GOUT
Gout is a disease where uric acid breakdown is affected in the body. Needle-like uric acid crystals (monosodium urate) collect in the joints anywhere in the body. Hence, gout is also known as crystal-induced arthritis.
Some uric acid is derived from a food substance in the diet known as purines, but the more significant part is produced by our bodies daily. In gout, the average balance is lost—too much uric acid is produced by the body or too little is excreted. (Normal uric acid level in the blood is 3.0 to 6.0 mg per 100 ml).
When uric acid in the blood and body fluids increases (hyperuricemia), uric acid in the fluid around the joints (synovial fluid) forms crystal deposits and gout results, typically in the joint at the base of the big toe. Gout can also affect the knee, ankle, foot, hand, wrist and elbow. Gout generally occurs in three phases:
• Sudden joint pain and swelling attack that goes away after five to ten days.
• period when there are no symptoms.
• Pain and swelling that comes and goes, and the development of deforming deposits called tophi, which come on later.
90% of gout sufferers are men older than 40; 1 in 4 is a family history of the ailment. Gout has long had a reputation for being an illness that results from the excessive consumption of food and drink, but gout is also known to strike at any time and for no apparent reason.
People who are obese or suffer from hypertension may be at greater risk for crystal-induced arthritis. The stress of an injury, such as a fracture or a surgical procedure, may provoke an attack. Thiazide diuretics, a standard treatment for high blood pressure that reduces the body’s water content, may raise uric acid levels in the blood and provoke gout in the susceptible person.
Gout is a type of arthritis affecting the synovial tissues. It is a metabolic disorder involving hyperuricemia (increased uric acid in the blood). Problems with increased uric levels may be a result of excessive production or inadequate renal excretion of uric acid. The other situations or conditions that may also contribute to increased uric acid are:
• Recent injury/surgery
• High purine diet
• Excessive alcohol intake
• Infection
• Medical illnesses such as stroke and heart attack
DIAGNOSIS OF GOUT
Gout affects men significantly more, particularly in the age range of 40 to 60. It is signified by severe pain that invariably strikes suddenly in a single joint, often at the base of your big toe. An accompanying swelling and redness may also be observed.
Physicians diagnose gout by physical examination and medical history. The doctor may also take a blood test to measure the amount of uric acid in the blood. However, the blood test results are not conclusive. The doctor may have to remove fluid from an affected joint and examine it for crystals. The primary diagnostic tests include examining:
• Serum uric acid levels.
• Aspirating joint fluid to determine if monosodium urate crystals are present.
• Examine nodules (tophi) typically seen with gout for the presence of monosodium urate crystals.
TO CONTROL GOUT
There is no cure for gout, but it can be controlled. Proper treatment can help to avoid severe attacks and long-term joint damage. Treatment consists mainly of taking medication and watching your diet. The goals of treatment are to relieve pain, prevent future attacks and prevent joint damage.
• Attacks of gout have been known to be triggered by— drinking too much alcohol, overeating the wrong food, surgery, a sudden severe illness, crash diets and sometimes injury to a joint. Doctors may recommend that people with gout avoid certain foods high in purines, such as fish, gravies, eggs, peas, lentils, dry beans and red meat (mutton, beef and pork as opposed to chicken—all being high in purines) and liver.
• Also eliminate caffeine and white sugar, which increase pain and inflammation.
• Being deficient in specific nutrients can provoke an attack. So, essential nutrition and a prescribed intake of multivitamins and multi-mineral tablets are vital. Antioxidants like vitamins A, C, and E and enzymes play a vital role in controlling gout.
• Avoid niacin (vitamin B6 ) in your multivitamin supplementation programme. Niacin increases inflammation. Instead, use a multivitamin that contains niacinamide, a niacin derivative.
• People who take antibiotics for long periods or have Candida infections may have an increase of uric acid in the blood. So, replacing the micro-flora is advisable. Keep a diet of only raw fruits and vegetables. No cauliflower or spinach. Do this for at least 2 or 3 weeks. Fresh juice is good. Grains, seeds, and nuts are also recommended.
• Avoid fried foods. Roasted nuts or other foods that may have oil that has been heated or cooked. These oils become rancid when heated, and that rapidly destroys Vitamin E. When that happens. There is an increase in uric acid.
• Increase fluid intake as this will help flush the system of uric acid. Six to eight pints of filtered drinking water is best.
• Avoid all alcohol (including beer and wine). Alcohol increases the production of uric acid.
• If you are overweight. Lose the excess. That will lower serum uric acid levels. Exercise to lose weight. But avoid pain. Stretching, low-impact, or water aerobics can help.
AVAILABLE DRUGS FOR GOUT
Some drugs can be prescribed. But they may have their complications and side effects.
• Uricosuric drugs that lower the uric acid level by increasing the amount of uric acid passed in your urine. Allopurinol reduces the amount of uric acid in blood and urine by slowing the rate at which the body makes uric acid. But allopurinol is known to inflame blood vessels and cause problems with toxins in the liver. It has been known to cause sores on the skin. When taking this, people with a history of kidney trouble should be carefully watched by their doctor.
• Cortisone, a steroid, is prescribed for severe attacks, adding to the already stressed adrenal glands. Nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin-like drugs that help pain and swelling, include Colchicine which is used to prevent and reduce attacks. It is reported by many people to have serious side effects. Taking it in large amounts and for long periods can be toxic.