A disease of the joints due to an excess of uric acid in the blood.

 

Causes of Gout

Somewhat unfairly, gout has the image of a self-inflicted disease, the result of overindulgence on heavy wines and red meat. In fact, most cases have little to do with lifestyle.

The condition is due to excess uric acid within the body. Uric acid is produced by the digestion of protein and is usually excreted in urine. If the blood contains too much uric acid, it can crystallize inside the joints, the earlobes and the kidneys.

People who have gout nearly always have an inherited tendency to high blood levels of uric acid. There arc certain drugs that can increase uric acid levels, notably thiazide diuretics used to treat high blood pressure such as bendrofluazide. A much less common cause is anything that increases cell turnover, and therefore protein load; this includes certain forms of leukaemia.

Those with a tendency to gout may indeed find that overindulgence in rich foods or alcohol brings on an attack, probably by giving a little more protein than the body can handle. The disease is very unusual in women. It is most common in middle-aged men; finding it in a young person should prompt a search for an underlying blood disorder.

Symptoms of Gout

The most common initial symptom is sudden and extreme pain in one joint – most often the big toe, although any joint can be affected including the knees, elbows and shoulders. The pain is a result of crystallization of uric acid within the joint, which becomes swollen, hot and reddened, and tender to the slightest movement. Pain lasts for several days.

After repeated attacks the joints become misshapen and stiff. Crystals also precipitate in the ear lobes and the tissues around joints. Crystals may form within the kidneys, affecting kidney efficiency. These complications are unusual nowadays because the disease is recognized early and treatment is straightforward. The diagnosis is confirmed by finding high blood levels of uric acid, or by showing that fluid from an affected joint contains crystals of uric acid.

Treatment of Gout

Immediate relief is the first priority in the treatment of gout and this is effectively given by an anti-inflammatory drug such as ibuprofen, indomethacin or diclofenac but not aspirin.
Failing that, one old remedy for gout is colchicine, although this does tend to cause diarrhoea as a side effect. It is important to review any medication people with gout may be taking in case certain drugs are to blame and, if so, to stop or alter their dosage. A blood count will detect the rare blood disorders that can cause gout. Some adjustments to lifestyle may be sensible, especially reducing alcohol intake and being cautious about rich foods.

Many people with gout have only occasional attacks, which are adequately handled by pain relief alone. However, if attacks are frequent, if there is kidney damage or if the blood uric acid is persistently very high, then long-term treatment usually becomes advisable. Allopurinol is the mainstay. This is a drug that increases the output of uric acid in the urine by making it into a more water-soluble form. Taken just once a day and with few side effects, allopurinol now makes the complications of gout a thing of the past for the great majority of sufferers.

Complementary Treatment

Western herbalism remedies containing celery seed can speed up uric acid excretion, helping to reduce pain and inflammation. Celery seed is particularly useful in cases of recurrent gout. Chakra balancing can be used for pain control. Hypnotherapy can be used for pain relief, and to change unwanted patterns of behaviour. Possible Ayurvedic treatments include panchakarma detoxification, oral medications and diet. Other therapies to try: Chinese herbalism; homoeopathy; cymatics; autogenic training.