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GoutBONE DISORDER – Gout

Gout – a very small, acute affection of joint causing very big pain. Motion is life, as earthdo — Being immovable is more painful than any other.

Gout makes anyone disabled by crippling or locking the joints with its deposits. Arthritis isinflammation & pain in joints, which restricts movements. It is one of the most commonsufferings, where the sufferers are made to live with pain throughout the life. Arthritis maybe due to wear & tear mechanism, in case of age or due to deterioration of the cartilagepads 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 lifetrack. for aged persons is disability. Gout is one of that kind, which affects joints and mindi.e. a type of arthritis which affects persons of age below 50. It is mainly due to increaseduric 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 man’s disease or King’s disease. It is one of theoldest 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 fruitsor kings, where fruits are the major natural staple foods for man. The organic acids in thefruits, forms alkaline carbonates for alkalization of the body. Our body’s normal PH is 6.5-7.2.Many Nutritionists says that our food should be more alkaline than acidic. When our bodybecomes 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 toxicwastages.

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 orstarvation

Even though complaints get aggravated, due to stiffness in cool climates, it attacks mostly in hotclimates.

Pathology & Progress of the Gout – Uric acid is a waste end product of body metabolism, which occursnaturally. Uric acid results from the breakdown of purines, a compound that is found mostly in animal originfoods 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 andconnective 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 withmore potential. This time it won’t respond easily to anti-inflammatory type of medicines. Even if it responds, itwon’t 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 mostlyaccompanied with are

Increased uric acid level due to elimination defects — Renal failure, Drugs, Hyperparathyroidism,Down’s 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 toits 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 thefirst 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 thesurrounding soft tissues, lead to destructive changes in the joint and cause persistent inflammation. Uric acidcrystals 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 alsoform deposits in the kidney or urinary tract causing renal stones, in long course of time. With propertreatment, the disease won’t progress to this advanced stage.

Symptoms of Gout – Initial symptom of pain is usually followed by swelling, stiffness & restriction ofmovements. 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 thelower 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 onweeks 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) injoints, 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, physicalexamination and laboratory investigations to treat the disease, in initial period itself, since every diseaseresponds very well in initial period. The main diagnostic tools in confirming the Goutare

Blood tests for elevated serum uric acid level will mostly disclose the presenceof elevated level in case of gout, but it is not confirmative, since there are lotsof people who have this elevated level, without any symptoms. Like wise, eventhough it is mostly elevated in gout, there are exceptional cases where itseems 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 orerosions

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 andpeas

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 stuffvegetables, salads.

Folic acid, Vit C sometimes helps in uric acid elimination. In some cases, it flares up the condition evenwith 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 conditionsand manages the situation. For centuries, the treatment was related with diet. Some doctors ask thepatients, to avoid fruits, and some other asks to take in plenty. Some doctors frame the life style with lessstress, changing the diuretics drugs & drugs for hypertension with caution. The most commonly used drugslike anti-inflammatory drugs (NSAIDs) or Corticosteroids taken orally or in the form of injection into theaffected joint, usually benumb the pain i.e. these drugs kill only the pain, but the production of the uric acidor 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 treatedproperly, unless it occurs frequently and hurts much. Also, Pain killers cannot be taken by peptic ulcerpatients. Sometimes these drugs itself can stir up the gouty condition.

Homeopathic Approach – Treatment should be aimed at reducing serumurate level & its deposits than killing the pain. Pain is the indicator ofpresence of inflammation or uric acid crystals. If we put off the pain, wecannot judge the proceedings & presence of the disease. Even though theeffect is seen only in great toe, it affects body wholly (its impact can be seenin other joints, kidneys, soft tissues, tendon sheaths & skin). Thus for cure,the disease must be treated, completely in a holistic manner internally, ratherthan with pain killers or applications which mask the complaints by causing abenumbing sensation Gout causes pain in many places. So it is moreimportant to correct uric acid level i.e. hyperuricaemia, not just relieving thepain 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 onfire. With mountain of difficulty, patients take precautions about food and restrict one by one and latercorrelate 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 getstrengthened, 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 onstructural damage will occur with deposits. Usually functional damages can be corrected fully, whereasstructural changes cannot be cured completely, & can only be managed. So, it is better to treat Gout oninitial attack itself, otherwise it will take much time to eliminate it, from its root. The symptoms of gout usuallywax and wane. Improvement on homeopathy treatment will be in a slow manner. Have patience, to get reliefor be a life-long patient. So, for a safer & long-time protection, opt for homeopathy. Homeopathy shallprovide complete cure for gout.

The results of homoeopathy treatment through my experiences in gout cases are far superior, to usual wayof treatment with other system of medicines. The homeopathic medicines commonly used in cases of Goutare Aconite, Benzoic acid, Belladonna, Beri beri vul, Bryonia, Causticum, Cimicifuga, Colchicum, Kalmia,Ledum, Lithium carb, Lycopodium, Phosphorus, Rhus tox, Tarentula, Pulsatilla Urtica urens. Thesemedicines should be taken under the advice and diagnosis of a Qualified Homoeopath.