Gout and Uric Acid Imbalance – Modern and Ayurvedic Perspectives

Abstract

GOUT is a well understood and described type of arthritis. GOUT is a picturesque presentation of uric acid disturbance. In epidemiological studies we see there are many people who are troubled by this disease. GOUT is an inflammatory form of arthritis which commonly affects the body’s smaller joints.In this there are 2 types which are hyperuricemia of metabolic origin or hyperuricemia of renal origin .The role of genetic predisposition is becoming more evident. Their diagnosis is based on radiological and laboratory features and also management of gout includes the management of flares, chronic flares and preventions as well as management of comorbidities. And other important points for management of gout include diet and lifestyle modification, avoid alcohol intake and also avoid sedation of hyperuricemic drugs.

Introduction

GOUT is an inflammatory arthritis that causes pain and swelling in the joints. Its attacks develop between your big toe or lower limbs. It happens when a high level of urate builds in your body over a long period of time but less to remove then this will form. It attacks where more than a week then it resolves. Inflammation and pain of joints is due to this.However there are more people with high serum urate could also be affected by this. It mainly affects big toe joints. It also affects other joints like feets, wrist, ankles and elbows.

Types

The types are divided into two:

1. Hyperuricemia of renal origin: Gout is the renal excretion of uric acid.
2. Hyperuricemia of metabolic origin: This group comprises about 10%  cases of gout which is characterized by excess production of uric acid.

Causes

GOUT is caused by having higher than normal uric acid in our body. This may occur if there is a high level of uric acid in your body and if your body has a hard time getting rid of it. When uric acid is built around the joints synovial fluids and uric acid crystals are formed. These crystals can cause inflammation, pain and swelling to the joints. The exact cause of GOUT is not known. The problem is mainly common in male and in women after menopause, and who drink excess alcohol. GOUT is most commonly seen in people with:

1. Obesity
2. Kidney disease
3. Diabetes
4. Anemia
5. Leukemia and other blood cancers.

Symptoms

1. Intense joint pain and reduces to discomfort which usually begins during night and interrupt sleep
2. Swelling stiff and warm
3. Generally developed at the base of big toe- Metatarsal joints. But it may develop elsewhere at the front of the foot or ankles, knees, wrist, fingers and elbow.
4. It can be acute with symptoms that come suddenly and also chronic with more frequent symptoms or flares.

Investigation

Test may be done it includes:-

1.   Physical examination
2.  Blood test: To measure uric acid in blood (TLC, DLC, HB%, ESR)
3. Synovial fluid Analysis
4. Synovial Biopsy’
5. Other Tests may include:Imaging tests like X-Ray, CT scan: specially dual    marker or MRI and Ultrasound.

Management

Lifestyle Modification

1. Low purine diet
2. Avoid alcohol intake
3. Exercise regularly
4. High fructose syrups
5. Avoid sugary drinks

Medication we use

1. NSAIDs: It helps to reduce inflammation and swelling during gout attacks commonly.
2. Corticosteroids: It commonly works to reduce pain and inflammation.
3. Colchicine: It is also used in treatment of gout reduces inflammation and pain in the body. It is used within 24 hours of gout attack. It is also very useful. It also causes vomiting and diarrhea.

Ayurvedic Overview

Ayurveda being the oldest established medical system of india. Its main aim is to promote health and prevention of many diseases.In ayurveda we correlate gout with vatarakta. Vatarakta disease is a special type of disease.In which vata and rakta get contaminated and give rise to pain and inflammation in the small joints of the body and both internal and external symptoms are arised this condition is called vatarakta disease.Due to modern medicine, the amount of uric acid in the blood increases and collected in joints in the form of urate crystals, causing gout and blood related disease. There are many treatments we will use in ayurveda which help to control our gout attacks and some of them are  less due to dietary changes. Vatarakta is classified into two types according to site and duration of manifestation.
Uttana vatarakta: The disease mainly affects the Twak (Skin) and Mamasa (Muscle) dhatu and present with some clinical symptoms like itching, Burning, superficial pain, pricking type of pain, tingling and spasm, deformities in the organs etc. Gambhira vatarakta: The disease affects the deeper dhatus of the body and symptoms are stiff and hard edema, severe pain in the internal part of edema, dark and copper colour skin, burning, pricking and boils in the joints. Firstly, Uttan Vatarakta will occur, if treatment is not done over a time it turns into gambhir vatarakta. Uttan and Gambhir Vatarakta can also occur together.

Dietary changes

1. Like eating a low protein diet
2. Avoid alcohol
3. Quit smoking
4. Avoid citrus fruits and dairy products.
5. Exercise and yoga
6. Avoid stress
7. Meditation

Lifestyle modification: Some changes in day to day life

1. Drink plenty of water
2. Doing exercise regularly
3. Reduce weight
4. Avoid items like red meat, seafood, organ meat and alcohol
5. Include strawberries, apples,pears, and papaya in your diet.

Ayurvedic Management for Gout

Ayurvedic treatment for Gout aims to restore vitiated vata dosha and Rakta dhatu to normalise

1. Raktamokshan (Blood letting therapy): This is the first and most effective procedure of vatarakta, the raktamokshana can be done by leeches, siravyadha etc. frequent blood letting in smaller amounts.
2. Snehan (Oleation therapy):  in this process medicated oil and ghee given internally.
3. Virechana (Purgation therapy): after the body is properly oelated , virechana can be administered using castor oil etc.
4. Vasti (Medicated enema): Vasti is the ideal treatment for normalising the vata dosha in our body. There are multiple types of Vasti that should be used in Vatarakta treatment.
5. Swedana (Fomentation therapy): Dhanyamla dhara, Patra pinda sweda, kashaya dhara etc.
6. YOGA Therapies:  Such as Surya namaskar, Ustrasana, Sarwangasana, Naukasana
7. Pranayam: Such as Nadi shuddhi and Kapalbhati etc.

Herbal Remedies for Gout By Planet Ayurveda

Planet Ayurveda is a GMP and USDA organic certified company. All their products are made in pure form and using natural herbs. They use the best quality of herbs in their medication. All the medications are prepared by expert doctors and follow the basic principles of ayurveda. These medications are free from chemicals and preservatives. There are many medications prepared for different diseases but in this disease we used GOUT CARE PACK for the treatment of GOUT.

Products Description

1. Kaishore Guggul

These classical tablets are made up of wonderful herbs like Haritaki (Terminalia chebula), Amalaki (Emblica officinalis), Ginger (Zingiber officinalis), Black pepper (Piper longum) and many other herbs. In this we mainly used Triphala which are used to remove toxins from the body. It reduces pain and swelling injoints. This is very useful for removal of lymphatic congestion and uric acid.

Dosage: 2 tablets two times a day with warm water after food.

2. Punarnava Capsule

These are in the form of a capsule which is prepared with single herb Punarnava (Boerhavia diffusa) and it really works on pain and swelling. It has anti-inflammatory or anti oxidant properties which helps in managing the uric acid. It also helps toreduce swelling around the joints and edema and also helps to remove toxins from the body.

Dosage: 2 capsules twice a day with warm water after food.

3. Giloy capsule

These are in the form of a capsule which is made up of real extract of Giloy (Tinospora cordifolia) herb. It has an anti-inflammatory property which helps in reducing pain and swelling of the body and other symptoms of gout. Also has antioxidant properties which improves our immune system and also clears the blocked channels of the body. Giloy capsules are also very useful in fever associated with this disease.

Dosage: 1 capsule Twice a day with warm water after food.

4. Navkarshik Churna

Navkarshik churna has a proper blend of natural herbs like Amalaki (Emblica officinalis), Bibhitaki (Terminalia billerica), Vacha (Acorus calamus), Giloy (Tinospora cordifolia) there are many other herbs which is useful for the treatment of gout . It has an anti oxidative property which helps to remove excess uric acid  from the body. This churna helps to balance Vata dosha and improves the immune system. This churna is very effective in painful and swollen joints.

Dosage: 1 tsp twice a day with warm water after food.

5. Dashmularish

Dashmularishta is a fermented syrup formulation and it involves 10 classical herbs like Agnimantha (Premna integrifolia), Sonapatha (Oroxylum indicum), Bilva (Aegle marmelos) etc. It is made up of hot potency herbs that pacify the aggravated vata dosha which is the main cause of Vatarakta. So it is very useful in the management of GOUT.

Dosage: 2 tsp twice a day with equal amount of water after food.

Conclusion

In this article we conclude a topic on gout in detail. As we know, it is chronic inflammatory arthritis that causes pain and swelling in joints after we studied or discussed types, symptoms and management and also we discuss here the ayurvedic overview or treatment which helps in reducing the uric acid or attacks of gout. Here we also take a very effective treatment from Planet Ayurveda. It is a GMP certified company which provides a GOUT CARE PACK for the treatment of gout.