Gout is a systemic disease. The cause of the disease is a metabolic disorder in which the concentration of uric acid in the blood increases, which leads to the deposition of uric acid crystals (urates) in the joints and soft tissues.¹.

At the same time, an increased content of uric acid in the blood does not always indicate gout. Hyperuricemia also accompanies a number of diseases, such as kidney disease, tumors, or blood diseases. This condition can be observed after excessive physical exertion or with the abuse of fatty foods. Only 10% of hyperuricemia states progress to gout.

The most characteristic sign of gout is the accumulation of urates in tissues and organs and the occurrence of acute attacks of pain in places of their accumulation.

What can lead to gout? As with any disease in the development of gout, there are risk factors:

• insulin resistance;
• hypertension;
• eating large amounts of red meat and offal;
• alcohol abuse, especially beer;
• impaired excretion of uric acid in kidney disease;
• some types of anticancer therapy and treatment of tuberculosis;
• autoimmune diseases;
• hereditary predisposition.

Gout usually affects the joints, which determines the clinical picture. As a rule, the pain is very strong, painful and chronic. The main symptoms of gout are:

• attacks of acute arthritis;
• the formation of tophi – gouty nodes in places of the greatest accumulation of urates;
• kidney damage.

The joints of the big toe are most commonly affected. Less commonly involved are larger joints: ankle, knee, elbow, wrist, hand joints.

An attack of pain often begins at night or in the morning. Redness and swelling of the joint appears, pain occurs, which intensifies to the maximum after 12-24 hours. Very often, the joint becomes hot to the touch and painfully reacts to the lightest touch.

Most often this gout affects men after 40 years. They get sick 7 times more often than women². The disease in women is mainly associated with changes in metabolism during menopause and is due to a decrease in estrogen levels. The fact is that estrogens directly affect the production of uric acid, reducing its concentration in the blood.

In addition, the diet of men and women is also different. In the diet of men there are a large number of provoking factors: red meat and offal, strong alcohol and beer. Excessive physical activity, stressful conditions also lead to an increased content of uric acid.

The course of gout in men and women also differs.². Features of gout in men:

• the onset of the disease occurs at the age of 30-40 years;
• the big toes and joints of the foot are most commonly affected.

Features of gout in women:

• the onset of the disease in old age and postmenopausal status;
• the joints of the hands are more often affected;
• more often tophi (gouty nodes) are formed.

Causes of gout

The disease occurs when protein metabolism is disturbed in the body. Previously, gout was called the “royal disease”, since only rich people had access to a large amount of natural wine, meat – products that contribute to the development of gout. Today, this food is available to various segments of the population. Elderly people are more often affected, but there are cases of the disease even in 30 years.

• The risk group includes: beer drinkers, meat eaters, obese people.

• Gout often develops in people taking diuretics.

• Gout occurs when there is a malfunction of the kidneys or kidney disease.

Absolutely all processes in your body are controlled by the brain. Your brain cells receive information from all organs and systems, analyze this information, produce the necessary reaction, and transmit appropriate orders through nerve cells to various organs of your body.

List of top 10 inexpensive and effective drugs for gout

Gout treatment includes both pharmacological and non-pharmacological therapies.². Non-drug therapy includes: reducing the amount of meat and seafood in the diet, giving up alcohol, beer and smoking, weight loss in obesity, learning the right way of life.

Drug therapy includes the removal of acute attacks of gout and antihyperuricemic therapy, which allows you to reduce the level of uric acid in the body, prevent the formation of urates and dissolve those that have already formed.

In the acute period, non-steroidal anti-inflammatory drugs (NSAIDs) in combination with Colchicine help relieve pain. Next, anti-gout drugs are prescribed.

Together with our expert – general practitioner Mikhail Lystsov we have compiled a rating of inexpensive and effective drugs for gout.

Non-steroidal anti-inflammatory drugs (NSAIDs)

1. Ketonal

The active substance of Ketonal is Ketoprofen, which has analgesic, anti-inflammatory and antipyretic effects. The maximum content of the drug in the blood is observed within 15-30 minutes after administration. It binds to blood proteins by 99% and penetrates well into the joint fluid, therefore it is actively used in the treatment of gout.

Сontraindications: peptic ulcer of the stomach and duodenum, hemophilia and bleeding disorders, severe renal and hepatic failure, heart failure in the stage of decompensation, condition after coronary artery bypass grafting, bleeding or suspicion of them, dyspepsia, pregnancy and lactation, children under 12 years of age , hypersensitivity to ketoprofen and acetylsalicylic acid.

Take the drug 1-2 capsules 2-3 times a day with plenty of water or milk.

2. Nimesulide

At the heart of Nimesulide is the active ingredient of the same name. The drug inhibits the synthesis of prostaglandins – provocateurs of inflammation. Nimesulide acts directly in the area of ​​inflammation, has analgesic, antipyretic effects. The maximum effect is achieved 2-3 hours after taking the pill.

In addition to attacks of gout, Nimesulide is effective in rheumatic and psoriatic arthritis, spondylitis, osteoarthritis and osteochondrosis, myalgia of various nature, sprains, tendons and other pains. Take the drug 1 tablet 2 times a day after meals.

Сontraindications: the same as other non-steroidal anti-inflammatory drugs, but children’s age is limited to 12 years. Also, Nimesulide should not be taken with other NSAIDs.

3. Meloxicam-Akrihin

The main active ingredient is Meloxicam, which also belongs to the group of non-steroidal anti-inflammatory drugs. Meloxicam is used in the treatment of osteoarthritis, arthrosis, degenerative joint diseases, rheumatoid arthritis, spondylitis, muscle diseases, sciatica and other pains. It is actively used in the treatment of gout, although the manufacturer does not note this. Meloxicam should be taken 1 tablet 1 time per day.

Сontraindications and the side effects are the same as those of other NSAIDs.

4. Celecoxib

The drug is named after the main active ingredient. Its peculiarity lies in the fact that Celecoxib is most effective in elderly patients (especially in women), does not reduce kidney function and is less irritating to the gastrointestinal mucosa. Celecoxib effectively relieves joint pain, so it is often prescribed in the treatment of gout. You need to take the drug 1 capsule once a day or in two divided doses.

Сontraindications: hemorrhagic stroke, subarachnoid bleeding, age up to 18 years.

Antigout agents

5. Colchicine

Colchicine is the first line drug for gouty attacks. The drug reduces the level of white blood cells in the area of ​​​​inflammation and reduces the uptake of uric acid salts. Colchicine is very effective in acute attacks of gout: already in the first 12 hours the condition improves significantly. With daily use of Colchicine, the likelihood of a second attack is reduced by 75%³.

Method of application: take the drug for an acute attack of gout, 1 tablet every 1-2 hours until the pain decreases (no more than 8 tablets per day). To prevent recurrent attacks, Colchicine is taken half a tablet once a day for the entire period of treatment.

Противопоказания: hypersensitivity to components, acute cardiac, hepatic and renal failure, pregnancy and lactation, age up to 18 years. The main side effects of treatment are nausea, vomiting, and abdominal pain.

6. Colchicum-dispert

Colchicum is a herbal preparation that is made from autumn colchicum seeds. Refers to effective anti-gout agents. In terms of pharmacological action and contraindications, it is a plant analogue of Colchicine, but it has no age restrictions, and the set of side effects is much less³.

Method of application: in case of an acute attack, take 2 tablets at once, then one tablet every 1-2 hours until pain relief.

Сontraindications: hypersensitivity to the components of the drug, pregnancy and lactation, hepatic and renal failure, oppression of hematopoiesis.

7. Allopurinol

Allopurinol is a Russian-made anti-gout agent. The active substance of the same name in the composition inhibits the enzyme involved in the synthesis of uric acid. The drug reduces the content of uric acid in the blood and urine and, as a result, reduces its accumulation in organs and tissues.³.

 Allopurinol is effective in the long-term treatment of chronic gout, but cannot be used in its acute phase, as it increases the pain and severity of the attack.

How to use: the drug is taken 1 tablet once a day. The dose can be increased gradually until the desired effect is achieved.

Сontraindications: renal and hepatic insufficiency, pregnancy and breastfeeding, children under 3 years of age.

8. Febuxostat

Febuxostat is a Russian-made anti-gout medication. The main active ingredient – febuxostat – inhibits the enzymes involved in the synthesis of uric acid, thereby lowering its content in the blood. Febuxostat is usually prescribed for intolerance to first-line drugs. The drug can be taken regardless of food, it helps well at any age. However, long-term treatment with Febuxostat can lead to dyspeptic disorders, skin rashes and edema. Sometimes there is a slight decrease in liver function and a recurrence of a gouty attack.

How to use: 1 tablet once a day, regardless of the meal.

Сontraindications: hypersensitivity to the components of the drug, severe renal and hepatic insufficiency, pregnancy and lactation, age up to 18 years.

9. Gout

Another drug with febuxostat in the base. Goutagrel is prescribed for the treatment of chronic hyperuricemia, gouty arthritis and tophi. The drug can be taken only after the removal of an acute attack of gout – 1 tablet per day.

Сontraindications: hypersensitivity to febuxostat, age under 18 years, pregnancy and lactation, galactose intolerance and lactase deficiency. Occasionally, the drug causes side effects in the form of headache, diarrhea, nausea, skin rash.

10. Urisan

In our list, Urisan is the only dietary supplement, while it takes its rightful place in the treatment of mild gout. Urisan is a herbal preparation that contains flavonoids and curcumin. It helps reduce pain, reduces inflammation and swelling of the joints, removes salts and normalizes the level of uric acid. Urisan should be taken 2 capsules 2 times a day with meals.

Противопоказания: pregnancy and lactation, individual intolerance to the components of the drug.

How to choose drugs for gout

The choice of an effective drug for gout directly depends on the stage of the disease and requires a mandatory consultation with a doctor. Some drugs are incompatible with diuretics, others are contraindicated in an acute attack of the disease. Self-administration of the drug can cause increased pain and worsening of the condition. Do not self-medicate, entrust the choice of the drug to the doctor.

Reviews of doctors about drugs for gout

Not so long ago, the main purpose for gout was diet, but the treatment of the disease should be complex and combined. In an acute attack, colchicine and non-steroidal anti-inflammatory drugs are prescribed, and after the attack is relieved, long-term anti-gout agents should be taken.

Gout treatment is usually long-term and is combined with a strict diet. At this time, diuretics are canceled or replaced with alternative drugs. Currently, gout is often combined with pathology of the kidneys and the cardiovascular system, obesity. It also requires an integrated approach to the treatment of gout.

Popular questions and answers

The most common questions about the treatment of gout are answered by general practitioner Mikhail Lystsov.

How to quickly get rid of gout pain?

– If you experience gout pain, you should immediately consult a doctor. You can independently take a non-steroidal anti-inflammatory drug (for example, Nimesulide or Meloxicam) or a drug previously prescribed by a doctor. Self-administration of antigout drugs is unacceptable.

What foods are good for removing uric acid?

Uric acid levels are lowered by foods low in protein and purines. These include dairy products, lean meat (especially chicken), vegetable oils, fruits and vegetables. It is recommended to drink more liquid to stimulate the kidneys.

Which doctor should I contact for gout?

– If you are experiencing gout symptoms for the first time, you should consult a therapist. He will conduct an inspection and the necessary research. When the diagnosis is confirmed, the rheumatologist will deal with the treatment.

Gout: treatment with folk remedies

The use of traditional methods of treating gout in combination with medication reduces pain, duration and frequency of attacks.

The disintegrating effect of many medicinal plants on mineral formations in the joints is associated with the influence of biologically active substances (essential oils, organic acids, microelements) in the pH of the urine, which changes the degree of its saturation with crystalloids.

With an increase in the pH of urine from 6.5 to 7, the sediment of some types of phosphates doubles, and with a sharply acidic reaction of urine, they dissolve.

Stimulate the excretion of urinary salts herbal preparations rich in organic acids:

• apple,

• lemon,

• wine stone,

• amber

• salicylic …, which affect the function of the endocrine glands, some functions of the cerebral cortex, acid-base rivnostan in the body, the reaction of urine.

The metabolism in cells will improve due to the normalization of capillary blood flow. The processes of removing toxins and toxins from cells and organs will intensify, immunity will strengthen.

Medicinal plants according to their action can be conditionally divided into groups:

1. Salt-soluble and diuretic;

2. Improving metabolism;

3. Stimulation of peristalsis of the smooth muscles of the urinary tract

4. antispasmodic;

5. anti-inflammatory;

6. Disinfectants.

The collection includes medicinal herbs, namely 🍃:

• horsetail

• common goldenrod

• goose cinquefoil

• dandelion root

• Shepherd’s bag

• nikolaychiki flat

• medicinal marigolds

• Rowan ordinary berries

• fragrant violet

• lingonberry

Herbal remedy for gout

Briefly about the components of the collection of medicinal plants 🍃:

• Horsetail is used as a diuretic, anti-inflammatory and hypotensive agent. It has been experimentally established that field horsetail promotes the removal of lead from the body.

• Potentilla goose – by action it is a diuretic painkiller and hemostatic. Due to its anti-spasmodic properties, the peristalsis of the smooth muscles of the urinary tract is stimulated. As part of the collection, goose cinquefoil plays an important role.

• Shepherd’s purse – used as a regulator of metabolism in the body, a diuretic in inflammatory processes.

• Marigolds are a good diuretic and diaphoretic factor, especially in case of metabolic disorders, urolithiasis. Effective sechoochisny remedy for salt diathesis.

• Fragrant violet – has antimicrobial, anti-inflammatory properties, somewhat lowers blood pressure.

• Goldenrod ordinary – has a pronounced anti-inflammatory effect in cases where the microbial flora is resistant to antibiotics. Goldenrod is effective in urolithiasis complicated by pyelonephritis. The action is diuretic choleretic, solegin, antiseptic.

• Dandelion root enhances zhivchotvorennya, exhibits diuretic, antispasmodic and laxative properties, effective action in the prevention of general atherosclerosis.

• Nikolaichiki flat exhibit antispasmodic and diuretic effects, have a calming effect on the central nervous system.

• Rowan ordinary (berries) are useful for kidney disease, salt diathesis, renal colitis, diarrhea, vitamin A and C deficiency, liver and gallbladder disease. Rowan ordinary is characterized as a salt-soluble, diuretic and multivitamin raw material.

• Common lingonberry – the medicinal properties of the plant are similar to those of bearberry leaves, which can serve as an equivalent substitute. A distinctive feature is that the leaves and berries of cranberries reduce the amount of uric acid. The action of improving metabolism and salt-soluble, diuretic, antiseptic, astringent.

External remedies for gout

Normalization of the diet – diet for gout

In addition to drug treatment, proper nutrition is of great importance – a diet for gout. If the patient adheres to the diet, then the attacks of the disease may not occur for years.

It is rare for anyone to finally get rid of the “royal disease”. But certain dietary restrictions can significantly reduce attacks of gout exacerbation. In the people, the gout diet comes down to eating less meat products, fatty and salty foods, and also refusing to drink coffee, sugar and alcoholic beverages.

It is advisable to limit salt in the diet, as it retains fluid in the tissues and prevents uric acid compounds from being washed out through the kidneys.

Best & Worst Foods to Eat with Gout | Reduce Risk of Gout Attacks and Hyperuricemia

Purine-rich foods that should be restricted include:

1. Legumes – peas, beans, lentils, beans.

2. Fish – sprats, sardines, sprat, cod, zander, pike.

3. Offal – kidneys, liver, lungs, brain.

4. Mushrooms – white, champignons.

5. Some vegetables (sorrel, spinach, figs, rhubarb, radishes, asparagus, cauliflower).

6. Meat (pork, veal, lamb, goose).

7. Sausages (especially liverwurst).

8. Meat and fish broths, yeast, oatmeal, polished rice.

9. Meat is best consumed boiled, since about 50% of purines go into fat.

It is shown to limit products that excite the nervous system: coffee, strong tea, cocoa, spicy snacks, spices, etc. Drinking alcohol can trigger gout attacks because alcohol impairs the excretion of uric acid by the kidneys.

I must say that not everyone is able to immediately abandon the usual diet. But when at the first attack there is pain, as if they are being cut alive, many still try to switch to a more moderate diet.

Useful products for gout are milk and dairy products (containing calcium to strengthen bones), cereals, vegetables (potatoes, zucchini, cucumbers and tomatoes, pumpkin), berries, all kinds of nuts (except peanuts), boiled meat and boiled fish.

Nutrition for gout:

EXCLUDED FROM THE DIET:

SOUPS:

Meat and mushroom broths, soups with sorrel, spinach, legumes

MEAT:

Veal, chicken, lamb, pork, kidneys, liver, lungs, brain, sausages, smoked meats, canned food

FISH:

Fatty, salty, smoked, canned

DAIRY PRODUCTS:

Spicy and salty cheese, feta cheese

Cereals and pasta:

legumes

VEGETABLES:

Lettuce, rhubarb, sorrel, spinach, cauliflower

Fruits, berries, SWEETS:

Figs, raspberries, chocolate

BEVERAGES:

Cocoa, strong tea and coffee, yeast and alcoholic drinks

Cold SPICES:

Sauces on meat and fish broth, mushroom broth, pepper, mustard, horseradish

Snacks:

Spicy and salty snacks, smoked meats, canned food, sausages

Fats:

Lamb, beef, pork, cooking oils

ALLOWED IN LIMITED QUANTITIES

Bread and flour products:

Limited pastry products

EGGS:

One egg per day of any preparation

MEAT:

Beef, rabbit, chicken, turkey – boiled 1-2 times a week

FISH:

Low-fat varieties of fish in boiled form 1-2 times a week

Cereals and pasta:

pasta

Fruits, berries, SWEETS:

plum

BEVERAGES:

tomato juice

RECOMMENDED FOR THE DIET:

Bread and flour products:

Wheat and rye bread.

SOUPS:

Vegetarian soups with the addition of various vegetables and cereals, borscht, okroshka, beetroot, milk soups

SEAFOOD:

Shrimp, squid

DAIRY PRODUCTS:

Milk, kefir, curdled milk, cottage cheese, non-spicy cheese

Cereals and pasta:

Various cereals of any preparation

VEGETABLES:

Potatoes, beets, carrots, zucchini, pumpkin, tomatoes, sweet peppers, eggplants, white cabbage, cucumbers

Fruits, berries, SWEETS:

Any fruits, fresh berries and after heat treatment, dried fruits, honey, jam

BEVERAGES:

Weak tea and coffee with milk, fruit and vegetable juices, rosehip infusion

Cold SPICES:

Sauces on vegetable broth, tomato, sour cream milk, vanillin, cinnamon

Snacks:

Vegetable salads, soft cheese

Fats:

Butter and vegetable oil

What happens if not treated?

In most cases, the development of gout leads to severe complications that pose a real threat to your health, and often life.

These complications include:

• gouty arthritis

• urolithiasis disease

• fever (temperature can rise to +40)

If you do not take urgent measures or use ineffective treatment, then powerful pathological processes will inevitably start in your body, which will lead to irreversible changes in the functioning of the musculoskeletal system and internal organs.

Constant pain, in addition to general discomfort, will lead to the development of psychosomatic and vegetative-vascular disorders. In addition, in the absence of proper medical care, joint deformity can be irreversible.

If you received useful information, then we are happy!

Be healthy!

Sources:

1. Gout. Guidelines for general practitioners (family doctors). Ministry of Health of the Russian Federation. 2015. https://endouroclinic.ru/media/file-galleries/qpbowb/Podagra%20Rukovodstvo%202015.PDF
2. Clinical guidelines. Diagnosis and treatment of gout in general medical practice, 2013. https://rykovodstvo.ru/exspl/56548/index.html
3. Register of medicines of Russia. https://www.rlsnet.ru/drugs/monural-2053