Gout

Gout

Ques : 1          What is Gout disease?        

Ans :               This is an inborn error of purine metabolism characterized by pain and swelling of first metatarsophalangeal joint initially, followed by other joints with high blood uric acid level.

Ques : 2          What are the causes of Gout?

Ans :               The exact exact aetiology is unknown. The probable causes are

  • Usually above 40 years.
  • Hereditary factor or congenital.
  • Sedentary life.
  • Mostly males.
  • Excessive intake of purines.
  • Temperate climate.

 

Ques : 3          What are the clinical features of the two types of gout?

Ans :               (1) Acute.  (2) Chronic.

Acute : Onset – sudden.

  1. Premonitory symptoms – nausea, vomiting, flatulence, abdominal pain, renal colic or polyuria etc.
  2. Predisposing factors – trauma to joints, infection, surgery, cold drugs etc.

Symptoms –

  1. Affected metatarsophalangeal joint, ankle, knee, hand.
  2. Aggravation at night.
  3. Locally excruciating pain, tenderness, swelling, veins prominent.
  4. Lymphangitis and cellulitis.
  5. Malaise, headache, tachycardia, fever with chill.

 Chronic –

  1. Gradually irreversible change occurs in joints, capsule, tendon, bursae etc.
  2. Recurrent attacks.
  3. Pain with stiffness and deformity of joints.
  4. Involving wrists, ankles, knees, elbows, shoulder, hips etc.
  5. Characteristic tophi occur in the lobes of the ears and around the finger joints. There are nodules of soft cheesy urates which often ulcerate.

 

Ques : 4          How can we diagnose Gout?

Ans :               Gout may be confused with rheumatoid arthritis and other inflammatory arthropathy. Diagnosis of gout rests with family history of gout, absence of uric acid in early cases and negative result in radiological examination. In later cases, however, high blood urea and characteristic radiological findings confirmed the diagnosis.

Ques : 5          Which tests and investigations can be useful?

Ans :               Investigations:

  1. Urine test – Volume diminished and high colour.
  1. Blood test – Leucocytosis, E.S.R. –high, uric acid level raised. 

Complications :

  1. Acute tenosynovitis, bursitis, supraspinatous tendinitis.
  2. Chronic pyelonephritis, renal failure.
  3. Diabetes mellitus.
  4. Renal calculus, renal colic. 

Prognosis :

In case of early diagnosis and proper treatment, the prognosis is favourable.

Ques : 6          What can be the possible treatments of Gout?

Ans :               A, Acute –

  • Hot or cold compress over the affected joints.
  • Rest in bed and immobilization of the affected part.
  • Vegetarian diet with plenty of fluids.
  1. Chronic –
  • Moderate exercise is also beneficial.
  • Diet-purine containing foods are to be avoided. Fast intake should be minimized to prevent obesity. Plenty of fluids should be taken.
  • Homoeopathic Remedies :
  • Treatment of complications.

Ques : 7          Which Homoeopathic Remedies are useful in Gout?

Ans :               (1) RHUS TOX- Rheumatic gout ; the joints are red, shining and swollen. Stiffness and lameness of affected parts. The pains are tearing, burning, or as if sprained. Worse on the first moving limp after rest, or during rest ; better by motion.

(2) ACONITE – Synochal fever. The parts affected are swollen red, shining. Tearing of stitching pains, less when moving the parts. The pains are intolerable at night, patient becoming desperate.

(3) ARNICA- Hard, red swelling of big joint. Violent pains as of sprained or contused, with a sensation as if resting upon something hard. Great fear of being struck or touched. Worse by moving parts. After mechanical injuries.

(4) BRYONIA – Red or pale tensive swelling, particularly of joints. Stitching and lameness of affected parts. The pains are tearing, burning, Or as if sprained. Worse on motion.

(5) COLCHICUM- It is the best drug for relieving the pain of acute gout.

 

Ques : 8          Which Biochemic Remedies are useful for Gout?

Ans :               (5) Biochemic Remedies :-

(1) CALC. FLUOR- Gouty enlargements of the finger-joints.

(2) NATRUM SULPH- In acute cases of gout. This remedy should be alternated with Ferrum Phos. In chronic gout it alone suffices. Gout in feet, acute and chronic.

(3) CALC. PHOS. – Rheumatic gout worse at night and in bad weather. Hyroma patellae.

(4) NATRUM MUR – Acute gout. Chromic gout, profuse, sour-smelling sweat. Urine dark red. Pains go suddenly to heart ; sore hamstrings.

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