Gout

Gout is a true crystal deposition disease, it is pathological reaction of the joint or periarticular tissue to the presence of MSUM (monosodium urate monohydrate) crustals. These crystals are formed secondary to hyperuricaemia.

Decreased uric acid excretion

• Renal defects or failure
• lead toxicity
• lactic acidosis.
• Drugs
• Hyperparathyroidism
• Myxedema
• Sarcoidosis

CLINICAL FEATURES

1. ACUTE PHASE: The big toe is the classic site to be affected. Other sites are ankle, midfoot, knee, small joints of hands, wrist and elbow. The joint and surrounding tissue are swollen, red, hot, shiny and extremely painful.

2. CHRONIC GOUT: There is development of tophi (irregular, firm, nodular or fusiform swelling) around extensor surfaces of fingers , hands, forearm, elbows, Achilles tendon or helix of ear if there is uncontrolled hyperuricaemia for long duration.

3. RENAL MANIFESTATIONS: Uric acid deposition in kidneys lead to uric acid stones causing renal colic. It may gradually lead to progressive renal disease.

INVESTIGATIONS

• Blood analysis for uric acid, renal function test, FBC, ESR, CRP, lipid profile
• Synovial fluid analysis
• 24 hour urinary uric acid excretion
• X-rays of affected joints

DIFFERENTIAL DIAGNOSIS

• Infection
• Psoriatic or reactive arthritis
• Osteoarthritis
• Traumatic arthritis
• Palindromic rheumatism
• Rheumatoid arthritis

MANAGEMENT

• Reversal of factors promoting hyperuricaemia e.g. diuretics, alcohol abuse.
• Treating associated problems like obesity, hyperlipidaemia, hypertension.
• Correcting lifestyle patterns e.g. starvation, dehydration.
• Use of ice pack on affected site.
• Conventional treatment includes NSAIDS & urate lowering therapy.

HOMOEOPATHIC TREATMENT

Homeopathy can help in correcting Gout by correcting the metabolism disturbance causing increased Uric Acid levels thus giving a long term solution rather than only reducing uric acid levels till you are on medication.
This kind of treatment needed in depth analysis of patient’s totality and would need an in person consultation with a homeopathic physician. There are few drugs which are known specifics which help in reduction of Uric Acid levels,some are detailed below but we recommend to see a homeopathc physician in person to get Gout treated in right way.

Drugs that help to relieve gout are as follows:

COLCHICUM: It is indicated when smaller joints, fingers, toes, wrists & ankles are affected. The pains are violent, patient cannot bear to have the parts touched or to have anyone near him.

LEDUM: The ball of great toe is affected, it is swollen, sore & painful on stepping. All the pains travel upwards. Pains worse from warmth, pressure & motion.

URTICA URENS: This remedy cures more cases of gout than any other. It helps to subside pain & swelling.

AMMONIUM PHOSPHORICUM: This is useful when there are nodosities in the joints. More indicated in chronic cases where there are deposits of urate, concretions in the joints.