Do you suffer from sudden burning pain, stiffness in a joint, especially a big toe? You may also be getting these attacks in your foot, ankle or knees. You need to see your doctor even if the pain is gone after some days as you may be suffering from Gout which is a kind of arthritis. Gout refers to a certain form of inflammation of the joints and swellings of a recurrent type. Although it is chronic in character, it breaks often in acute attacks. It is a disease of the wealthy and chiefly affects middle-aged men. Women, after menopause, are also sometimes affected by this disease. This disease has increased in recent times affecting nearly 1-2 percent of the western population at some point in their lives. The increase may be due to metabolic syndrome, longer life expectancy and certain changes in the diet. It was historically known as ‘the disease of kings’.
An attack of gout is usually accompanied by acute pain in the big toe, which becomes tender, hot and swollen in a few hours. It is almost impossible to put any weight on the affected foot during the acute stage of the disease. It may also similarly affect other joints such as the knees and the wrists and sometimes more than one joint may be affected at a time. The attacks usually occur at midnight or in the early hours of the morning, when the patient is suddenly awakened. The acute attack generally lasts for a week or so. During this period, the patient may have the following symptoms:
· High fever
· Disinclination to eat
· Severe pain in the stomach in some cases.
However, the general health of the patient remains unaffected. The attack may occur again after several weeks or months. The interval of attacks become shorter if the disease is not treated properly. The joint becomes damaged by arthritis. This is chronic gout in which chalky lumps of uric acid crystals remain in the joint and also form under the skin.
Another serious complication of gout is kidney stones containing uric acid, causing severe pain in the stomach. In some cases, the kidneys become damaged and do not function properly. This is a serious condition as the poisonous waste products which are normally removed by the kidneys accumulate in the blood.
Hyperuricemia is the underlying cause of gout. This can be due to the following reasons:
· Genetic predisposition
· Under excretion of urate, the salts of uric acid.
The other important factors which cause Gout are as follows:
· Heredity. This is an important factor in causing this disease and certain races are prone to gout.
· Lifestyle. These include consumption of alcohol, fructose-sweetened drinks, meat and alcohol, regular eating of foods rich in protein and carbohydrate and lack of proper exercise. Stress is also regarded as an important cause of gout.
· Medical conditions. This disease generally occurs in combination with other medical problems such as metabolic syndrome which is a combination of abdominal obesity, hypertension, insulin resistance and abnormal lipid levels.
· Medication. Diuretics have been associated with attacks of gout. Other medications such as niacin and aspirin increase the risk.
Doubts or Myths regarding Gout:
There are many doubts or myths regarding Gout and believing them could make your pain worse and cause serious or even life-threatening complications. They are as follows:
· Over time, gout will go away on its own.
· Gout is mild form of arthritis.
· Gout is a rare condition.
· Gout only affects the big toe.
· Gout only affects the big toe.
· A Gout attack never lasts longer than ten days.
· Gout goes away between Gout attacks.
· Eating cherries can cure Gout.
Gout must be diagnosed and treated in patients with hyperuricemia and the classic podagra. X-rays must be done for identifying chronic Gout. There are many different kinds of diagnosis such as Synovial Fluid test and this is done based upon the identification of monosodium urate crystals in synovial fluid or atophus.
There are some blood tests commonly performed such as white blood cell count, electrolytes renal function and erythrocyte sedimentation rate. The most important differential diagnosis in Gout is septic arthritis. This must be done in those with signs of infection or those who do not improve with treatment.
There are basically two types of Gout. They are:
· Primary Hyperuricemia
· Secondary Hyperuricemia.
In addition to these two, there are four types of Gout according to medical science. They are:
· Asymptomatic Gout
· Acute Gouty arthritis
· Interval Gout and,
· Chronic Tophaceous Gout.
The main aim of the treatment of Gout is to settle the symptoms of an acute attack. If the attacks are repeated, they can be prevented and treated by different drugs. It is easy to get rid of the pain by applying ice for twenty to thirty minutes several times a day. Options for acute treatment include nonsteroidal anti-inflammatory drugs , colchicines and steroids. Lowering the uric acid levels can cure the disease and treatment of comorbidities is also important.
NSAIDs. This is the usual first-line treatment for gout and improvement may be seen within four hours and treatment is recommended for one or two weeks. For those patients who are at risk of gastric side effects from NSAIDs, an additional proton pump inhibitor may be given.
Colchicine. This is an alternative treatment for those patients who are unable to tolerate NSAIDs. Its usage is limited because of its harmful side effects.
Steriods. Glucocorticoids have been found to be as effective as NSAIDs and may be used if contraindications exist for NSAIDs. They are also effective in healing when injected into the joint but a joint infection may be excluded, as steroids worsen this condition.
Pegloticase. This treatment was approved in the USA to treat Gout in 2010. It is the best option for those people who are intolerant to other medicines. This is administered as an intravenous infusion every two weeks and has been found to reduce uric acid levels in this population.
Without treatment, an acute attack of Gout usually resolves in seven days. Those with Gout are at increased risk of hypertension, diabetes, metabolism syndrome and renal and cardiovascular disease. Without any treatment, acute gout may also develop into chronic gout with destruction of joint surfaces, joint deformity and painless tophi. With aggressive treatment, it may dissolve. Kidney stones also frequently complicate gout and it may be difficult to eliminate it and this occurs due to low urine pH promoting the precipitation of uric acid.
Non Surgical treatment of Gout:
Urate-lowering medications lower the urate levels by helping to banish or by decreasing the production of uric acid. Preventive therapy must be continued because there is no benefit to taking a break from medication.
Probenecid increases the efficiency of uric acid excretion by the kidney and is called a uricosuric drug. Losartan is used to treat high blodd pressure but also has a useful, though weak, urate-lowering effect just as the lipid-lowering drug fenobibrate. Allopurinol and febuxostat work by eliminating the formation of uric acid. Periodic measurement of liver function is recommended during the treatment with febuxostat and with allopurinol. Pegloticase works by breaking down urate into allantioin, an end product that is easily got rid of.
Gout has the distinction of being one of the most frequently recorded medical illnesses throughout history. Researchers are working on the development of more effective Gout medications.
Prevention of acute Gout involves the following precautions:
· Maintaining adequate fluid intake
· Weight reduction
· Dietary changes
· Reduction in alcohol consumption
· Medications to treat hyperuricemia.
You can certainly help prevent or reduce the severity of future gout attacks. If you have been prescribed some medications for gout, it is important that you take those medicines as instructed to prevent future attacks. If you are overweight, take some steps to lose weight. You may also be advised to reduce or completely eliminate your alcohol intake or to adjust your diet too.
Home Remedies or Natural Treatments:
There is no better remedy than a fast for the natural treatment of Gout. The patient must undertake a fast for five to seven days on orange juice and water. Sometimes the condition may worsen in the early stages of fasting when uric acid, dissolved by juices, is thrown into the bloodstream for natural elimination. However, this usually clears up if fasting continues. In severe cases, it is advisable to undertake a series of short fasts for three days or so rather than one long fast. A warm water enema must be used daily during the period of fasting in order to cleanse the bowels.
After the acute symptoms of Gout have subsided, the patient may adopt an all-fruit diet for further three or four days. In this regimen, he must have three meals a day of juicy fruits such as grapes, apples, pears, peaches, oranges and pineapple. After the all-fruit diet, the patient may gradually embark upon eating fruits for breakfast, steamed vegetables such as lettuce, beet, celery, water cress, turnips, whole wheat flour, cottage cheese and butter during lunch. For dinner he can have sprouts such as alfafa and mung beans, salads and raw vegetables, whole wheat bread and butter. Alfafa prevents the deposition and future conditions of Gout. It is the best and natural cure for Gout.
The patient must avoid all purine and uric acid producing foods such as meats, eggs and fish. Glandular meats are especially harmful. He must also avoid all intoxicating liquors, tea, coffee, sugar, white flour products and all canned and processed foods as these will not help him to get rid of Gout naturally. He must eat very little spices and salts.
Cherries have been miraculously found to be very effective in treating Gout naturally. To start with, the patient must consume ten to twenty five cherries a day to naturally cure the ailment. Foods high in potassium such as potatoes, bananas, leafy green vegetables, beans and raw vegetable juices are helpful in the natural removal of Gout. Carrot juice, in combination with juices of beet and cucumber, is especially valuable in healing Gout naturally at home. The juice of French or string beans has also proved very effective to get rid of Gout. Raw potato juice and fresh pineapple juices are also beneficial.
The feet of the patient must be bathed in Epsom salt foot baths twice a day. Half a pound to one pound of salt may be added to a foot bath of hot water. Full Epsom salt baths must also be taken three times a week. The baths may be reduced to two per week later. Cold packs at night, applied to the affected joints will be beneficial. Fresh air and outdoor exercise are also essential in naturally curing Gout. The patient must try and eliminate as much stress from his life as possible.
You can also boil one teaspoon of pepper in one cup of vinegar and one cup of water, dab this mixture onto the painful joint and leave it on for two or three hours. This is the best natural remedy for treating Gout.
Safflower has excellent natural healing properties. Take it in capsule form to hasten your natural healing process. This is one of the most useful and natural Gout home remedies. Bananas also help in naturally banishing uric acid from the system.