What is Gout?
Gout is a common type of inflammatory arthritis caused by accumulation of uric acid crystals in the body. This causes sudden and severe pain in the joints particularly the big toe and generally during night time. Gout is one of the most commonly reported disease in the world. Gout attacks occur more with men than women.
What causes Gout?
Gout is caused by the accumulation of urate crystals in the body joints. Urate crystals are formed by uric acid which doesn’t leave the system through urine. Uric acid is a waste material generated in the body when the digestive system processes a chemical compound named purine. Purine exists naturally in the human body and is also present in large quantities in certain food items like meat, seafood, alcohol like beer and sugary drinks.
In normal scenario, uric acid dissolves in urine and will be passed out normally. But when the quantity of uric acid is high in the body, it forms urate crystals which accumulated in joints. These crystals then causing pain, swelling and tenderness in the affected joints.
The main risk factors that contribute to Gout are
1. Diet: Intake of foods with high purine content like red meat, sea food, beer and other alcoholic beverages, sugary drinks is one of the main reasons for having gout.
2. Obesity: Overweight people tend to have a much higher amount of uric acid in their bodies
3. Certain medical conditions like blood pressure, diabetes and kidney diseases also increase the risk of having gout
4. Gender: Gout occurs more in men than women. In women, gout attacks are seen more after menopause as uric acid levels in women get higher mostly only after menopause.
5. Excessive alcohol consumption can increase the chances of gout
6. Certain medications like diuretics and cyclosporine are known to cause gout
Stages of Gout
1. Asymptomatic hyperuricemia is the stage before gout attack and is when the uric acid content in blood is getting higher
2. Acute gout is the gout attack stage when the uric forms into urate crystals and are accumulated in joints, Pain normally goes away after few hours
3. Interval gout is the time interval between gout attacks. Around 60% of the people get a second attack within a year and more than 80% get a second attack within 3 years. The interval period will generally be painless
4. Chronic gout is when the uric acid level remains high for years and attacks become more and more frequent
The main symptom is extreme pain most commonly in big toe however it can also occur in other joints like ankle, wrist, elbow or knees. The affected joint will become reddish in color with swelling. They will also become very tender which causes tremendous pain from even a very light contact.
The following are some of the tests used to diagnose gout
Joint aspiration test: Here a needle is used to draw out sample fluid from the affected joint. Urate crystals can be seen during careful examination under a microscope in case of gout.
Blood tests: can show the level of uric acid in blood which will be a good indication
X-rays: are used to rule out other cases of inflammation
Ultrasound tests: are also used to detect the presence of urate crystals
Treatment is based on medications to treat gout attacks and to prevent further occurrence. Gout attack medications include nonsteroidal anti-inflammatory medicines like ibuprofen or indomethacin, colchicine and also corticosteroids in some cases. Medication to prevent further complications from gout and further attacks include medicines to block uric acid production and/or increase removal of uric acid from the body.
All these medications have some side effects like stomach pain and ulcers, mood changes, high blood pressure, low blood counts and kidney stones.
Ayurvedic treatment for Gout in India
Ayurveda is probably the oldest medical system which is still in practice today. This has been in existence for more than 3000 years in India. The treatments are fully based on herbal medication which has nil to minimal side effects.
As per Ayurveda, each person has 3 doshas and 7 dhatus and that these are made of five fundamental elements air, water, earth, fire and ether/space. The three doshas are
1. Vata which is a combination of air and ether and is responsible for circulation and airflow
2. Pitta, a combination of fire and water, is responsible for digestion and metabolism
3. Kapha made of water and earth takes care of lubrication and in forming structure and shape
The seven dhatus or tissues are
1. Plasma or rasa in Sanskrit
2. Blood or rakta in Sanskrit)
3. Muscle or mamsa in Sanskrit
4. Fat or medas in Sanskrit
5. Bone or asthi in Sanskrit
6. Marrow or majja in Sanskrit
7. Reproductive tissue or shukra in Sanskrit
A healthy body constitution is when the doshas are in balance in a person and the dhatus or tissues are healthy. Disease occurs when there is any imbalance or vitiation of doshas and dhatus in the body.
Gout is classified as ‘Vata rakta’ disorder in Ayurveda. Excessive intake of salty, spicy, meat, dried/preserved food, alcohol vitiates pitta and vata dosha and raktha dhatu. This vitiation causes toxins or ‘ama’ which blocks the free circulation (vata) and also impacts digestive fire (pitta). These toxins get accumulated in smaller joints like in toe which causes the condition of gout.
Ayurvedic treatment for gout is based on correcting the vata dosha, improving digestive fire (pitta dosha) and also in ensuring that the tissues are rejuvenated and strengthened to prevent further attacks. Treatment procedures include Virechana (induced purging), swedana (induced sweating), Dry fomentation, Massage, Oil bath, Bundle massage, Sarvangadhara (pouring of medicated water over the body) and Sirodhara (pouring medicated oil or buttermilk over the head). Treatment duration is typically 14-21 days and cost of ayurvedic treatment for gout will be around 1,000 to 2,800 USD.