Can gout be completely cured


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What does medicine understand by gout?

Doctors understand gout to be a metabolic disease that causes painful inflammation in joints due to the deposition of uric acid crystals. However, the crystals can also be deposited in bursae, tendons, in the skin, in the ear cartilage and in the kidney. If gout is left untreated, kidney stones and kidney damage can easily occur.

What are the symptoms of gout?

The signs and symptoms of gout almost always come on suddenly, and often at night. They include intense joint pain that affects the metatarsophalangeal joint of the big toe in 50 percent of cases and is most severe in the first four to twelve hours after the onset of the gout attack. Swelling, reddening and overheating can also occur. After the strongest pain has subsided, joint problems, for example in the form of restricted mobility, can persist for a few days to weeks. Later gout attacks usually last longer and affect several joints.

How does the doctor diagnose the disease?

At the beginning, your attending physician will have an anamnesis interview with you, in which he will ask you about your symptoms, other complaints, eating habits and any medication you have taken. This is followed by a physical exam, during which the doctor palpates the joints and abdomen. Blood will also be taken from you so that you can measure the uric acid level in it. In the case of an acute gout attack, this can also be in the upper normal range, but is practically always increased in the chronic course without appropriate treatment measures.

A blood test is also used to determine blood sedimentation, C-reactive protein and leukocytes (white blood cells), the values ​​of which are usually also elevated. If there is a joint effusion, he takes the fluid from the joint and examines it under a microscope. The detection of uric acid crystals in the synovial fluid can confirm the diagnosis of gout. In the advanced course of gout, an X-ray examination can also be carried out, which can be used to determine possible damage to joints.

What are the causes of gout?

Gout occurs when uric acid crystals build up in your joint. Your body produces uric acid when it breaks down purines - substances that occur naturally in your body. Purines are also found in certain foods such as meat and seafood. Other foods, such as alcoholic beverages, especially beer, and beverages sweetened with fructose, also promote higher levels of uric acid. Uric acid usually dissolves in your blood and passes through the kidneys into the urine. However, if your body produces too much uric acid or the kidneys excrete too little uric acid, increased levels of uric acid in the blood (hyperuricemia) can occur, which lead to uric acid crystals in a joint or surrounding tissue, which causes the typical signs of inflammation.

Where can gout occur?

In 50 percent of all cases, an attack of gout occurs at the metatarsophalangeal joint of the big toe. But in principle, other joints such as shoulder, hand and knee joints can also be affected.

Who Is Most Commonly Affected by Gout?

On average, men are more likely to develop gout than women. Typically, gout affects middle-aged men and postmenopausal women. People with metabolic syndrome, in particular, tend to have high levels of uric acid in their blood. Doctors understand this to mean a combination of obesity, high blood pressure, a disturbed fat and cholesterol balance and a pathologically disturbed blood sugar level.

What types of gout are there?

Doctors differentiate between primary and secondary gout.

In the primary form are congenital disorders in which, in most cases, the kidneys do not excrete enough uric acid. In Lesch-Nyhan syndrome, on the other hand, a congenital genetic defect leads to an overproduction of uric acid, which means that the kidneys are overwhelmed with excretion. From one secondary gout speak medical experts when acquired disorders are responsible for an excess of uric acid. These include diseases such as leukemia, certain tumor diseases, untreated diabetes mellitus, kidney diseases and various medications (e.g. cytostatics), radiation as part of cancer treatment and anemia.

What are the stages in gout?

in the Stage 1 - Asymptomatic hyperuricemia - there are elevated uric acid levels without the affected person showing symptoms of the disease. in the Stage 2 - acute gout - the first gout attack occurs, which is accompanied by severe pain and extreme sensitivity to touch. The signs of inflammation usually subside within one to two weeks. The Stage 3 refers to the time span between two attacks of gout, which can be repeated at irregular intervals. There are usually no symptoms between gout attacks. The Stage 4 - Chronic gout - is characterized by permanent pain, whereby in addition to joints, organs such as the kidneys can also be affected.

What is a gout lump?

In chronic gout, uric acid deposits can cause so-called gout tophi. Doctors understand this to mean small, painless lumps that are embedded in the synovial membrane, the cartilage or in the bones near the joints and later in the skin around the joint. Common sites are fingers, hands, feet, the auricle and the elbow. Sometimes they also appear in the kidneys and other organs. If the gout nodules break open, they can release chalky amounts of crystals, which can cause deformations in the affected areas.

What conservative treatment methods are there?

Conservative treatment of gout is based on two pillars: non-drug measures and drug therapy. Non-drug measures include patient counseling, nutritional advice, physiotherapy and occupational therapy. In the case of an acute gout attack, an anti-inflammatory pain reliever such as diclofenac or ibuprofen is used first. As an alternative, your treating doctor can also prescribe other active ingredients in tablet form, such as cortisone. Cold compresses and cryotherapy can also help reduce inflammation. The goal of long-term therapy is to permanently lower elevated uric acid levels in order to permanently prevent the progression of gout. In most cases, the active ingredient allopurinol is used as a uric acid-lowering drug, which leads to a lower formation of uric acid in the body. Possible alternative agents include probenecid, febuxostat and colchicine.

When should an operation be performed?

One treatment option for larger gouty tophi is surgical removal, which is usually done under local anesthesia. This can reduce damage to the joint and the associated loss of freedom of movement. In the case of minor gouty tophias that do not lead to pain or restrict movement, an operation does not necessarily have to be performed, as drug treatment is often sufficient.

In the case of chronic gout, in which individual joints are already severely damaged, there is the possibility of replacing them with artificial joints. The operation is usually carried out as an inpatient, so that a stay of several days in the hospital is necessary after the medical procedure. Postoperatively, the new joint can initially cause severe pain, but in most cases the procedure is less painful than if the affected person continued to live with the broken joint. Exercise and occupational therapy can help patients deal with the new joint.

Are there any home remedies that can help with gout?

In general, if you have a gout attack, you should keep the affected joint still until you no longer have any symptoms. You can use cooling compresses to relieve pain. All you need is a towel that you have soaked in cold water beforehand. Quark wraps are also recommended as a possible alternative. On the other hand, ice packs that are too cold and can cause skin damage are not suitable. Cooling can take place several times a day, but should not last longer than ten minutes at a time. Furthermore, baths in warm water with bath products such as hay flowers or chamomile flowers can relax muscles and joints. To promote the excretion of uric acid through the kidneys, special teas made from birch leaves, linseed or as an infusion with cloves of garlic are recommended.

What should I watch out for if I have gout?

Although a hereditary predisposition to hyperuricemia is widespread, the risk of a gout attack can be minimized by lowering elevated uric acid levels. In particular, a healthy lifestyle can help prevent a gout attack. This includes regular exercise, avoidance of obesity and the consumption of only small amounts, ideally no alcohol at all. Above all, you should pay attention to a healthy diet, which manifests itself through the consumption of low-purine foods. These include fruits, vegetables, low-fat milk and dairy products, eggs, and grain products. On the other hand, you should reduce the consumption of meat products and offal as well as lavish protein-rich meals.

Furthermore, medical experts advise you to ensure a sufficient fluid intake of two to three liters, with suitable drinks being tap and mineral water, tea and coffee. Sweetened drinks, however, are not recommended. The aim of such preventive measures is to keep the uric acid level in the blood of gout patients, if possible below six milligrams per deciliter. For this, no more than 500 milligrams of uric acid per day and no more than 3000 milligrams of uric acid per week should be consumed. Special nutrient tables, in which the uric acid content of food is indicated, can help those affected with the daily composition of their menu.

Can Gout Be Cured Completely?

Whether the gout is curable depends on the form of the gout. If the disease is congenital, early treatment can often permanently lower the uric acid level and thus mostly enable those affected to lead a normal life. In this case, however, the disease is not curable. If the gout attack is due to diet, the disease can be avoided by lifestyle adjustments.

Does the health insurance company pay the treatment costs?

The health insurance companies usually cover the treatment costs. However, if you have any questions about special treatments and you are not sure whether these will also be covered, you can contact our specialists at any time.

About the author: Dr. med. Benjamin Gehl

Specialist in plastic, aesthetic and reconstructive surgery

As a specialist in plastic, aesthetic and reconstructive surgery, Dr. Gehl has always been in the field of medical content production.

Due to his training, many years of service in reconstructive and plastic surgery, as well as numerous foreign assignments in India, Africa and America, he knows which techniques and treatments are used internationally for medical indications and which are state of the art.

Furthermore, he deals daily with new trends and techniques in operative and non-operative surgery. Further training and studies are just as much a part of his passion as the publication of scientific papers on the latest subject-specific topics.