Gout is a complex of disorders in which crystals of monosodium urate monohydrate derived from hyper uricaemic body fluids give rise to
Inflammatory arthritis (swollen and inflamed joints)
Tenosynovitis (swelling of muscle-tendon and its sheath)
Bursitis (swelling in space of joints)
Urolithiasis(kidney stones)
Gout affects mainly small joints. It is associated with a high blood level of uric acid. More common in males than women. The First Metatarsophalangeal joint of the big toe is commonly affected. Ankle, knees are also affected.
Etiology
High blood level uric acid – more than 7mg/dl depends upon the balance between purine synthesis and uric acid elimination through the kidney and intestine.
High protein diet like meat, organ meat, beer, alcoholic beverages, sardines, legumes (dried peas beans), cauliflower, mushroom, spinach, etc.
Drugs like diuretics and aspirins etc.
SYMPTOMS
Sudden onset. Severe pain often at night. The affected joint looks red, hot, swollen with severe pain.
Sometimes crystals get accumulated in joints forming tophi (seen commonly at Achilles tendon and around elbows).
Types according to the onset
Acute gout
It happens repeatedly due to a sudden rise in uric acid following alcohol, diet, and diuretic drugs.
It may also provoke by trauma, unusual physical exercise
Chronic gout
Recurrent gout attack leads to chronic. This leads to erosion of cartilages and bones causing severe joint deformity.
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Ayurvedic management
Internal remedies
Some choices of medications include
- Kokilaksha kashayam , Amritottara kashayam , Guduchyadi kashayam ,Rasnaerandadi kashayam
- Hareetaki churnam with gudam in Guduchyadi kashayam
- Saddharana tablet or Kaishora guggulu
- Guggulu tiktaka ghrutam
- The medicines may vary according to patient condition and are strictly to be taken based on ayurvedic physician prescription.
External therapy
Choices of external therapies include :
- Abhyangam with Pinda thailam or Madhuyastyadi or Mahanarayana thailam or Kottam chukkadi thailam
- Lepanam with Jadamayadi choornam
- Dashamoola ksheera dhara
- Virechanam is best panchakarama in gout.
Food to avoid
- Black gram (urad dal), Kulatha, Radish, Alcohol, Sugarcane, Curd
- High purine rich food like meat, legumes, beer, sardines, tuna, mushroom etc.
Food to include
- Low purine diet like rice, eggs(limited intake)
- Nuts and fat-free cheese, milk
- Bread and cereals: low fiber, white flour or refined grain, pasta and macaroni
- Plums and dark berries
- Green gram, Wheat, buffalo milk, amla, bitter gourd, raisins, ash gourd.
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