Gouty arthritis is a type of inflammatory disease that affects the joints. Urate accumulates in them, subsequently destroying the cartilage and surrounding tissue. It takes 1-2 weeks to make a diagnosis since there are many similar pathologies. After the conclusion and final diagnosis, the patient is told how to treat gouty arthritis. Treatment can be inpatient or outpatient, it depends on the course of the disease. Treatments for Gouty Arthritis
The first line of therapy – NSAIDs, COX-2 inhibitors
The first line of anti-inflammatory treatment for an acute attack of gouty arthritis is non-steroidal anti-inflammatory drugs and selective COX-2 inhibitors. Evidence suggests that NSAIDs can provide marked symptom relief within 24 hours of use, and are also significantly less expensive than other treatments for the acute course of the disease. Therefore, NSAIDs should be the first choice in patients with acute attacks who do not have contraindications against their use. These include:
Like all medicines, NSAIDs have side effects. Your doctor will help you take precautions to reduce the risk of adverse reactions. For example, by prescribing a minimum dose for the shortest period of time. Taking NSAIDs with food can prevent heartburn, nausea, and vomiting. Frequent or prolonged treatment with these anti-inflammatory drugs leads to stomach ulcers. They can also cause a severe allergic reaction.
If the patient has stomach problems or has severe side effects, instead of NSAIDs, treatment with COX-2 inhibitors is prescribed (Etoricoxib, Celecoxib). COX-2 is more effective in the treatment of gouty arthritis than traditional NSAIDs.
The second line of therapy – systemic corticosteroids and synthetic adrenocorticotropic hormone
Parenteral adrenocorticotropic hormone is useful in acute gout. It is used in the treatment of disease if gout does not have a reaction to NSAIDs or if it is found: For gouty arthritis of the ankle joint, treatment with corticosteroids is used orally, intravenously, intramuscularly. In the treatment of the disease, corticosteroids have been used since 1952. The best are Polcortolone, Prednisolone and Methylprednisolone. The dosage, method, and duration of use are agreed with the doctor. The effectiveness of drugs has been proven for years. Improvement after their use occurs within 48 hours. Intra-articular injections of corticosteroids are useful when one or more joints are involved in the inflammatory process.
- congestive heart failure;
- chronic renal failure;
- gastrointestinal bleeding.
The medicine is administered intravenously, intramuscularly or subcutaneously. A quasi-randomized study compared with Indomethacin and ACTH showed that ACTH is significantly superior to Indomethacin in efficacy. Among patients receiving synthetic adrenocorticotropic hormone, the following side effects were observed: moderate hypokalemia, hyperglycemia, edema.
But synthetic adrenocorticotropic hormone is very expensive and not always available. After the use of corticosteroids and ACTH, it is possible for the resumption of acute attacks. Therefore, doctors recommend taking colchicine in a prophylactic dose at the same time as them.
Colchicine treatment is poorly tolerated and rarely prescribed due to the side effects of the gastrointestinal tract. Colchicine is an alkaloid derived from autumn colchicum. Almost all patients receiving a therapeutic dose of the drug develop nausea and vomiting. Drug interactions with Erythromycin, Simvastatin, and Cyclosporine increase the risk of colchicine-induced toxic effects.
The third line of therapy is the reduction of urate from the body
Allopurinol is a commonly used hypolipidemic drug in the treatment of gouty arthritis. The medicine is well tolerated if taken correctly. It works by reducing the amount of urate. Allopurinol is available in a dosage of 100 and 300 mg. The medicine is broken down and excreted through the kidneys. Take the drug until the level of urate will not be within the required range. The main thing is not to start taking Allopurinol in large doses, otherwise, an acute attack will resume.
Another drug that reduces the amount of urate in the body is Febuxostat. Unlike Allopurinol, it can be taken for kidney problems. Febuxostat should not be taken for chronic heart disease.
Uricosuric preparations, for example, Sulfinpyrazone and Probenecid, cannot be used if the patient had kidney stones. But sulfinpyrazone and probenecid may be an alternative to allopurinol if it does not fit.
Home remedies (recipes)
Inflammatory diseases of the joints are difficult and long-term treatment. So that the healing process goes faster, uses all available methods, including treatment with folk remedies. The main recipes that positively affect the disease in the acute and chronic stages:
- Finely chop 1 tsp. the bark of white and five-stamen willow, fill the grass with 1 cup boiling water. Infuse the product until it has cooled to room temperature, then strain. Take 5 times a day for 1 tbsp. l
- One liter of boiling water, pour 1 cup shell nuts of Siberian cedar. Put infuse in a sealed container for 3 hours. Take tincture 3 times a day 30 minutes before meals 1/2 cup.
- Yellow overripe cucumbers grate. Apply the grated cucumber mixture to the ankle joint for a day, bandaging it with gauze or bandage.
- Take a whole egg, pour 200 gr. apple cider vinegar. Put in a dark place for 3 days. Then add 200 gr. butter. Mix well and keep in the refrigerator. Apply during the day as soon as you feel the onset of pain. Lubricate sore spots with a thin layer of this product. After soaking the paste, lubricate the ankle joint with baby cream. This will avoid skin irritation.
Recipes requiring external use are used for 7 days. If irritation, rash or redness occurs, their use should be discontinued.
How important is dieting?
People with gouty arthritis should follow a diet to avoid acute attacks. Like other medical conditions, nutrition plays an important role in treating the disease. A person unknowingly increases the level of purines due to the consumption of foods with their high content. The diet for gouty arthritis has one purpose – the exclusion of foods rich in purines and the inclusion of foods containing them low in the diet. Negatively affect the health of the patient’s salt. Its consumption should be limited to 5–8 grams. in a day. In addition, it is prohibited:
- red meat;
- hot dogs;
- beans and spinach;
- bakery products;
- meat and fish broths;
- caffeine, strong tea, and chocolate.
Experienced doctors recommend removing uric acid (urate) from the body by drinking plenty of alkaline mineral water, juices and fruit drinks, and weak tea. Include essential fatty acids in your diet, they help reduce inflammation (nuts, flax seeds, tuna, etc.). Peppers, tangerines, oranges, cabbage, cucumbers, potatoes, pineapple, parsley, celery, elderberry, avocado, and other vegetables and fruits are allowed in unlimited quantities.
Despite the strict diet of gouty arthritis, its treatment does not prohibit fasting days once a week. On this day, you can have a little boiled meat or fish, low-fat dairy products (400 g of cottage cheese and 500 g of kefir), vegetables (1.5 kg), fruits (1 kg).