I would like to share the following article by Dr Midhun Jose, MD; Father Muller Homoeopathic Medical College, Deralakatte, Mangalore.
Dr Jose explains the condition of gout extremely well and how it is becoming more common in modern society.
Gout is an inflammatory joint disease, with increased uric acid level in blood. The deposition of monosodium urate crystals in the joints leads to inflammation. Important risk factors for gout includes obesity, chronic kidney diseases, intake of high purine foods such as animal liver, shellfish, alcoholic beverages, etc. The prevalence of gout is more frequently seen in men than women. In recent years the prevalence of gout is increased among people because of the shift in diet and the change in lifestyle. Hyperuricemia [high serum uric acid levels] is the major feature of gout. i.e., the serum uric acid level rises above 6.8 mg/dl(1).
Not everyone with hyperuricemic levels suffers from gout. Gout mostly develops when there is an increase in production of uric acid with improper elimination. Gout usually affects the joints, periarticular tissues and kidneys. In current scenario, gout affects not only the elderly but also the younger generation. Previously gout was common in between 40-60 years. Now the peak incidence is between 30-50 years.(2)
EPIDEMIOLOGY:
In normal men taking purine free diet, the daily urinary excretion of uric acid is 350 to 500 mg. In males at puberty the uric acid level is around 5.2mg/dl. In females it is up to 4.7mg/dl but rises after menopause(3). The incidence and prevalence of gout has increased in the recent years. It is more common in urban than rural communites. In India the prevalence of gout is 0.12% as per International League of Nations against rheumatism and its prevalence is more in men above the age of 50 years.(4)
RISK FACTORS AND ETIOLOGY:
The gout in ancient times was known as “The King of diseases” since it was present only in high class people(5). But now the incidence is increased because of the change in diet and lifestyle. The risk factors for the gout include alcohol, dietary excesses (meat, sea foods and liver), surgery, trauma, sepsis, stress, starvation, dehydration, drugs like diuretics, aspirin, etc.(6)(2)
Ninety percent of patients have primary gout in which there is impairment in the uric acid excretion. Secondary gout results from hyperuricemia due to renal imbalance or from chronic use of diuretics.(7)
CLINICAL FEATURES:
Acute gout – It usually presents with affection of first metatarsal phalangeal joint (podagra). Other common sites include ankle, mid foot, knee, fingers, etc. The pain is of rapid onset and is usually seen in morning. The clinical features include pain, tenderness, swelling and shiny skin.
Recurrent gout – In some people recurrence of attack is seen within one year and is usually present with the involvement of more joints.
Chronic gout – It is usually present with tophi (deposition of large MSU ([Mono sodium urate] crystals around fingers, hands, forearm, toes, and sometimes in helix of ear).(7)
Renal and urinary tract manifestation – increased uric acid level can lead to renal stone formation. Progressive renal disorders can occur as a complication of chronic tophaceous gout.
COMPLICATIONS:
Renal damage – Acute Hyperuricemic nephropathy,
Chronic Hyperuricemic nephropathy,
Cardio vascular system – higher incidence of hypertension, and
Ischemic heart disease.(8)
MANAGEMENT OF GOUT:
General management of gout primarily includes dietary restrictions. Mainly alcohol, red meat, sea foods, while intake of low fat dairy products, vitamin C and coffee may reduce SUA level.
The management of gout by allopathic way is mainly through anti-inflammatory drugs and analgesics. When the oral medication fails, they go with intramuscular corticosteroid injection (9). However, some of these drugs can create dependency and side effects. So gout must be treated in a systemic way to reduce the uric acid level and avoid its complication.
The full article is available at: https://www.homeobook.com/gout-homoeopathic-remedy-urtica-urens-to-eliminate-uric-acid/ and goes into homeopathic treatment of this condition. I strongly recommend anyone wishing to undertake homeopathic support consult a qualified Classical Homeopath.
REFERENCE:
- Dr. Arup Kumar Kundu, Abhishek Kundu; Textbook of Rheumatology; The Associations of Physicians of India; Chapter 39,Gout in 2017, p. 180-182.
- Parkodi R, Parthiban M, Rukmangatharajan S, Kanakarani P, Panchapakesa RajendranC; Clinical Spectrum Of Gout In South India, p. 61-63.
- Y P Munjal, API Textbook of Medicine, 10TH edition, (Volume 2), p. 2483-2484.
- Dr. Arup Kumar Kundu, Textbook of Rheumatology, The Associations of Physicians of India, Chapter 98,Gout in Indian Scenario, p. 444-448.