Category Archives: Nephrology

Topics related to nephrology and homeopathic treatment for neurological disorders will be posted under this category.

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ANAEMIA

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Anaemia can be defined as decreased haemoglobin counts or reduced red blood cell counts or reduced oxygen carrying capacity of blood, due to “loss of” or “abnormality of” red blood cells or haemoglobin.

Normal Heamoglobin Counts

  • 6 months to 5 years of age > 11g/dl
  • 5 years to 12 years of age > 11.5g/dl
  • 12years to 16 years of age > 12g/dl
  • Adult Females (non-pregnant) > 12g/dl
  • Adult Females (pregnant) > 11gm/dl
  • Adult Males > 13g/dl

CAUSES OF ANAEMIA

  • Blood losss
  • Excessive Red Blood Cell destruction
  • Heamoglobinopathies
  • Hypovitaminosis B12
  • Hypoferremia
  • Anaemia of Chronic diseases
  • Autoimmune haemolytic anaemia
  • Inflamatory bowel diseases
  • Hypervolemia or water retention due to sodium or other salts.
  • Genetic hereditary conditions like Thalasemia
  • Certain cancers
  • Kidney diseases
  • Reduced erythropoetin production
  • Excessive RBC destruction
  • Impaired RBC production
  • Certain infections like malaria which causes RBC destruction.
  • Certain drugs which causes RBC destruction eg. Quinine causes chinchonism.
  • Bone Marrow lesions and pathologies
  • Etc.

CLASSIFICATION OF ANAEMIA

There are many types of anaemias. It can be broadly classified into 7 categories depending upon their causes

Anaemia due to

  1. Blood Loss
  2. Hemolysis
  3. Impaired or abnormal Erythropoesis
  4. Hypervolemia
  5. Chronic Diseases
  6. Nutritional deficiency

Based on RBC morphology it can be classified into 3 groups

  • Microcytic
  • Macrocytic
  • Normocytic

FEW COMMON and RARE TYPES OF ANAEMIA

  • Iron Deficiency Anaemia
  • Aplastic Anaemia
  • Megaloblastic Anaemia
  • Pernicious Anaemia
  • Sideroblastic Anaemia
  • Autoimmune Hemolytic Anaemia
  • Myelodysplastic Syndrome
  • Thalasemia
  • Fanconi Anaemia
  • Congenital Dyserythropoetic Anaemia
  • Daimond-Blacfan Anaemia
  • Myelopthisis
  • Anaemia of Prematurity
  • Erythroblastopenia or Pure Red Cell Aplasia
  • Hereditary Spherocytosis
  • Hereditary Elliptocytosis

SYMPTOMS

  • Weakness
  • Lethargy
  • In children it affects growth in general
  • Somnolence, Drowziness in day time
  • Disturbed sleep at night
  • Pallor, general pale appearance of skin, mucous membranes and eyes.
  • Dyspnoea on Exertion.
  • Reduced Immunity, tendency to catch infections and slow recovery and healing.
  • Bodyaches
  • Cyanosis in severe cases
  • Palpitations
  • Tachycardia
  • Low blood pressure
  • Chest pain
  • Depression
  • Craving for indigestible things , PICA
  • Cold clammy extremities
  • Oedematous swelling of extremities, dependent oedema
  • Angina or cardiac failure in severe cases
  • Will impact general growth and repair of all the vital organs and tissue of the body.

HOMEOPATHIC MEDICINES FOR ANAEMIA

Depending upon the cause of anaemia and general constitution of the patient, one of the following medicines may be called for duty by a homeopathic physician.

  • Ferrum Metallicum
  • Ferrum Phosphoricum
  • Cinchonna Officinalis
  • Natrum Muriatic um
  • Arsenicum Album
  • Abrotanum
  • Hamamelis Verginiana
  • Pulsatilla Nigricans
  • Janosia Ashoka
  • Crotalus Horridus
  • Lachesis
  • Acidum Phosphoricum
HOMEOPATHIC TREATMENT, Infectious diseases, Nephrology, Opthalmology, Orthopedic, Rheumatology, Urology

REACTIVE ARTHRITIS

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Reactive Arthritis was also called Reiter’s Arthritis is RF-negative and HLA-B27 Linked Imflamatory oligoarthritis typical with Enthesitis, accompanied with Inflamatory occular and/or inflamatory genitourinary and other systemic manifestation usually post gastrointestinal or genitourinary infection.

During world war one and two many cases emerged with the Triad of Symptoms viz. Inflamation of Joints, Inflamation of eyes and Inflamation of Uretha. Which drew attention of medical community due to common presentation in many giving it some syndrome like picture. On further investigations it was found out that most of them were exposed to urogenital or Gastro-intestinal infection 1-4 weeks prior to onset of this Triad of Symptoms. This was initially termed as “Fessenger-Leroy-Reiter’s Syndrome” or simply  “Reiter’s Syndrome”. But as the physician Hans Conard Julius Reiter  was involved in attrocities and war crimes with Hitler, so his name was removed and later renamed and termed as “Reactive Arthritis”.

EPIDEMIOLOGY OF REACTIVE ARTHRITIS

  • AGE – It more frequently affects age group of 20-40 years.
  • SEX – It is more common in Males then in Females.
  • ETHNICITY – Due to its association with HLA-B27 it is frequently found in white race compared to dark race as comparatively HLA-B27 occurs more commonly in white population.
  • RISK FACTOR – Person with HIV positive status are more prone to develop reactive arthritis.

SIGNS AND SYMPTOMS OF REACTIVE ARTHRITIS

The onset of symptoms of Reactive Arthritis typically starts 4-35 days after an initial infection of gastro-intestinal system or genito-urinary system.

TRIAD OF REACTIVE ARTHRITIS

Reactive arthritis in most of the cases presents where patient cant – SEE, PEE, climb the TREE! due to following Classical Triad of Symptoms of reactive arthritis

i) OLIGOARTHRITIS

Oligoarthritis involving less than five joints. It may frequently involve knee and sacroilliac joint as well. May present itself in additive pattern where it starts with one joint and add another joints subsequently or it may be migratory in pattern where the set of inflamed joints keep changing by addition and simultaneous substraction of joints involved.

ii) NON-GONOCOCCAL GENITOURINARY INFLAMATION

Inflamation of genitourinary system classically presents itself at the onset of the disease. Not always but in many its typically after initial sexual exposure. It presents as frequent burning micturation, uritheritis, prostatitis, balanitis in men and salpingitis, vulvitis and vaginitis in women.

iii) OCCULAR INFLAMATION

Occular Inflamation may present itself as mild conjunctivitis or uveitis in 75% of cases with gastrointestinal origin and 50% of cases with urogenital  involvement. patients have intermittent irritation in eyes with blurred vision typically commences at onset of disease.

OTHER SYMPTOMS

  • Few patients also presents with peculiar symptom which is specific to reactive arthritis, its Keratoderma Blenorrhagica which are small hard nodule commonly appear on soles occasionally on palms and rarely on other parts of body subcutaneous nodules are not incluced. Even in absence of above mentioned triad of symptom the presence of Keratoderma Blenorrhagica is diagnostic for reactive arthritis.
  • In reactive arthritis; typical to HLA B27 related immunological reactions; involves Entheses that is where skeletal muscles attaches with bones through tendons, where it causes Enthesitis and tendon inflamation especially the tendo-achilles and also fascia in particular Plantar Tendinitis.
  • Occasionally patients also suffer from dactilitis giving finger sausage-like apperance “sausage finger” due to inflamation.
  • Mucocutaneous involvement presents as ulcerative or non ulcerative stomatitis, apthous ulcers and geographic tongue are also seen as presentation of this disease
  • Cardiac involvement causing pericarditis and aortic regurgitation in cases which do no recover soon or if its recurring or progressive.
  • Gastrointestinal manifestation like pain and cramps with frequent semiformed stools with mucous and insome cases blood due to  inflamation and ulcceration in gastrointestinal tract.

Most of the cases of Reactive Arthritis recover within six months, in many cases it keeps comming back time and again and in few it becomes chronic and progressive which may increase risk of severe complications.

COMPLICATIONS OF REACTIVE ARTHRITIS

In chronic progressive and recurring cases the patient may develop following complications

  • Ankylosing Spondylosis
  • Disabling Arthritis
  • Aortitis
  • Aortic Regugitation
  • Conduction defects of Heart
  • Pericarditis
  • Amyloid deposits
  • Immunoglobulin A Nephropathy

CAUSE OF REACTIVE ARTHRITIS

Reactive Arthritis is is HLA B27 linked inflamatory arthritis and enthesitis preceeded by a spell of infection either of genito-urinary system  or gastro-intestinal system by following commonly involved organisms

GENITO-URINARY INFECTIONS ASSOCIATED WITH REACTIVE ARTHRITIS

  • Chlamydia Trachomatis
  • Ureaplasma Urealyticum

GASTRO-INTESTINAL INFECTIONS ASSOCIATED WITH REACTIVE ARTHRITIS

  • Salmonella Spp.
  • Shigella Spp.
  • Campylobacter Spp.
  • Yersinia Spp.

4-35 days after the spell of urethritis or food poisoning by above mentioned organisms the symptoms of reactive arthritis sets in, where the synovial fluid has negative culture ans is free from infection and but the HLA B27 linked  inflamation is thought to be triggered due to

  • Autoimmune reaction due to cross reactivity of micro-organism antigen with joint tissue  or
  • Micro-organism antigenic components that may have settled in joint tissue.

DIAGNOSIS OF REACTIVE ARTHRITIS

Clinically the Reactive Arthritis can be diagnosed with help of Sensitivity and Specificity Guidlines laid down by American College of Rheumatology, for clinical diagnosis with given set of presenting symptom, its as follows

  1. Arthritis > 1 month with Urethritis and/or cervicitis has  sensitivity of 84.3% and specificity of 98.2%.
  2. Arthritis > 1 month with Urethritis or Cervicitis or bilateral Conjunctivitis has Sensitivity of 85.5% Specificity of 96.4%.
  3. Arthritis, Urethritis and Conjunctivitis has Sensitivity of 50.8% and sensitivity of 98.8%.
  4. Arthritis > 1 month, Conjunctivitis and Urethritis has Sensitivity 48.2% and Specificity of 98.2%.

Patients falling in above criteria or those showing just Keratoderma Blenorrhagica without any other symptoms and other suspected cases can be sent for following test for further evaluation.

  • HLA B27 testing
  • Urine routine and culture
  • STOOL Routine and culture
  • Throat swab culture
  • Cervix and Urethral swab culture
  • Erythrocytes Sedimentation Rate
  • C-Reactive Protein Test

HOMEOPATHIC TREATMENT FOR REACTIVE ARTHRITIS

Being an immune mediated systemic reaction that too the one that is triggered with different causative agents and even to same agents different individuals will respond differently.

Though they may have same set of general symptoms like the classical triad of reactive arthritis but intensity of each of the symptom of triad will differ in each individual,

Now this is where the homeopathic individualisation process starts. In Homeopathy we believe that though majority of human genome is the same but the minor variations in gene and the epigenome make the whole lot of difference in various characteristerics of each individual, similarly their immune reaction also varies, so every person should have individualised medicine.

Homeopathic Treatment is based on symptom similarity and individualisation of case based on peculiar symptoms based on which the case is individualised and medicine is selected.

Alternatively as per Homeopathic principle of Genus Epidemicus or pathology based symptomatology there can be disease specific homeopathic medicine derived from common symptomatic representation of a disease condition in a group of population.

Now this can not be the most similimum homeopathic prescription but roughly it can hit the disease condition within an indivudual though not accurate but will yeild some results in most of the cases.

To yield best homeopathic results there can be no generalised common approach for all cases.

But still if we have to attempt common standardised pathology based approach then to give some guidelines on homeopathic approach towards cases of reactive arthritis I have attempted following rough guidelines which may help to give some vision in approach towards such cases.

Its seen that in few case it begins after gastro-intestinal infection and in some case post genito-urinary infection. So this will further guide determining “morbid cause” behind the disease directing us in homoeopathic similimum medicine selection.

Now reactive Arthritis shows a triad of symptom in most of the cases. So this triad helps us to reach to group of medicines with such combination of symptoms.

Intensity, occurance of symptoms and its sequence in triad differs in each individuals. For example

  • In some person urogenital symptoms may be more severe compared to occular symptoms or arthritis symptoms, where as in others arthritis and ocular symptoms would be more severe than urogenital symptoms.
  • Some may not have occurence of  conjunctivitis
  • In some all three triad occur at a time where as in some patients it may occur gradually one after another in different sequence.

All this helps us find out the “seat of disease” in an individual and its degree of affinity towards various organs which can be related to homeopathic medicines during selection process.

Further arthritis may show different pattern like

  • progressive
  • migratory
  • additive
  • symetry
  • predominantly involved joint
  • sequence of joint involvement
  • number of joints involved
  • severity
  • intensity
  • type of sensation and other symptoms

Also similarly symptoms of occular involvement and urogenital involvement should be take in to account in absolute detail. This further helps refine and classify the patient and the respective medicines to be repertorised.

Which other systems and organs are involved like mucous membranes, skin, heart, kidney etc and what type of pathology they are showing like tissue destruction or just inflamation and functional disturbance or tissue lysis with regenerated and degenerative changes this will help to decide what “type of miasm” is underlying wether its psoric, syphillitic or psychotic type pathology.

Certain symptom are very “peculiar” for the  disease and occurs in few individuals like Keratoderma Blenorrhagica eruption, now location of this eruption will further help individualise the case.

Enthesitis – Inflamation of tendo-achilles and plantar fascitis is  “very specific” to the disease but does not occur in all individuals, so if plantar fascitis or inflamation of tendo-achilles if occurs in someine with this disease then it helps further in individualisation of during homeopathic medicine selection.

Other than this the general health and family background should be noted to derive  constitutional types and association of HLA B27 in 75% of this individual further helps in individualisation and homeopathic medicine selection.

COMMONLY USED HOMEOPATHIC MEDICINES FOR REACTIVE ARTHRITIS

  • PHOSPHORUS
  • ARSENICUM ALBUM
  • RHUS TOXICODENDRON
  • BRYONIA ALBA
  • LEDUM PALUSTURE
  • THUJA OCCIDENTALIS
  • ANTIMONIUM CRUDUM
  • ARGENTUM NITRICUM
  • BORAX
  • MERCURIOUS SOLUBILIS
  • PULSATILLA NIGRICANS
HOMEOPATHIC TREATMENT, Infectious diseases, Nephrology, Urology

URINARY TRACT INFECTION

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Urinary Tract Infection is an infection in any part of the urinary system i.e kidney, ureters, bladder and urethra.

Infection of the urinary tract is a very common and distressing condition.

Acute infections of urinary tract can be anatomically subdivided into two general catagories.
Lower urinary tract infection
Upper urinary tract infection

Infections at these sites may occur together or independently and may be asymptomatic or may present with clinical symptoms.

When there are recurrent infections it can be classified as relapses or reinfections. Most relapses are thought to result from unresolved prior infections.

CAUSES OF URINARY TRACT INFECTIONS

Many different micro organisms can infect the urinary tract, most common agents are the gram negative bacilli.

Ecoli causes approximately 80% of acute infections in patients and other organisms are proteus, klebsiella, enterobacter, pseudomonas, chalamydia etc.

PATHOGENESIS of URINARY TRACT INFECTION

Adhesion of bacteria is the first step in the pathogenesis of Urinary tract infectiion.

The entry of uropathogens into the urinary tract is usually from periurethral colonisation of females or often from prepucial colonisation of uncircumcised males. About 75% of organisms is distal urethra are a mixture of lactobacilli, streptococci, staphylococci, while remaining 25% are anaerobic. When the host defenses are weakened urtheral colonisation and mucosal adhesion of bacteria occurs.

Usually in a normal healthy individual a series of non specific and specific mechanisms prevent this process.

The non specific mechanisms are the flushing effect of urine, normal vaginal flora and tamm horsfall glycoprotein which complexes with bacteria and are eliminated through urine.

Circulating IgG and IgM in upper urinary tract act as specific immunological mechanisms.

Secretory IgA in the upper and lower urinary tract particularly the urethra provide a barrier to ascent of infection. In addition to humoral defence, cellular response also plays a role in preventing ascent of infection.

FACTORS INVOLVED IN THE PATHOGENESIS OF URINARY TRACT INFECTION

HOT SUMMER CLIMATE

There is lots of water loss from the body surface through pirspiration in form of sweat which causes depletion, it sufficient water is not consumed thos might lead to change in ph level of urine making it acrid which may excoriate the inner linning of urinary tract thus making it more sussceptible to infections.

LOW WATER INTAKE

Low water intake causes increase in concerntration of metanolites in urine making it more corrosive in nature to inner linning of urinary system thus damaging it and giving opportunity yo organsims to infect and colonise in urinary system.

DIABETES

High sugar levels are associated with infections as they not only reduce immunity but also provide with instant and easy source energy for micro-organosms to multiply and grow

IMMUNOCOMPROMISED INDIVIDUALS

Immunocompromised imdividuals especially those on therapy with drugs known to suppress immunity, individuals with Human Immunodeficiency Virus Infection, Diabetics and other immunodeficiency disease conditions provide easy breeding ground for opportunistic micro-organisms to infect immunocompromised tissue of urinary system.

PRE-EXISTING GENITAL INFECTIONS

Pre-existing genital infection may fimd route from genitals to urinary tract and may infect it as well which is more common in females also in females ots seen that skin infecyions of vulva may traverse intonthe urinaty system and may infect it.

FEMALE ANATOMY

Female are more prone to the development of Urinary tract infection. Women have a shorter urethra, wbich shortens the distance that bacteria must travel into the urinary tract. Gram negative enteric organisms risiding near anal region colonise the periurethral region and cause infections.

USE OF BIRTH CONTROL DEVICES

Women who use diaphragm as a birth control have a high risk of urinary tract infections.

MENOPAUSE

After menopause there is decline in the oestrogen level causes changes in urinary tract and that make a women more vulnerable to infections.

SEXUAL ACTIVITY

Sexually active women tend to have more tendency to have urinary tract infections, as the act facilitates the entry of introital bacteria into the bladder.

BLOCKAGES IN URINARY TRACT

Any impediment to free flow of urine as with renal calculi, strictures,, tumors, prostatic hypertrophy favour the development of Urinary tract infections.

URINARY TRACT ABNORMALITIES

Babies born with urinary tract abnormalities that hinder the flow of urine to leave the body normally or cause urine to back flow urine up in urethra have a increased risk of Urinary tract infection.

CATHETHER USE

Use of catheters have a high risk of urinary tract infections. This may include in patients who are hospitalised, amd im some cases it also advised on daily basis especially in patients with urethral stricture, patients who are having neurological abnormalities, paraylsed patients which make it difficult to control their ability to urinate.

CLINICAL FEATURES OF URINARY TRACT INFECTION

The clinical features depend on whether the infection is on upper tract or lower tract.

CYSTITIS OR URETHRITIS

Infection in bladder is common in women during thier reproductive years. Patient with cystitis or urethritis may be asymtomatic or may present with frequency, urgency, suprapubic pain and dysuria, nocturia, urge incontinence, a sensation of incomplete bladder emptying may accompany lower urinary tarct infection.
The urine may have offensive odour and haematuria occurs in 30% of cases. On physical examination usually reveals mild suprapubic or urethral tenderness.

PROSTATITIS AND SEMINAL VESICULITIS

The usual symptoms of prostatic infection are frequency, dysuria, perineal or groin pain, difficulty in voiding urine and painful ejaculation. Relapsing urinary tract infections are associated with above symptoms in men are suggestive of chronic bacterila prostatitis.

ACUTE PYELONEPHRITIS

Emphysematous pyelonephritis is a particularly severe form of upper urinary tract infection.

Symptoms of acute pyelonephritis include fever with chills, nausea, vomiting and diarrhoea.

Physical examination reveals tachycardia, myalgia, renal angle tenderness. Most patients have significant leucocytosis and bacteria detectable in gram stained urine.

CHRONIC PYELONEPHRITIS

Chronic pyelonephritis is known to develop as a result of infection and vesicoureteric reflex. It is a form of upper urinary tract infection. Many patients remain asymtomatic for a long time and present with symptoms later.

ROLE OF HOMOEOPATHY IN TREATMENT OF URINARY TRACT INFECTION

Homoeopathy plays a very significant role in the management of Urinary tract infections. In homoepathy we adopt a holistic approach to Urinary tract infection with a detailed case analysis and individualisation of each patient.

FEW INDICATED HOMOEOPATHIC REMEDIES

CANTHARIS

Cantharis has main sphere of action on the genito urinary system.Indicated in case of urinary tract infection. Cantharis patient has intolerable urging and tenesmus. Frequent urge to pass urine. This is one of the important symptom which points towards cantharis. There is intense burning and cutting pain during urination. Severe back pain, violent paroxysms of cutting burning pain in whole renal region. Urine scalds and is passed drop by drop.

STAPHYSAGRIA

Staphysagria is more commonly indicated in Urinary tract infections in female. Suited to women who are newly married and have ineffectual desire to urinate, as a result of sexual activity.,often known as honeymoon cystitis. Presents with burning in urethra while urinating. Feeling of pressure on the bladder with sensation as if undone completely. Sensation as if drop of urine is rolling continously along urethra. Prostatic enlargements which cause infections in urinary tract can also be very well managed with Staphysagria.

BENZOIC ACID

Benzoic acid is indicated remed in urinary tract infections, when there is a very strong smell in urine, the odour is as if that from horse urine. Another strong symptom that indicates Benzoic acid is intense pain in urethra. Also indicated in cystitis. The complaints of benzoic acid are changeable. When the urine is scanty or light he suffers from backache and pain in joints. When the urine is copious and plenty and urine is full of deposits he feels better. Presents with alternate light and heavy urine.

APIS MELLIFICA

Apis mellifica acts on the urinary system and presents with burning at the end of urination. The urine may be scanty,despite scanty urine the patient has constant urge to urinate. Urine is dark coloured or muddy. Presents with burning and soreness when urinating. A great anasarca appears and the face is swollen with bags under eyes. Great agony in voiding urine. Unconcious flow of urine.

SARSAPARILLA

Sarsaparilla acts through the ganglionic system upon the genitourinary system . Its is one of the indicated remedies in irinary tract infection when urine is either too often or too copious pale and scanty. There is much pain at the conclusion of passing urine, which is almost unbearable. Patient has to wake up two to three times at night to pass urine. Pain in the bladder region or lower abdomen extends to back.

BERBERIS VULGARIS

Berberis vulgaris has affinity towards the genito urinary system. Berberis is indicated in urinary tract infections. Cystitis with twings of cutting pain or burning sensation that extends towards the urethra and its opening may indicate the need for this remedy. There is no desire to urinate. After emptying the bladder the patient feels some urine is left inside, undone sensation. There are irregularities of urine, with copius discharges. There is Changeability of urine like benzoic acid.

LYCOPODIUM

Lycopodium is one of the indicated remedy in urinary tract infection. A marked feature or one of the prominent feature of lycopodium is polyuria during night must arise at night and pass large quantity of urine.,altough day time urine is normal. Painful urge to urinate, but has to strain to pass urine. Pain is felt at the back before passing urine. Flow of urine is slow and with feeble stream. The urine is often muddy with brick dust or with red sand deposits.

SULPHUR

Sulphur has a important role in urinary tract infection. The patient has unsual desire to pass urine at night. The most characteristic symptom that indicates the use of sulphur is great burning sensation while passing urine. Frequent micturation, enuresis. Mucus and pus in urine, parts sore over which it passses. Has sudden call to urinate must hurry. The urine scalds the urethra while passing urine and smartine is so intense that it lasts for a long time after urination.

CLEMATIS ERECTA

Clematis has main sphere of action on the genito urinary tract. Its is very effective for urine infections in patients who have suffered from sexually transmitted disease. Slow inflammation of urethra will infilterate and urethra feels like a large whip cord, painful on pressure. Patient cannot emtpty bladder completely. He has undone sensation, when he appears to have finished urinating, it wil keep dribbling often. Presents with frequent scanty urination.

PREVENTIVE MEASURES IN URINARY TRACT INFECTION

Some useful steps to reduce your risk of Urinary tract infections

Stay hydrated, drink plenty of liquids. Drinking enough water helps to dilute your
urine and hence ensures that you will urinate more frequently allowing the bacteria to be flushed from your urinary tract.

Urinate frequently, do not hold urine when you need to urinate. Holding urine when you need to evacuate can help the bacteria present that may develop into infectiions.

Emtpty your bladder soon after intercourse and drink enough water to flush out the bacterias.

Maintain good hygeine. Keep genital area clean, after urinating and bowel movement always clean the area from front to back by doing so it wil prevent bacteria in anal region from spreading to vagina and urethra.

Avoid using scented feminine products and use of douches, diaphragms which can cause irritation and infections which contribute to bacterial growths leading to urinary tract infections.

Wear comfortable cotton undergarments as other fabrics can trap moisture creating a potential breeding for bacteria. Avoid tight clothing.

HOMEOPATHIC TREATMENT, Nephrology, Nutrition, Urology

Dietary Calcium Intake Reduces Kidney Calcium Stones!

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Dietary Calcium Reduces Calcium Oxalate Stone Formation in Kidney!

Frequently we find many doctors eliminating dietary calcium intake levels to alarming low levels in cases of urinary stones, thinking that calcium is the main culprit in formation of renal stones! Knowing not that reduced dietary calcium intake may actually trigger calcium oxalate stone formation even further and spoiling the case, as not only low dietary calcium intake will trigger calcium oxalate stone formation but also it will affect bones joints muscles and other body physiology.

Unlike Supplimental calcium , Naturally occuring dietary calcium may actually reduce the risk of renal stone formation! But supplimental calcium is found to increase the risk.

Calcium Oxalate stones are the most common type of Renal stones found in 75% of all the cases of Renal Stones.

Naturally occuring Dietary Calcium binds with oxalate from food in gastro-intestinal tract to form Calcium Oxalate  in gastro-intestinal tract and thus reducing Oxalate absorption in blood and in turn reduces Oxalate concentration and excretion in urine thus reducing risk of forming renal stone. As Oxalate is 15 times more potent in forming renal stones compared to Calcium.

It is recomended to patients suffering from Calcium Oxalate stones that they should not reduce intake of calcium and maintain their regular recomended dietary intake of natural dietary calcium .

But not to take supplimental calcium as supplimental calcium tablets have shown to form calcium oxalate stone if taken for prolonged period of time.

14mm Renal Caliculus removed nonsurgically at Dr SHAH's Homoeopathy
14mm Renal Caliculus removed nonsurgically at Dr SHAH’s Homoeopathy
14mm Renal Caliculus removed nonsurgically at Dr SHAH's Homoeopathy
14mm Renal Caliculus removed nonsurgically at Dr SHAH’s Homoeopathy

For further reading and details on renal stones/urolithiasis/kidney stones click on the following link:

RENAL CALICULUS

RENAL CALICULUS /UROLITHIASIS/KIDNEY STONES / URINARY STONES

When solids and particulate metabolites or salts starts depositing at any level of urinary collecting system it forms renal stones or urolithiasis

Urolithiasis is more common in males than in females

Increased concentration in urine, of the constituents of stones is associated with stone formation.

1) Calcium Oxalate/Phosphate Stones comprises 75% of every stones.

Its observed that almost 50 % of cases of Calcium Stones that have idiopathic hypercalciuria and doesn’t have hypercalcemia.

10 % of cases calcium stone cases have both hypercalcemia and hypercalciurea

5% have Enteric(4.5%) or Primary (0.5%) hyperoxaluria

20% have hyperuricosuria

15-20% have unknown metabolic anomaly

2) Struvite Stones (Magnesium, Ammonia, Calcium, Phosphate) usually due to renal infections comprises off 10-15% of all stones.

3) Uric Acid Stones comprises 6% of all stobe cases 50% of which are associated with hyperuricosuria and/or hyperuricemia and 50% are of idiopathic origin.

4) Cystine Stone comprises only of 1-2% of all the cases

5) Other and unknown types of stones comprises of upto 10% of all the cases

An organic matrix of mucoprotien is present in all above all types of stones which acts as an additional binding matrix and it makes up almost 2.5 % of weight of all stones.

Renal caliculus, while selecting homoeopathic remedy for Kidney stones it is important to make note of all accompanying symptoms, like type of pain , character of urine, and if there are gravels in urine then its colour shape size should be noted, also other miasmatic and constitutional background should be evaluated for proper similimum remedy selection.

Risk factors

Increases Risk:

Dehydration, Low water intake, excess grapefruit or apple juice intake soft drinks containing phosphoric acid especially areated drinks.

Excess red meat consumption increases concerntration of certain sulfurous amino acids like cystiene and  methionine which acidifies urine , decreases citrate excretion through urine and increases excretion of calcium and uric acid through urine thus increasing risk of renal stones.

Calcium suppliment tablets and VitaminD suppliment for long term may cause Calcium Stones

Studies show that low dietary calcium promotes calcium stones:- Unlike supplimental calcium , Natural dietary calcium actually protects you against renal stones. As it binds with ingested oxalate from food in gastro-intestinal tract to form calcium oxalate and thus reducing its absorption and inturn reducing oxalate concentration in urine. Oxalate is 15 times more potent in forming renal stones compared to increased levels of calcium in urine.

Sodium and fluoridated water increases urinary excretion of calcium thus increases risk of stone formation.

Low urinary excretion of citrate

Decreases Risk:

Unlike supplimental calcium , Natural dietary calcium actually protects you against renal stones. As it binds with ingested oxalate from food in gastro-intestinal tract to form calcium oxalate and thus reducing its absorption and inturn reducing oxalate concentration in urine. Oxalate is 15 times more potent in forming renal stones compared to increased levels of calcium in urine

Studies show that low dietary calcium promotes calcium stones.

Magnesium inhibits stone formation.

Patassium promotes urinary excretion of citrate and citrate inhibits crystallisation of calcium and thus reduces risk of urinary calcium stones

Commonly Used Homoeopathic Remedies For Renal Caliculus

Renal caliculus, while selecting homoeopathic remedy for Kidney stones it is important to make note of all accompanying symptoms, like type of pain , character of urine, and if there are gravels in urine then its colour shape size should be noted, also other miasmatic and constitutional background should be evaluated for proper similimum remedy selection.

  1. Berberries Vulgaris sensation of retention of urine and urge to pass it again soon after passing, patient is thirstless, bright red mealy sediments, bubbling sore sensation in renal region, pain in urinary bladder region, pain radiating from lumbar region to pelvis and down to lower limbs while passing urine, burning in urethra even when patient is not passing urine, feequent micturation, well indicated in patients with renal caliculus with gouty diathesis and elevated uric acid levels and urate crystals in urine. Works well in patients having  glomerulonephritis along with Renal Caliculus.
  2. Hydrangea Arborescens white amorphous salt in urine giving urine a turbid colour,  white amorphous salt in urine deposits in form of gravel. Sharp pain in loins especially in left side with unquenchable thirst for large quantity  water, unlike berberries vulgaris which has thirstlessness. Well indicated in patients with enlarged prostate and also having Renal caliculus.
  3. Cantheris In patients with bleeding due to renal stones, heamaturia and Nephritis, Intolerable constant urge to pass urine with paroxysmal acute cutting and burning from lumbar region to pelvis in front, urinary tract infection due to stone initially causing membranous scales giving appearance of bran in water when passed profuse urine and later on urine mixed with blood passes drop by drop  jelly like shreddy urine , membranous scales giving appearance of bran in water, infection of urethra due to damage by renal stone causing irritation in urethra increasing sexual desire.
  4. Sarsaparilla Scanty slimy flaky sandy and bloody urine, gravels in urine that passes in thin stream, this medicine should be thought of when  sand-like gravels seen on daiper of children and they are cranky before and during passing urine, Kidney stones on right side.
  5. Pareira Brava/ Condodendron Tormentosum great tenesmus while passing urine, constant urge to pass urine but has to strain much while passing has to bend down on his knees and press head on floor in front to pass urine causing pain to radiating till his thighs, Urine dribbles after micturating, pain in glans penis, renal stones in patient with gonorrhoeal urinary tract affections.
  6. Borax Small red particles in urine and on daiper of child who cries while passing urine, hot smarting pain in urethra.
  7. Solidago Redish brown thick sediment gravels with offensive albuminuria , pain in renal angle radiating forward and downwards towards abdomen and pelvis.
  8. Silicea its a wonderful homoeopathy know for its ability to expel foreign particle from body, for which it is also termed as surgeons knife, Red or Yellow sedimentation prostorrhoea due to tenesmus in patients with retention of urine due to renal caliculus
  9. Lycopodium  Heavy Red Sand Particle in urine, pain in right hypochondrium and right lumbar region , renal stones in old men with slow feeble urine with stangury, tenesmus and retention of urine.
  10. Calcarea Carbonica Calcium oxalate crystals in urine, sour fetid smelling urine with dark brown colour and white sediments and haematuria.

For further reading and details on renal stones/urolithiasis/kidney stones click on the following link:

RENAL CALICULUS

Gastroentrology, Gynaecology, HOMEOPATHIC TREATMENT, Infectious diseases, Nephrology, Neurology, Oncology, Rheumatology, Urology

ABDOMINAL PAIN Homeopathic Medicines

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ABDOMINAL PAIN -10 BEST HOMOEOPATHIC MEDICINES

Pain in abdomen may be due to many reasons it can be because of minor gastric disturbance or may be due to severe conditions like Pancreatitis, Hepatitis, Ascitis, Cholecystitis, Cholelithiasis, Urolithiasis, Apendicitis, Tumours Malignant or Non Malignant, Hernia, Strangulated Hernia, Gastric or Peptic ulcers, fistula in Gastro Intestinal tract, Gynaecological complaints, Helminthiasis or Amoebiasis or other infections, Urinary tract infections etc.

All these may be due to minor infections or minor physiological disturbance to severe septic conditions and severe autoimmune conditions. So if pain persists then Its advisable to rule out any underlying pathological condition under observation of qualified physician.

In homeopathy each medicine has its own sphere of action, that is, more affinity towards certain organs and systems compared to other, also such action has a peculiar mode of action producing perculiar type of pathology in the organ, system and organism as a whole.

So its important to understand the person’s constitution and underlying pathological cause due to which the patient is having pain so that we can relate it to medicinal symptoms and select the most similimum medicine to treat not only the symptom of pain but also the underlying cause along with.

There are many medicines in homoeopathy which has special affinity towards certain abdominal organs and nerves along with,  which can be used for abdominal pain depending on which organ and system is involved and what kind of patholigy its showing.

Below I have mentioned GENERAL MEDICINES that have specific affinity towards certain abdominal organs and produce peculiar pathological action giving rise to characteristic symptoms in corresponding constitution types that have been mentioned.(FOR MORE SPECIFIC CONDITIONS BEHIND ABDOMINAL PAIN I HAVE GIVEN LINKS OF MY VARIOUS ARTICLES)

  1. MAGNESIA PHOSPHORICA One of the best Anti-spasmodic remedy in homoeopathy, Severe cramping pain in abdominal muscles due to indigestion causing flatulence or constipation, gas in bowel loop compelling patient to bend double with eructation of gases, patient has fullness and distention of abdomen patient has to the loosens the belt or clothing around belly and walk with frequent release flatus  relieved by rubbing with pressure and warmth.
  2. NATRUM PHOSPHORICA complaints due to hyperacidity burning pain in abdomen and sour eructation , good remedy for Gastro-oesophageal-reflux disorder, patient has sensation of some lump type obstruction in throat, good remedy for flatulent colic during jaundice.
  3. CARBO VEGETABILIS Its one of the best homoeopathy emergeny life saving remedies , can be used from minor to severe conditions ; typically suited to fat sluggish and lazy persons with weak vital force and immunity; typically shows singns of sluggish circulation causing hypoxic condition; also it affects the blood vessels causing ecchymosis and mucosal heamorrhage; stagnant circulation causing sepsis gangrene patient goes into septic shock with cyanosed appearance blueness of face and exretmities  , very cold body but hot head; very good remedy for abdominal affections with or without infections Contractions from chest to abdomen; all gone empty sensation in abdomen not relieved after food, cramps in abdomen compelling patient to bend double, pain in abdomen due to slow sluggish digestion causing food to putrify, pain in abdomen and septicemia due to strangulated hernia.pain aggravates by lifting weight,exterme fetid flatulence with Gastro-oesophageal-reflux disorder distentension and fullness of abdomen pt has to loosen belt and clothes around waist(Mag phos); aggravation 30 minutes after meals even with the lightest mealor food, sour rancid belching, severe burning pain in epigastrium which is sensitive to touch ; general hyperacidity and flatulence due to indigestion ; pt has aversion to food in general esp heavy oily food, gastric disturbance triggers asthmatic affections. pain due to ulcers fistula in Gastro-intestinal tract. a good remedy in cholera typhoid liver affections gengrene hernia appendicitis
  4. PLUMBUM METALLICUM constrictive sensation in internal organs,contracting and boring pain in abdomen, sensation as if whole abdominal wall is pulled backwards and tied to spine causing pressure tightness of abdomen and radiating pain, abdominal pain due to lead poisoning painter’s colic, pain in abdomen due to kidney ailments like acute nephritis etc. accumulation of gasses in bowel loop which doesnt pass off causing abdominal pain.
  5. CAULLOPHYLUM False labour pains, Spasmodic pain of abdomen due to gastric disturbances.
  6. COLOCYNTHIS cutting agonising pain in abdomen, boring sensation as if stone were ground together in abdomen,
  7. MAGNESIA CARBONICA typically suited to individuals having hyperacidity and excessive secretion of digestive juices and mucous from gastro-intestinal tract,sour body odour , broken down and worn-out women during climecteric age having uterine affections; this individuals are oversensitive to external impressions like noise touch bright lights etc,typically ailments from blows , shock,  brain fag, this constitutional types have tendency towards constipation; Pain in abdomen with Rumbling and Gurgling within very heavy downward dragging sensation towards right illiac fossa and pelvis, colicky gripping pain preceeds stools with severe tenesmus in constipation or when these subjects contract diarrhoea or dysentry.
  8. BRYONIA ALBA typically suited to individual having tall dark robust lean and strong muscle fibre; patients having right sided complaints, Patient has  stitching and tearing pain worse by slightest motion making patient too irritable due to pain , pt wants to rest complately due to it , burning, stitching, tearing, pressing pain in epigastrium as if a heavy stone was in the pit of the stomach, region to tender and sensitive to touch or slightest motion even on breathing for that purpose, severe constipation with stitching tearing pain in abdomen with dry hard knotty large stools difficult to pass.
  9. NUX VOMICA predominantly a male remedy. It is a wonderful remedy to start homoeopathic  treatment as it antidotes bad effects of most allopathic and homoeopathic medicines taken in past also it balances digestive system thats been disturbed due to irregular lifestyle ; medicines alcohol spicy oily food etc; Its frequently used by homoeopath as first prescription when the homoeopath wants to borrow time to conclude the constitution of the patient and yet start the basic treatment; This remedy is typically suited to persons whose constitution is deranged and shaped up as a result of leading irregular and sedentary life style ; like irregular meal pattern ireegular sleep pattern night watching ; no exercise ; excess of sexual indulgence and frequent excess of alcoholic beverages causing digestive disturbance and liver affections Bruised and Sore abdominal muscles with stitching spasmodic colicky pain causing short breath and urge to pass stools ; abdominal distended with gaseous accumulationspain due to strangulated inguinal and umbilical hernia; Pain in abdomen due to alcoholic hangover; Pain due to severe constipation as a bad effect of allopathic medication.
  10. ASAFOETIDA Typically suited more to hysterical and Hypochondriacal patients,flatulent and spasmodic contraction of stomach and oesophagus with reverse peristalsis, abdominal pain due to severe ulcers fistulas and other abdominal presentation of secondary and tertiary syphillis; this rem,edy has typical boring pulsating and throbbing pain; lots of gas formation pain around umbilicus gasses accumulates in large quantity and the whole ball of gas ascends upwards giving out frequent loud eructations with pain in epigastrium.

ABDOMINAL PAIN DUE TO UROLITHIASIS/RENAL STONES/KIDNEY STONES/URINARY BLADDER STONE AND URINARY TRACT INFECTION : CLICK THE FOLLOWING LINK

RENAL CALICULUS

ABDOMINAL PAIN DUE TO MENORRHAGIA and DYSMENORRHOEA : CLICK THE FOLLOWING LINK

http://atomictherapy.org/best-menorrhagia-medicines-homoeopathy/

ABDOMINAL PAIN DUE TO GALL STONES/GALL BLADDER STONE/CHOLELITHIASIS AND CHOLECYSTITIS : CLICK THE FOLLOWING LINK

http://atomictherapy.org/best-gall-stone-medicines-homoeopathy/

PAIN IN ABDOMEN DUE TO LEUCORRHOEA : CLICK THE FOLLOWING LINK

LEUCORRHOEA

PAIN IN ABDOMEN DUE TO CONSTIPATION : CLICK THE FOLLOWING LINK

ABDOMINAL PAIN Homeopathic Medicines

PAIN IN ABDOMEN DUE TO LOOSE MOTIONS/DIARRHOEA/DYSENTRY : CLICK THE FOLLOWING LINK

http://atomictherapy.org/best-loose-motion-medicines-homoeopathy/

KEEP READING THIS POST WILL BE CONSTANTLY UPDATED.

HOMEOPATHIC TREATMENT, Nephrology, Urology

RENAL CALICULUS

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When solids and particulate metabolites or salts starts depositing at any level of urinary collecting system it forms renal stones or urolithiasis

An organic matrix of mucoprotien is present in all above types of stones which acts as an additional binding matrix and it makes up almost 2.5 % of weight in all stones.

Urolithiasis is more common in males than in females

Increased concentration in urine, of the constituents of stones is associated with stone formation.

COMPOSITION AND INCIDENCE OF DIFFERENT TYPES OF RENAL STONES

1) Calcium Oxalate/Phosphate Stones comprises 75% of every stones.

Its observed that almost 50 % of cases of Calcium Stones that have idiopathic hypercalciuria and doesn’t have hypercalcemia.

10 % of cases calcium stone cases have both hypercalcemia and hypercalciurea

5% have Enteric(4.5%) or Primary (0.5%) hyperoxaluria

20% have hyperuricosuria

15-20% have unknown metabolic anomaly

2) Struvite Stones (Magnesium, Ammonia, Calcium, Phosphate) usually due to renal infections comprises off 10-15% of all stones.

3) Uric Acid Stones comprises 6% of all stobe cases 50% of which are associated with hyperuricosuria and/or hyperuricemia and 50% are of idiopathic origin.

4) Cystine Stone comprises only of 1-2% of all the cases

5) Other and unknown types of stones comprises of upto 10% of all the cases

An organic matrix of mucoprotien is present in all above all types of stones which acts as an additional binding matrix and it makes up almost 2.5 % of weight of all stones.

Renal caliculus, while selecting homoeopathic remedy for Kidney stones it is important to make note of all accompanying symptoms, like type of pain , character of urine, and if there are gravels in urine then its colour shape size should be noted, also other miasmatic and constitutional background should be evaluated for proper similimum remedy selection.

14mm Renal Caliculus removed nonsurgically at Dr SHAH's Homoeopathy
14mm Renal Caliculus removed nonsurgically at Dr SHAH’s Homoeopathy

14mm Renal Caliculus removed nonsurgically at Dr SHAH's Homoeopathy
14mm Renal Caliculus removed nonsurgically at Dr SHAH’s Homoeopathy

Risk factors

Increases Risk:

Dehydration, Low water intake, excess grapefruit or apple juice intake soft drinks containing phosphoric acid especially areated drinks.

Excess red meat consumption increases concerntration of certain sulfurous amino acids like cystiene and  methionine which acidifies urine , decreases citrate excretion through urine and increases excretion of calcium and uric acid through urine thus increasing risk of renal stones.

Calcium suppliment tablets and VitaminD suppliment for long term may cause Calcium Stones

Studies show that low dietary calcium promotes calcium stones:- Unlike supplimental calcium , Natural dietary calcium actually protects you against renal stones. As it binds with ingested oxalate from food in gastro-intestinal tract to form calcium oxalate and thus reducing its absorption and inturn reducing oxalate concentration in urine. Oxalate is 15 times more potent in forming renal stones compared to increased levels of calcium in urine.

Sodium and fluoridated water increases urinary excretion of calcium thus increases risk of stone formation.

Low urinary excretion of citrate

Decreases Risk:

Unlike supplimental calcium , Natural dietary calcium actually protects you against renal stones. As it binds with ingested oxalate from food in gastro-intestinal tract to form calcium oxalate and thus reducing its absorption and inturn reducing oxalate concentration in urine. Oxalate is 15 times more potent in forming renal stones compared to increased levels of calcium in urine

Studies show that low dietary calcium promotes calcium stones.

Magnesium inhibits stone formation.

Patassium promotes urinary excretion of citrate and citrate inhibits crystallisation of calcium and thus reduces risk of urinary calcium stones

 

Commonly Used Homoeopathic Remedies For Renal Caliculus

BERBERRIES VULGARIS

Sensation of retention of urine and urge to pass it again soon after passing, patient is thirstless, bright red mealy sediments, bubbling sore sensation in renal region, pain in urinary bladder region, pain radiating from lumbar region to pelvis and down to lower limbs while passing urine, burning in urethra even when patient is not passing urine, feequent micturation, well indicated in patients with renal caliculus with gouty diathesis and elevated uric acid levels and urate crystals in urine. Works well in patients having  glomerulonephritis along with Renal Caliculus.

HYDRANGEA ARBORESCENS

white amorphous salt in urine giving urine a turbid colour,  white amorphous salt in urine deposits in form of gravel. Sharp pain in loins especially in left side with unquenchable thirst for large quantity  water, unlike berberries vulgaris which has thirstlessness. Well indicated in patients with enlarged prostate and also having Renal caliculus.

CANTHERIS

In patients with bleeding due to renal stones, heamaturia and Nephritis, Intolerable constant urge to pass urine with paroxysmal acute cutting and burning from lumbar region to pelvis in front, urinary tract infection due to stone initially causing membranous scales giving appearance of bran in water when passed profuse urine and later on urine mixed with blood passes drop by drop  jelly like shreddy urine , membranous scales giving appearance of bran in water, infection of urethra due to damage by renal stone causing irritation in urethra increasing sexual desire.

SARSAPARILLA

Scanty slimy flaky sandy and bloody urine, gravels in urine that passes in thin stream, this medicine should be thought of when  sand-like gravels seen on daiper of children and they are cranky before and during passing urine, Kidney stones on right side.

PAREIRA BRAVA / CONDODENDRON TORMENTOSUM

great tenesmus while passing urine, constant urge to pass urine but has to strain much while passing has to bend down on his knees and press head on floor in front to pass urine causing pain to radiating till his thighs, Urine dribbles after micturating, pain in glans penis, renal stones in patient with gonorrhoeal urinary tract affections.

BORAX

Small red particles in urine and on daiper of child who cries while passing urine, hot smarting pain in urethra.

SOLIDAGO

Redish brown thick sediment gravels with offensive albuminuria , pain in renal angle radiating forward and downwards towards abdomen and pelvis.

SILICEA

its a wonderful homoeopathy know for its ability to expel foreign particle from body, for which it is also termed as surgeons knife, Red or Yellow sedimentation prostorrhoea due to tenesmus in patients with retention of urine due to renal caliculus

LYCOPODIUM CLAVATUM

Heavy Red Sand Particle in urine, pain in right hypochondrium and right lumbar region , renal stones in old men with slow feeble urine with stangury, tenesmus and retention of urine.

CALCAREA CARBONICA

Calcium oxalate crystals in urine, sour fetid smelling urine with dark brown colour and white sediments and haematuria.

HOMEOPATHIC TREATMENT, Metabolic Disorders, Nephrology, Orthopedic

GOUT

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Gout is metabolically mediated type of arthritis strongly associated with genetics as a major cause, to which diet and lifestyle plays a contributory factor in its pathogenesis.It is primarily caused due to disorder of purine metabolism (purine is one of the major component of our gene it forms base pairs / nucleotides with pyrimidine to give structure to our gene; also purine is present in many food that we eat esp. certain sea food and many pulses).

Its when the final product of purine metabolism i.e uric acid, starts crystallizing and forming Monosodium Urate Monohydrate then it starts depositing in joint and tissues around joint its called gout and not mere hyperuricemia can be termed as gout.

PATHOGENESIS OF GOUT

GOUT PATHOGENESIS FLOW CHART
Purine De Novo Synthesis with Salvage Pathway and GOUT
Purine De Novo Synthesis with Salvage Pathway and GOUT

Overproduction of uric acid may be due to one or more of following factors:-

  • Catabolism,
  • Loss of purine salvage mechanism,
  • Defective or sluggish transportation,
  • Under excretion of uric acid,
  •  Reduced elimination of uric acid due competition of metabolites for elimination,

which results into  hyperuricemia triggering Gout.

Although hyperuricemia has been found to trigger gout but many having maintaining uric acid within normal limits still develop gout and many having uric acid on higher side are still not developing gout. So genetics has major role in determining at what level of serum uric acid the patient may develop Gout.

When Uric acid crystalises into monosodium urate, it then starts precipitating in joints, tendons and surrounding tissues,in small clusters of deposits called tophi. Each tophus is collection of monosodium urate crystals surrounded by a protein wall. This protein wall prevents its interaction with surrounding cells and thus prevents inflamatory response. Occasionally this walled-off tophi breaks open the protein wall and so the urate crystals comes out naked in contact with surrounding cells, which may be due to medical, surgical metabolic, physical stress or sometimes even rise in serum uric acid levels may lead to breaking of this wall, which causes acute inflamation and sets in acute arthritis within few hours.

SYMPTOMS OF GOUT

Its usually observed that small joints of extremities which are not sufficiently insulated to tolerate cold and shocks and those that are in region where circulation is affected due to gravity dependence, like great toe and ankle , small joints of feet, hands and wrist are more prone compared to other joints. Although it can affect all the joints and can present itself with different signs and symptoms but it is classically known as Podagra for the one characteristic symptom it frequently presents in most of the patients, its the intense burning and sharp excruciating pain with mild redness and swelling especially on base of great toe (at first metatarso-phalangeal joint) starting suddenly and frequently at night waking patient up from sleep.

 

 GENES ASSOCIATED WITH HYPERURICEAMIA AND GOUT

1) Absence of gene associated with breakdown of Uric Acid.

In humans unlike other carnivorous primates(meat eater in particular) the Uricase /urate oxidase, an enzyme which breaks down uric acid to 5hydroxyisourate then to allantoin,  has became non functional during evolution phase and is present only as psuedogene/junk gene so, the humans have tendency towards probability of elevated levels of uric acid due to lack of breakdown and accumulation which may trigger gout.

Uric Acid though may have beneficial effect as its a very powerful antioxidant and scavenger, helping body to protect itself from oxidative damage and thus prolonging life and reducing age-specific cancers, so hominids may have opted out the Uricase gene in selective evolution.

After we identified urate oxidase and its activity, we have artificially prepared protien Rasburicase. Rasburicase is now used to treat patient developing acute hyperuriceamia during chemotherapy. Also a PEGylated form of urate oxidase is in clinical development for treatment of chronic hyperuriceamia having “treatment failure gout”.

2) Defect in genes associated transportation and transfer of uric acid for elimination.
  • SLC2A9 The encoded protein by this gene plays a role in transportation of uric acid and also in development and survival of chondrocytes in the cartilage matrix. Any SNP (single neucleotide polymorphism) in this gene causes transcript variants encoding different isoforms, which increases the risk of development of Hyperuriceamia and also it may alter joint cartilage matrix both of these anomaly plays a major role in formation of gout.
  • SLC22A12 has 2 transcript variants encoding different isoforms; basically it encodes urate transporter and urate anion exchanger protein which regulates the level of urate in the blood; its an integral membrane protien primarily found in kidney; SNP of this gene causes altered reabsorption of Uric Acid by the kidney.
3) Genes associated with purine salvage mechanism.
  • PRPSAP1 and HPRT1 are gene related to Purine salvage mechanism.
  • Phosphoribosyl Pyrophosphate Synthatase associated Protein 1(PRPSAP1).
  • PRPP (5-phosphoribosyl 1- pyrophosphate) is a substrate used by HGPRT during purine salvage pathway.
  • Hypoxanthine Phosphoribosyl Transferase 1 (produce hypoxanthine-guanine phosphoribosyl transferase (HGRPT)which plays main role in generation of purine nucleotide through purine salvage pathway).

SNP or deletion of any of the above mentioned gene causes hyperuriceamia and also other severe conditions.

4)Certain Genetic Disease And Syndromes Presents Hyperuricemia And Gout As One Of The Symptom Like In  :-

  1. Familial Juvenile Hypouricemic Nephropathy (FJHN) associated with UMOD gene. UMOD gene produces Tamm horsfall protien, whose function is still not well understood but defect in this gene produce many autosomal renal disorders characterised by juvenile onset of hyperuricemia, gout and progressive renal failure.
  2. Medullary Cystic Kidney disease (type I and II).
  3. Lesch Nyham Syndrome is an X-linked Syndrome caused due to HPRT1 Gene deletion (details of HPRT1 have been mentioned elsewhere above in this page).

Physical trauma, Wasting Diseases ,Surgery are associated with increased uric acid levels.

MEDICINES ASSOCIATED WITH HYPERURICEMIA

Diuretics in higher doses, niacin, aspirin ACE inihibitors angiotensin receptor blockers  beta Blockers ritonavir pyrazineamide ciclosporin tacrolimus.

DIAGNOSIS OF GOUT

In patients with recurrent acute episodes of arthritis especially of great toe accompanying hyperuricemia is sufficient to establish the diagnosis. However an episode of acute arthritis in many instances may not accompany hyperuricemia, so arthroscentesis should be done for synovial fluid analysis for visualising monosodium urate crystals or tophus is the only confirmatory test whether patient is hyperuricemic or not.

DIET AND LIFESTYLE ASSOCIATED TO GOUT AND HYPERURICEMIA

Food rich in purine especially red meat and sea food is considered to be associated with hyperuricemia. Its found that moderate consumption of purine rich vegetarian diet is not associated with the condition. Also total protien  has no impact untill not much of it is in form of purine.

Alcohol consumption and Fructose sweetened food and drinks are strongly associated with it.

Metabolic syndrome, diabetes, cardiovascular disease, and aging process are also associated with this condition and they tend to worsen each other.

Vitamin C, Coffee and switching to Dairy Products for protein requirement will also help.

Weight reduction and regular exercise helps reduce Uric acid.

Raised uric acid level is also associated with renal stones and urate nephropathy.

HOMOEOPATHIC REMEDIES FOR GOUT and HYPERURICEMIA(raised serum uric acid)

ARNICA MONTANA

Arnica is a traumatic remedy par excellence. Arnica is an useful remedy in chronic cases of gout. Old cases of gout rouse into a new soreness of joints with great sensitiveness. Arnica is an important remedy in injuries, bruises, shocks etc. Trauma in all its varieties mental or physical and their effects recent or remote are met with this remedy. If we observe a arnica patient in order to get the external manifestations of his state, he is constantly moving,turning and highly restless. The patient has sore lame bruised feeling, so sore that he can lie on one part only for a while and must keep changing position as the bed he lies on feels hard. Limbs ache as if beaten. Inflamation of joints.

ACTEA RACEMOSA

Actea racemosa is a very well indicated remedy in gouty and rheumatic diathesis. Swelling of joints with raised uric acid levels. Its muscular and crampy pains are primarily neurotic origin, occuring in nearly every part of the body. Pains of actea racemosa are like that of electric shock, comes suddenly and also its relieved suddenly. There is stiffness and pain in the tendo achillies. It has wide action on muscles nerves joints. Rheumatic aching pains in joints and muscles with stifness of joints. Causes depression of mind with low spirits and exhaustion along with oversensitiveness especially during pain.

ABROTANUM

Abrotanum is a very valuable remedy which is used more frequently. Indicated in gout and increased uric acid levels. Rheumatism and gout alternate with haemorrhoids. Abrotanum increases circulation and opens small arteries as a result the blood flow and local defense of joints and muscles is stimulated. Abrotanum relives gout pain.

ACONITE NAPELLUS

Aconite napellus is very well indicated in rheumatic and gouty conditions of joints. Those that come on as first attack. Not old rheumatic and gouty attacks but those that come on from exposure to cold. Rapidity of action of aconite determines its symptomatology. Presents with Symptoms are acute painful and violent pain in the joints. Aconite is indicated in acute onset of pain and swelling. Used in 1st stage of inflammatory condition with severe mental restlessness. Fear. Fright and anxiety.

BELLADONNA

Belladona is useful in inflamtory rheumatism and gout.Symptoms that suggest this remedy are sudden onset, swollen joints, red hot, throbbing pain with extreme sensitiveness. Complaints of belladona that is the pains and suffering come on suddenly run a regular course and subside suddenly. Sudden attack of cold worsens the complaints.

COLCHICUM AUTUMNALE

Colchicum is a primary remedy used for treatment of gout because of its effectiveness.most useful in chronic gout.
Colchicum has marked action of the joints, indicated in case of gouty arthritis and increased uric acid levels. Helps in relieving the gouty paroxysms. Inflammation of great toe, gout in heel, cannot bear to be touched. Oedematous swelling and coldness of feet. Joints are red hot swollen. Pains are usually worse in evening and night.

LEDUM PALUSTURE

Ledum pal is mostly used in rheumatic and gouty diathesis. Remedy affects the fibrous tissues of joints especially small joints, ankles,heels.Used in cases where the gouty pains shoot through the foot, limbs and smaller joints. There is great swelling in the foot and ankle. Joints hot and swollen with with cracking in joints. Gouty nodosities. Ball of great toe is swollen. Soles are very painful can hardly step on them. Aggravation from warmth is so vreat that the patient can only get relief to his rheumatism by sitting with his feet in icy cold water.

NATRUM SULPHURICUM

Natrum sulph is used for symptoms associated with gout it may be acute or chronic. Swelling and burning of joints. Pain compels frequent change in position with stiffness of joints. Burning in sole with oedema of feet.

RHUS TOXICODENDRON

Rhus tox is one of the most frequently indicated remedy for rheumatic and gouty complaints. Rhus tox usually affects the fibrous tissue markedly joints, tendons, producing pain and stiffness. Rhus plays a good role in gouty complaints. Hot painful swelling of joints. Tearning pains in tendons, ligaments and fasciae. Affects the smaller joints, parts feel sore and bruised with stiffmess. All complaints worse from cold damp weather and motion in any ailment and relieved from warmth.

URTICA URENS

Urtica is useful in rheumatic and gouty diathesis. This remedy helps in elimination of uric acid from the body. The patient has tendency to uric acid and gout formation. The joint complaints are usually associated with hive like erruptions. Presents with pain in small joints. Worse from exposure to cold moist air, wet weather.

BENZOICUM ACIDUM

Benzoicum Acidim is a very Specific and Infallible remedy in cases of chronic and acute gout, usually given in lower potencies in frequent repetitions.

Tophus of Gout
LARGE TOPHUS OF GOUT AT Dr SHAH’s Homoeopathy

 

Large Tophus Of Gout at Dr Shah's Homoeopathy
LARGE TOPHUS OF GOUT 2 IMAGE CLICKED AT Dr SHAH’s HOMOEOPATHY by Dr DEEPAN P SHAH
Podagra Gout Hyperuricemia
PODAGRA GOUT HYPERURICEMIA
Podagra – Inflamation of 1st Metatarsophalangeal Joint (Joint of great toe to feet) in patient with Hyperuricemiam or elevated Uric Acid. Its a classical presentation of Gout.
PODAGRA GOUT HYPERURICEMIA
PODAGRA GOUT HYPERURICEMIA
Podagra – Inflamation of 1st Metatarsophalangeal Joint (Joint of great toe to feet) in patient with Hyperuricemiam or elevated Uric Acid. Its a classical presentation of Gout.