Gout is one of the most common metabolic diseases in industrialised countries. Gout is caused by permanently elevated uric acid levels, the so-called hyperuricemia. In order to prevent the outbreak of the disease, long-term therapy to reduce uric acid levels is necessary. In acute attacks of gout, the symptoms are relieved in such a way that the quality of life and life expectancy of healthy people can almost be achieved. With us in the Saxon State Spas, you receive extensive therapy possibilities with radon, which treat your symptoms and significantly improve your state of health.
As soon as the uric acid level exceeds 6.4 milligrams per decilitre (mg/dl) or a pH value of 7.4 is reached, hyperuricemia occurs. The presence of hyperuricemia alone does not constitute a clinical picture. Only when it occurs in conjunction with arthritis urica or tophi is it called gout.
A distinction is made between primary and secondary hyperuricemia, with the secondary one being gout. Hyperuricemia is particularly common in patients with conditions such as diabetes mellitus, obesity or hypertension, so there may be a genetic link between the two conditions.
With persistent hyperuricemia, too much uric acid accumulates in the blood over time, leading to uric acid deposits. The first attack of gout usually manifests itself as pain in the big toe. The increased concentration of uric acid in the blood causes urate crystals (uric acid crystals) to form, which are deposited in various parts of the body such as joints, bursae, tendons or the skin and ear cartilage.
In the long run, this leads to joint inflammation and consequently to joint damage. Another place where deposits can accumulate is the kidney, which can lead to kidney stones and, in the worst case, kidney damage.
The first attack of gout usually occurs in a single joint. This is then an acute gouty arthritis. The joint of the big toe is often affected, but it can also affect the metatarsophalangeal, ankle or knee joint. The attack of gout begins abruptly and manifests itself as a sudden stabbing pain in the affected joint. The joint is also very sensitive to touch and hurts when moving.
There is also a doughy swelling and the skin is red or even bluish discoloured and hot. Fever is often also involved. This acute attack can last up to a few days without therapy and can also repeat if left untreated. Gout is a disease that develops unnoticed over several years and has four disease stages in its course.
Stage 1: asymptomatic hyperuricemia
This first stage of the disease usually goes completely unnoticed, as hyperuricemia does not yet cause any symptoms. This is usually discovered during a preventive examination.
Stage 2: acute gout
The second stage of the acute attack of gout is extremely painful and occurs suddenly and, for the patient, unexpectedly in the early morning hours. Without treatment, the gout attack subsides on its own after one to two weeks.
Stage 3: time between two attacks
If no treatment has been initiated, the gout attacks reoccur at regular intervals. The stages between the individual attacks are characterised by the fact that the patient is completely free of symptoms. Nevertheless, the uric acid level remains elevated during this time and further deposits can form in the tissue.
Stage 4: chronic tophaceous gout
A chronic gout, which has already existed for several years, leads to the deposition of gout nodes, the so-called tophi, near the joints. Kidney stones also occur in this phase.
Most people with the disease have a congenital tendency towards increased uric acid levels. However, external factors also act as triggers. These include various diseases, taking medication, unhealthy nutrition, overweight and lack of movement.
In order for there to be an excess of urine in the blood, several unfavourable factors must coincide in addition to the genetic predisposition: Uric acid is produced by the breakdown of purines. On the one hand, purines are particularly rich in various foods such as meat and sausage, and on the other hand they are a component of the body cells.
They are released normally in the body. A surplus is only formed if the food contains too much purine or the body produces too much of its own purine. Another possible cause is that the kidneys do not excrete enough uric acid.
There is often a combination of several factors that lead to the onset of gout. So if there is already a genetic predisposition to gout, an attack can be triggered by the unfavourable factors mentioned above.
Purine-rich foods, alcohol consumption or even metabolic diseases caused by strict diets can cause an attack of gout. Similarly, injuries, infections or unusual efforts that lead to physical stress can cause an acute attack.
Treatment of gout with radon
During the drinking treatment, the healing water is absorbed particularly effectively via the gastrointestinal tract. In case of inflammatory joint pain such as gout, it provides relief from the inside out. This can last up to 9 months after treatment.
Natural healing water is created by the slow infiltration of rain water through different geological layers of rock. During this process it is cleaned, filtered and enriched with minerals and trace elements. In this enriched deep water, carbon dioxide is released by solidified magma from past volcanic activity. The noble gas radon is formed from the radium contained everywhere in the earth’s crust. The Bad Brambach mineral springs receive their health-promoting radon content from the Fichtelgebirge granite. All sources are strictly checked according to the Medicines Act.
First of all, the exact cause of hyperuricemia must be determined in order to establish the best possible therapy in the next step. Initially, the uric acid metabolism and kidney function are examined. The acute attack of gout can be detected by phagocytised uric acid crystals in the leukocytes. The examination is carried out using the X-ray method, which is used by both sides. Kidney stones are negative on X-rays, which means that they can only be made visible with a contrast medium.
The symptoms of gout are similar to those of septic arthritis, which can occur after joint punctures or injections. It is imperative to observe this important differential diagnosis. Nevertheless, the symptoms observed in gout are so characteristic that they are usually easy to diagnose. The current uric acid level is determined using a blood test. Under certain circumstances, however, this can return to normal relatively quickly after the attack. Therefore, repeated uric acid tests are indicated.
Another diagnostic option in unclear cases is a joint puncture to examine the synovial fluid: Here the uric acid crystals can be seen under the microscope. In the case of advanced gout, the changes in the joints can be determined on the X-ray.
The presence of various diseases such as obesity, high blood pressure, diabetes mellitus and heart and circulatory diseases also facilitate diagnosis.
If certain principles are observed, it is possible to lead a normal life with gout without restrictions. An important cornerstone here is a healthy and balanced diet. In this case, it is particularly important to avoid food rich in purine, as purine is responsible for the formation of uric acid. The aim of this balanced diet is that the uric acid level does not exceed six milligrams per decilitre. This means you can do without medication permanently.
There are special tables for gout patients that show the uric acid balance in foods so that you can get a precise overview of which foods are helpful. In general, gout patients should not consume more than 500 milligrams of uric acid per day, i.e. a maximum of 3000 milligrams per week.
Meat and various types of fish are particularly high in purine. Offal is the most purine-containing meat, so it is best to avoid it altogether. Food with a high fat content should also be viewed critically. When you grill or steam meat, you automatically reduce the fat content.
Good foods for those prone to gout are protein-containing foods such as milk and dairy products as well as fruit, vegetables and potatoes. It used to be assumed that certain legumes as well as asparagus and spinach also had a negative influence on uric acid levels. This has not been confirmed, however, because researchers in the USA have shown that purines from plant foods do not have a negative effect on uric acid levels.
In addition, a sufficient fluid intake is of utmost importance: Two to three litres per day is optimal unless there is another, parallel diagnosis. Eligible drinks are tap water, mineral water, tea and coffee.
One of the risk factors for hyperuricemia and gout is overweight, which is why gout treatment should always include gradual weight reduction. On the other hand, strict diets should be avoided, as this can promote the occurrence of an acute attack. In the long term, you are more likely to achieve the ideal weight through healthy, low-fat nutrition and sufficient movement. In general, avoid all extremes such as fasting or periods of thirst, as these all have a harmful effect on your gout.
The occurrence of gout can also be avoided with a hereditary predisposition: In 90 percent of people with elevated uric acid levels, the disease never breaks out. Make sure you eat a healthy diet, get enough exercise and keep a healthy weight to prevent gout attacks.
Gout is detected by detecting uric acid crystals in the synovial fluid. If necessary, it is also possible to check whether renal function is already impaired.
The concentration of uric acid can be determined in the blood: As soon as this rises above 6.8 mg/dl, this is considered an increase. An attack can also be diagnosed from the increased inflammation values.
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