. If the disease is established, then with the proper implementation of the recommendations of a specialist, one can live to a very old age, leading a completely qualitative active life without feeling defective. We wish you good health and a full and rich life!

[29], [30], [31], [32], [33], [34]

ICD-10 code

According to the international classification of diseases of the tenth revision (code for microbial 10) - microcrystalline types of arthritis, to which the urine gout refers, have their own individual code - M10. In this case, this category was painted in more detail:

• Idiopathic gout is indicated by M10.0.
• Lead type of pathology - coding M10.1.
• Drug Gout - M10.2 coding.
• Disease, tied to a malfunction in the kidneys - encoding M10.3.
• Secondary pathology - coding M10.4.
• Unspecified disease - M10.9.