Patients with longstanding hyperuricemia can have uric acid crystal deposits called tophi (singular: tophus) in other tissues such as the helix of the ear. Uric acid stones commonly also form in the kidney.
Symptoms thus almost always include an excruciating, sudden burning pain, redness and swelling in joints (particularly the big toe); occasionally, low-grade fever, nausea, flatulence, vague and travelling abdominal pains, loss of appetite, constipation and highly colored and scant urine may be seen. Causes may include an impairment of digestion due to intake of incompatible foods (particularly an excessive intake of proteins), non-elimination of metabolic wastes from the body, hereditary factors, age and gender (rarer in females), and climate. In terms of treatment, the first choice is for treatment via an alteration of dietary regimen.
Low oxalate and low-uric acid forming foods and a low meat diet is to be encouraged. High fiber, low protein foods should be emphasized, old rice (but not fresh rice), wheat, moong dal, garlic, onion, bitter gourd, papaya and green banana are beneficial. Sour and salty tasting foods and heavy and fried foods are to be avoided. Rhubarb is a specific food remedy for gout, as are sweet cherries and their juice. It is critical in the treatment of Gout that the patient is kept well hydrated.
Herbal medicines specifics for the treatment of gout include Lashun (Garlic), Guggul (Commiphora mukul) and Shallaki (Boswelia serrata) as well as Guduchi (Tinospora cordifolia) the last of which is applied in all conditions of aggravated ranjakapitta and pitta in the blood. The compound of Sunthi (Ginger), Kumari (Aloe vera) and Guduchi is a specific and especially effective formulation commonly used in treating gout.
In terms of lifestyle management, the patient should not perform any fast-paced exercise, but moderate exercise is to be encouraged, and idleness and a sedentary lifestyle avoided. Exposure to cold wind and rain, and cold-water bathing are strictly contra-indicated. Abhyanga is beneficial and the yoga asanas known as the Forward Bend and Lotus positions are particularly useful in treating gout.
