Gout

Arthritis can be complex sometimes when it affects more than one joint or the big toe. It is characterized by severe pain, swelling, redness & tenderness. This form of arthritis can affect any individual & is termed Gout. The joints affected will show severe inflammatory signs like pain, swelling & redness. It can even wake a person in the middle of the night during sleep.

Causes

When urate crystals get accumulated in the joint, there is marked swelling, redness & inflammation signs. If the bloodstream contains higher amounts of uric acid, it may lead to the formation of urate crystals in the joints. Uric acid is formed by the breakdown of purines.

Purines are found in red meat, tuna, beer, mussels, anchovies, sardines, shellfishes, & trout. Uric acids that are formed in the body are filtered through kidneys & excreted through urine. But when the quantity of uric acid produced is more, there will be difficulty in excretion. This causes the accumulation of uric acid in the body joints as urate crystals.

Some of the major risk factors identified are age, overweight, certain medications, family history, metabolic disorders, feeding, trauma, or any recent surgeries.

Symptoms

It can affect toe, ankle, knee & elbow joints. The symptoms worsen from the first 4 to 12 hours. The symptoms are characterized by swelling redness, hotness, reduced mobility & persistent discomfort.

Ayurveda perspective

In Ayurveda science, gout is referred to as vataraktha. By following Vata-rakta vitiating foods & activities, like cold foods, excessive physical activity, fermented food products, processed & dry foods, Canned foods, processed artificial meat & drinks. All these causes the vitiation of vata & raktha dosha. The vitiated doshas circulated through the body channels. As the blood itself is vitiated, it blocks the vata path.or way. Both obstruct the functions of each other. They localize in the joints & cause the pitta dosha to vitiate. And then the inflammatory signs are shown in the disease.

Types

Gout can be of 2 types based on the severity

Uttana– doshas are very superficial limited to skin & muscles. The symptoms are different types of pain associated with discoloration.

Gambheera– deeply seated doshas, & affects the deeper tissues with the complexity of symptoms

Management protocol

The treatment involves an integrative approach of avoiding an unwholesome diet as well as medications. It includes internal purification therapies like panchakarma, & pacifying therapies, shamana therapies. Panchakarma therapy involves the elimination of body toxins through purgation as well as an enema. It also has a significant effect on reducing inflammation also. The recommended herbs are Vata- raktha pacifying & reducing inflammation.

Since rakta & pitta are involved, virechana is recommended, with warm milk or castor oil in milk.

Medicated enema or vasti, both oil enema & Kashaya enema re best indicated in vatarakta.

In severe cases, bloodletting therapy is indicated to remove the impure blood & relieve toxins.

External therapies like massage, pouring medicated water, & applying pastes are also beneficial.

Shamana treatment has to be followed next depending upon the stage of the disease & the condition of the patient. Various Kashaya yogas, as well as other preparations, are greatly recommended in the treatment of gout.

Triphala kashaya with honey, medicated milk prepared from dasamoola, hareetaki choornam, kokilaksha kashayam, Guduchi kashayam with ghrita in Vata predominance, in sugar in pitta predominance, with honey in Kapha disorders. Along with castor oil, it is advised in severe cases of vata raktha.

Dos & Don’ts

Avoid processed meat like sausages, smoked meat, fermented meat, alcoholic beverages etc.

Drink a good quantity of water to enable proper urination

Limit the use of red meat & shellfishes, even after the recovery

Eat easily digestible foods & a low-calorie diet

Check weight frequently & maintain it in a safe range.