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Treatment of Gout

Homeopathic Treatment of Gout

Gout is a disease that results from an overload of uric acid in the body. This overload of uric acid leads to the formation of tiny crystals of urate that deposit in tissues of the body, especially the joints. Big toe is the most commonly affected (approximately 50% of cases).

When crystals form in the joints, it causes recurring attacks of joint inflammation (arthritis).  These attacks can happen over and over unless gout is treated. Over time, they can harm your joints, tendons, and other tissues. Gout is most common in men but women become increasingly susceptible to gout after menopause.

Gout is considered a chronic and progressive disease. Chronic gout can also lead to deposits of hard lumps of uric acid in the tissues, particularly in and around the joints and may cause joint destruction, decreased kidney function, and kidney stones (nephrolithiasis).

An acute attack of gout can wake you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the sheet on it may seem intolerable.

Causes of Gout:

The levels of uric acid in your blood rise until the level becomes excessive (hyperuricemia), causing urate crystals to build up around the joints. This causes inflammation and severe pain when a gout attack happens.

When the human body breaks down chemicals called purines it produces uric acid. Purines can be found naturally in your body, as well as in food, such as organ meats, anchovies, asparagus, mushrooms and herring.

Most of the time uric acid dissolves and goes into the urine via the kidneys. However, if the body is producing too much uric acid, or if the kidneys are not excreting enough uric acid, it builds up. The accumulation results in sharp urate crystals which look like needles. They accumulate in the joints or surrounding tissue and cause pain, inflammation and swelling.

The following have been known to bring about a gout attack and may be contributory causes of gout:

  • Obesity
  • Heavy alcohol consumption, especially beer
  • A diet high in purine foods, such as seafood and meat, and meat organs
  • Extremely low calorie diets
  • Regular aspirin use
  • Regular niacin use
  • Drinks high in fructose linked to gout risk - females who regularly consume beverages with a high fructose content are 74% more likely to develop gout, compared to women who consume such drinks no more than once a month.
  • Regular use of diuretic medicines
  • Medicines taken by transplant patients, such as cyclosporine
  • Fast weight loss
  • Chronic kidney disease
  • Hypertension (high blood pressure)
  • Psoriasis
  • Tumors
  • Myeloma
  • Hemolytic anemia
  • Lead poisoning
  • Hypothyroidism
  • Surgery
  • Kelley-Seegmiller syndrome
  • Lesch-Nyhan syndrome

Symptoms Of Gout:

The signs and symptoms of gout are almost always acute, occurring suddenly — often at night — and without warning. They include:

  • Intense joint pain: Gout usually affects the large joint of your big toe, but it can occur in your feet, ankles, knees, hands and wrists. The pain is likely to be most severe within the first 12 to 24 hours after it begins.
  • Lingering discomfort: After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. Later attacks are likely to last longer and affect more joints.
  • Inflammation and redness: The affected joint or joints become swollen, tender and red.
  • Severe pain in the joints: The patient may experience pain in his ankles, hands, wrists, knees or feet. More commonly the big toe is affected (podagra). Many patients describe the affected areas as warm/hot. The fluid sacs that cushion tissue (bursae) may become inflamed (bursitis) - when this happens in the elbow it is called olcranon bursitis, while in the knee prepatellar bursitis.
  • Gradually goes away: A bout can last for over a week if left untreated - and then gradually goes away during the following week or two.
  • Itchy and peeling skin later: As the gout subsides the skin around the affected area may be itchy and peel. By the end of it the patient feels fine.
  • Red/purplish skin: The affected area may become red or purplish, making the patient think he has an infection.
  • Fever: Some patients have an elevated temperature.
  • Less flexibility: The affected joint may be harder to use, the patient has limited movement.
  • No symptoms: Some patients experience no symptoms. In these cases it may develop into chronic gout.
  • Nodules: The gout may first appear as tophi (nodules) in the elbows, hands, or ears.

Stages of Gout:

  • Asymptomatic: High levels of Uric acid in blood but no joint complaints
  • Acute phase: Acute complaints described above occur for a brief period
  • Intercritical phase: There is no pain or swelling of joints in this phase, the patient is relatively symptom-free.
  • Chronic: Gout attacks may become frequent during this phase and the condition may affect many joints at a time (polyarticular). Tophi formation may also be seen.

Diagnosis of Gout:

  • Blood test - to measure your levels of uric acid. This test is not definitive as some people with high uric acid levels never have gout symptoms; while others who have gout symptoms do not have high levels of uric acid in their blood.
  • Joint fluid test - a needle is used to collect fluid from the affected joint. The liquid is then examined under a microscope to see whether urate crystals are present.

Treatment of Gout:

Drugs used to treat acute attacks and prevent future attacks include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs may control inflammation and pain in people with gout. Your doctor may prescribe a higher dose to stop an acute attack, followed by a lower daily dose to prevent future attacks.
  • Colchicine: If you're unable to take NSAIDs, your doctor may recommend colchicine (Colcrys), a type of pain reliever that effectively reduces gout pain — especially when started soon after symptoms appear. The drug's effectiveness is offset in most cases, however, by intolerable side effects, such as nausea, vomiting and diarrhea.
  • Corticosteroids: Corticosteroid medications, such as the drug prednisone, may control gout inflammation and pain. Corticosteroids may be administered in pill form, or they can be injected into your joint. Your doctor might inject a corticosteroid medication during the same visit as a joint fluid test — where he or she withdraws (aspirates) fluid from your joint with a needle. Corticosteroids are generally reserved for people who can't take either NSAIDs or colchicine.

Steps to reduce the risk of future attacks:

  • Control your weight: Being overweight increases your risk for gout. If you are overweight, a diet that is low in fat may help you lose weight. But very low-calorie diets increase the amount of uric acid produced by the body and may bring on a gout attack. For more information, see the topic Weight Management.
  • Limit alcohol, especially beer: Alcohol can reduce the release of uric acid by the kidneys into your urine, causing an increase of uric acid in your body. Beer, which is rich in purines, appears to be worse than some other beverages that contain alcohol.
  • Limit meat and seafood: Diets high in meat and seafood (high-purine foods) can raise uric acid levels.
  • Talk to your doctor about the medicines you take: Certain medicines that are given for other conditions reduce the amount of uric acid eliminated by the kidneys. These include pills that reduce the amount of salt and water in the body (diuretics, or "water pills") and niacin. Regular use of low-dose aspirin may raise the uric acid level. Low-dose aspirin may be important for the prevention of stroke or heart attack, so your doctor may want you to continue to take it.
  • Follow a moderate exercise program.

Homeopathic Treatment of Gout:

Having understood that Gout is caused by the constitutional factors [individualization , diathesis, temperament], it calls for constitutional approach towards its treatment.. The constitutional approach involves evaluation of the individual factors inclusive of one's personal and family history (ascertaining the genetic tendency), while planning a long-term treatment. Homeopathic approach to Gout treatment is more of a totalistic approach. Homeopathy helps in controlling the pain during the acute attack of gout as well as helps in preventing the recurrence of such episodes. It helps in reducing stiffness and improves the mobility of the joints.