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Gout
BONE DISORDER Gout
Gout a very small, acute affection of joint causing very big pain. Motion is life, as earth
do Being immovable is more painful than any other.
Gout makes anyone disabled by crippling or locking the joints with its deposits. Arthritis is
inflammation & pain in joints, which restricts movements. It is one of the most common
sufferings, where the sufferers are made to live with pain throughout the life. Arthritis may
be due to wear & tear mechanism, in case of age or due to deterioration of the cartilage
pads or cartilage tear or formation of spurs or loss of lubricating fluids or muscle stiffness.
Every one likes to go on Life Miles, with Smiles towards ageing. But the major fear of life
track. for aged persons is disability. Gout is one of that kind, which affects joints and mind
i.e. a type of arthritis which affects persons of age below 50. It is mainly due to increased
uric acid level in the body. Even though Gout seems to affect small joints, its pain is intolerable.
Gouty arthritis shares 7-9% of total arthritis cases.
Gout is a metabolic, degenerative & crystal (monosodium urate) depositing disease of joints
& connective tissues. It is also called as Rich mans disease or Kings disease. It is one of the
oldest diseases in the medical world. All the way, we learnt, man gets deviated from nature &
gets diseases, whereas gout has been identified in older days itself, i.e. from the age of fruits
or kings, where fruits are the major natural staple foods for man. The organic acids in the
fruits, forms alkaline carbonates for alkalization of the body. Our bodys normal PH is 6.5-7.2.
Many Nutritionists says that our food should be more alkaline than acidic. When our body
becomes acidic- arthritis, stiffness, headaches, depression, ulcer stomach, sores, may occur.
For that, alkaline foods like vegetables, juices & raw fruits should be taken which helps in eliminating toxic
wastages.
Incidence
Males are more predominantly affected than females.
Usually 30-50 age group is more commonly affected
Mostly people of O blood group and hypertension have increased incidence.
Gout more commonly occurs in people who have elevated serum uric acid levels
Start up usually follows unusually heavy diet or citrus fruits or its juices or alcohol or drugs or
starvation
Even though complaints get aggravated, due to stiffness in cool climates, it attacks mostly in hot
climates.
Pathology & Progress of the Gout Uric acid is a waste end product of body metabolism, which occurs
naturally. Uric acid results from the breakdown of purines, a compound that is found mostly in animal origin
foods and human tissues. It is normally eliminated by kidneys through urine. If it is not eliminated properly,
due to renal damage or excess production, it precipitates to form crystals and get deposited in the joints and
connective tissues. These deposits can cause injury or abrasions and give rise to inflammation of the joints,
causing pain, swelling, redness and tenderness.
The initial attack mostly occurs in one joint which will be for a week or more. It will mostly respond to anti-
inflammatory type of medicines. Later after a silent period, it again rebounds within a year or more, but with
more potential. This time it wont respond easily to anti-inflammatory type of medicines. Even if it responds, it
wont go away completely. In due course, flare up occurs in more joints, most frequently and more violently,
making the joint distorted and making the patient disabled.
Causes The ultimate cause is unknown. The Main triggers are
Familial genetic predisposition
Over weight excess fat increases uric acid production
Foods rich in purines- liver, kidney, sea foods, alcohol.
Starvation or fasting- reduction in calories may precipitate the gout
Multivitamins therapy especially when containing niacin
Drugs- diuretics, hypertensive drugs, anti inflammatory drugs, chemo therapy.
Trauma
Stress
The rise in uric acid may be due to increased production or decreased elimination. The conditions mostly
accompanied with are
Increased uric acid level due to elimination defects Renal failure, Drugs, Hyperparathyroidism,
Downs syndrome
Increased uric acid level due to increased production of uric acids Food, alcohol, obesity, diabetes,
heart diseases, psoriasis, polycythemia, leukemias.
Types of Gout Gout is classified mainly as primary or secondary gout
Primary Gout where no other cause can be identified. Mostly this type are genetic.
Secondary gout which may be due to high levels of uric acid, from over production as in case of foods,
alcohol, psoriasis, obesity, diabetes.or reduced elimination of uric acid due to kidney damage. In relation to
its intensity and period, gout can be further classified as
Acute gout it is a very active stage of disease, where hyperuricemia causes deposits of uric acid crystals,
in joint spaces which lead to sudden onset of intense pain and swelling in the joints. It commonly affects the
first metatarsal joint of the foot, but other joints can also be commonly involved.
Chronic gout As disease becomes older, the uric acid crystals deposited inside the joint and in the
surrounding soft tissues, lead to destructive changes in the joint and cause persistent inflammation. Uric acid
crystals deposited in soft tissues are known as tophi. These appear as yellowish deposits under the skin,
commonly occur in the fingers or toes, behind the heels or elbows, edges of the ears, etc. They can also
form deposits in the kidney or urinary tract causing renal stones, in long course of time. With proper
treatment, the disease wont progress to this advanced stage.
Symptoms of Gout Initial symptom of pain is usually followed by swelling, stiffness & restriction of
movements. There are two set of symptoms. They are
Pre deposit symptoms
The start up pain usually subsides within a month and recurs in short or long time.
Usually it gets started as acute and severe pain in toes and fingers
Complaints starts mostly in single joint (great toe) but can occur in one or more joints
Other common sites are knee, ankle and small joints of feet, hands, wrist & elbow. But the joints of the
lower limbs have greater incidence than the upper limbs
The inflamed joint is very painful, red, swollen, shiny and hot with dilated veins
The inflamed joint cannot be moved or touched.
Mostly aggravated in night
It may be accompanied with fever with chills, raised ESR, leucocytosis, etc., complaints recurs on
weeks or months intervals, weakness, fatigue, spasms.
Sleeplessness
Post deposit symptoms or Complications
Persistent inflammation or recurrent attacks will produce degenerative changes, bony erosions,
cartilage damage, deposition of monosodium bicarbonate crystals (chalky crystals named Tophi) in
joints, making the joint distorted or damaged, which are all, on the way to deformities and disability
Crystals can get deposited in cartilage of ear, soft tissues & tendon sheath
Renal stones and renal failure
Eczema in the gouty joints or crystal deposited areas
Diagnosis & Investigations It is better to evaluate the disease, with the history of complaints, physical
examination and laboratory investigations to treat the disease, in initial period itself, since every disease
responds very well in initial period. The main diagnostic tools in confirming the Gout
are
Blood tests for elevated serum uric acid level will mostly disclose the presence
of elevated level in case of gout, but it is not confirmative, since there are lots
of people who have this elevated level, without any symptoms. Like wise, even
though it is mostly elevated in gout, there are exceptional cases where it
seems to be very normal.
The most confirmative diagnose is examination of synovial fluid (lubricating fluid of the joints) *
Trace for needle shape uric acid crystals in synovial fluid
* For the presence of bacteria in synovial fluid
In advanced cases, X-ray may show joint distortion, with crystal deposition like crippling or spurs or
erosions
Preventive measures Prevention is the best defense against gout and its complications.
Avoid
Alcohol it increases the uric acid level, by acting as a diuretic.
Weight loss or starvation increases the uric acid level, due to lactic acidosis
Foods rich in purines- meat, liver, brain, kidney, cod liver oil, yeast, bread, sauces, beans, nuts and
peas
Acid foods- proteins-beans, dairy, fats, poultry, cooked grains, synthetic vitamins
Diets which have rich fat content
Fructose- i.e. fruit juices which increase uric acid level
Drugs- Hypertensive drugs, diuretics.
Overusing the joints during pain
Take
Foods which can be easily digested and eliminated
Apples, bananas, mango, cucumber, garlic which often seems to give betterment
Low purine diet such as fruits, breads, grains, cheese, eggs, milk products, sugar, spinach, green stuff
vegetables, salads.
Folic acid, Vit C sometimes helps in uric acid elimination. In some cases, it flares up the condition even
with a small piece of lemon or tomato.
Cherry and strawberry to neutralize the uric acid level
DOs
Drink plenty of water
Slow movement or slow exercise to avoid fixation or immobility.
Warm up the muscles with exercise
Rest and elevation for the part inflammed
Slowly increase habit of taking fruits since some cases & theories show that fresh and ripe grapes,
oranges & sour fruits cure the condition after a flare up.
Treatment Generally, Allopathy concentrates on the spot, and mostly treats the inflammatory conditions
and manages the situation. For centuries, the treatment was related with diet. Some doctors ask the
patients, to avoid fruits, and some other asks to take in plenty. Some doctors frame the life style with less
stress, changing the diuretics drugs & drugs for hypertension with caution. The most commonly used drugs
like anti-inflammatory drugs (NSAIDs) or Corticosteroids taken orally or in the form of injection into the
affected joint, usually benumb the pain i.e. these drugs kill only the pain, but the production of the uric acid
or its eliminating defect in the body is not at all interrupted or altered. If this condition is left untreated,
affected joints may get damaged permanently, causing disability. In most cases, gout does not get treated
properly, unless it occurs frequently and hurts much. Also, Pain killers cannot be taken by peptic ulcer
patients. Sometimes these drugs itself can stir up the gouty condition.
Homeopathic Approach Treatment should be aimed at reducing serum
urate level & its deposits than killing the pain. Pain is the indicator of
presence of inflammation or uric acid crystals. If we put off the pain, we
cannot judge the proceedings & presence of the disease. Even though the
effect is seen only in great toe, it affects body wholly (its impact can be seen
in other joints, kidneys, soft tissues, tendon sheaths & skin). Thus for cure,
the disease must be treated, completely in a holistic manner internally, rather
than with pain killers or applications which mask the complaints by causing a
benumbing sensation Gout causes pain in many places. So it is more
important to correct uric acid level i.e. hyperuricaemia, not just relieving the
pain or its effects on the joints.
A piece of pickle or a sip of lime juice or a gulp of tomato soup can precipitate the condition like oil poured on
fire. With mountain of difficulty, patients take precautions about food and restrict one by one and later
correlate every thing with pain. Supplementation and restriction can work only for the time being.
The ultimate cause is UNKNOWN. So you cannot attack the enemy who is hiding. We should get
strengthened, to withstand the situation or condition. Homeopathy protects us, by raising our body immunity.
Homeopathy can also surely bring dramatic effects of cure, since it treats wholly.
Success of the treatment mainly depends upon the early diagnosis & early treatment. Since later on
structural damage will occur with deposits. Usually functional damages can be corrected fully, whereas
structural changes cannot be cured completely, & can only be managed. So, it is better to treat Gout on
initial attack itself, otherwise it will take much time to eliminate it, from its root. The symptoms of gout usually
wax and wane. Improvement on homeopathy treatment will be in a slow manner. Have patience, to get relief
or be a life-long patient. So, for a safer & long-time protection, opt for homeopathy. Homeopathy shall
provide complete cure for gout.
The results of homoeopathy treatment through my experiences in gout cases are far superior, to usual way
of treatment with other system of medicines. The homeopathic medicines commonly used in cases of Gout
are Aconite, Benzoic acid, Belladonna, Beri beri vul, Bryonia, Causticum, Cimicifuga, Colchicum, Kalmia,
Ledum, Lithium carb, Lycopodium, Phosphorus, Rhus tox, Tarentula, Pulsatilla Urtica urens. These
medicines should be taken under the advice and diagnosis of a Qualified Homoeopath.