Gout

What is Gout?

Gout is a form of inflammatory arthritis that develops in some people who have high levels of uric acid in the blood. The acid can form needle-like crystals in a joint and cause sudden, severe episodes of pain, tenderness, redness, warmth and swelling.

CAUSES OF GOUT

Gout occurs when urate crystals accumulate in joints, causing the inflammation and intense pain of a gout attack. Urate crystals can form due to high levels of uric acid in blood.

Normally, uric acid dissolves in blood and passes through kidneys into urine. But sometimes either body produces too much uric acid or kidneys excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needlelike urate crystals in a joint or surrounding tissue that cause pain, inflammation and swelling.

Factors that increase the uric acid level in body include:

• Diet. Eating a diet rich in meat and seafood and drinking beverages sweetened with fruit sugar (fructose) increase levels of uric acid, which increase your risk of gout. Alcohol consumption, especially of beer, also increases the risk of gout.
• Obesity. If you’re overweight, your body produces more uric acid and your kidneys have a more difficult time eliminating uric acid.
• Medical conditions. Certain diseases and conditions increase your risk of gout. These include untreated high blood pressure and chronic conditions such as diabetes, metabolic syndrome, and heart and kidney diseases.
• Certain medications. The use of thiazide diuretics — commonly used to treat hypertension — and low-dose aspirin also can increase uric acid levels. So can the use of anti-rejection drugs prescribed for people who have undergone an organ transplant.
• Family history of gout. If other members of your family have had gout, you’re more likely to develop the disease.
• Age and sex. Gout occurs more often in men, primarily because women tend to have lower uric acid levels. After menopause, however, women’s uric acid levels approach those of men. Men are also more likely to develop gout earlier — usually between the ages of 30 and 50 — whereas women generally develop signs and symptoms after menopause.
• Recent surgery or trauma. Experiencing recent surgery or trauma has been associated with an increased risk of developing a gout attack.

SYMPTOMS OF GOUT

There are four stages of gout:

1. Asymptomatic hyperuricemia is the period prior to the first gout attack. There are no symptoms, but blood uric acid levels are high and crystals are forming in the joint.
2. Acute gout, or a gout attack, happens when something (such as a night of drinking) causes uric acid levels to spike or jostles the crystals that have formed in a joint, triggering the attack. The resulting inflammation and pain usually strike at night and intensify over the next eight to 12 hours. The symptoms ease after a few days and likely go away in a week to 10 days. Some people never experience a second attack, but an estimated 60% of people who have a gout attack will have a second one within a year. Overall, 84% may have another attack within three years.
3. Interval gout is the time between attacks. Although there’s no pain, the gout isn’t gone. Low-level inflammation may be damaging joints. This is the time to begin managing gout – via lifestyle changes and medication – to prevent future attacks or chronic gout.
4. Chronic gout develops in people with gout whose uric acid levels remain high over a number of years. Attacks become more frequent and the pain may not go away as it used to. Joint damage may occur, which can lead to a loss of mobility. With proper management and treatment, this stage is preventable.

DIAGNOSIS OF GOUT

Your doctor can make a diagnosis of gout based on a review of your medical history, a physical exam, and your symptoms. Your doctor will likely base your diagnosis on your description of your joint pain, how often you’ve experienced intense pain in your joint, and how red or swollen the area is.

Tests to help diagnose gout may include:

• Joint fluid test. Your doctor may use a needle to draw fluid from your affected joint. Urate crystals may be visible when the fluid is examined under a microscope.
• Blood test. Blood test to measure the levels of uric acid and creatinine in your blood. Blood test results can be misleading, though. Some people have high uric acid levels, but never experience gout. And some people have signs and symptoms of gout, but don’t have unusual levels of uric acid in their blood.
• X-ray imaging. Joint X-rays can be helpful to rule out other causes of joint inflammation.
• Ultrasound. Musculoskeletal ultrasound can detect urate crystals in a joint or in a tophus. This technique is more widely used in Europe than in the United States.
• Dual energy CT scan. This type of imaging can detect the presence of urate crystals in a joint, even when it is not acutely inflamed. This test is not used routinely in clinical practice due to the expense and is not widely available.

HOMEOPATHIC TREATMENT-

Homeopathic medicines provide symptomatic relief in Gout. The medicines are selected basis the theory of individualization and symptoms similarity by using Homoeopathic holistic approach.

Following remedies are highly effective in the treatment of Gout:

Colchicum

• Inflammation of the great toe, and in the heel.
• Edematous swelling and coldness of legs and feet.
• Joint stiff and feverish.
• Shifting rheumatism.

UrticaUrens

• Helps in elimination of uric acid from the body.
• Uric acid diathesis and gout.
• The joint symptomsare associated with hive like eruptions.
• Pain in acute gout deltoid, ankles and wrists.

Benzoic Acid

• Uric acid diathesis.
• The symptoms are associated with high colored urine and offensive.
• Rheumatic gout nodes very painful.
• Pain in great toe, cracking sounds.

LedumPalustre

• Gouty pains shoot all through the foot and limb and in joints, especially small joints.
• Ball of great toe swollen, hot, and pale.
• Ascending rheumatism.

AntimoniumCrudum

• Pain in fingers and heel.
• Associated with gastric complaints.
• Thick white coating of tongue.