NEWS

YU SONG HUA (SENIOR PHYSICIAN)

Gout is a type of crystal-related arthritis caused by monosodium urate (crystal) accumulation in the joints. It is directly related to hyperuricemia due to a purine metabolism disorder or reduced uric acid excretion. Its clinical presentation includes acute gouty arthritis, intermittent stage, chronic tophaceous gout, and kidney disease.

TCM theory on the causes of gout

1. 1. Yang-dominant body constitution with visceral toxicity: heat and inflammation in the visceral organs are the determining factors of joint issues. Toxicity develops when there are chronic heat and inflammation in the body. This is the root cause of gout.
2. 2. Dampness, heat and toxicity in the joints: When proper Qi is weakened, dampness, heat and toxicity can dwell in channels and meridians. When they attach to joints, they settle and form rock-like crystals. Therefore, dampness, heat and toxicity are the main culprits to crystal formation in gout.
3. 3. Spleen weakness and dampness: Spleen weakness and an uncontrolled diet can hurt the digestive system, and lead to dampness.
4. 4. Exogenous pathogens: Exogenous pathogens dwelling in muscles and joints can lead to poor Qi and blood flow, and channel and meridian blockage. This may cause joint swelling, deformity and stiffness.

Dietary guidelines

1. -Avoid high-purine foods: such as organ meat, beef, lamb, seafood, and beer, etc.
2. -Limit calorie intake. The majority of daily calories should come from plant proteins and carbohydrates.
3. -Increase alkaline foods in the diet, such as fruit and vegetables, nuts, and milk, to dissolve urate crystals.
4. -Increase high potassium foods in the diet, such as bananas, cauliflower, and celery. Potassium can reduce urate deposits and facilitate its excretion.
5. -Drink plenty of water, and avoid alcoholic drinks. Water helps with uric acid excretion, while alcohol contains large amount of purines, and therefore is not appropriate for those with gout.
6. -Avoid stimulants, such as strong tea, coffee and spicy condiments.

Treatment

Gout treatment can include acupuncture and/or herbal prescriptions to reduce heat and dampness in the body and unblock channels and meridians. Acupuncture is very effective for both acute and chronic pain. It is also important to maintain a healthy weight, eliminate alcohol, drink plenty of water (at least 2000ml/day), avoid getting colds, exhaustion and anxiety, and wear comfortable shoes to avoid joint damage. Use drugs that affect uric acid excretion with caution.

Food therapy:

1. 1. Grape rice porridge

Slow cook 40 grapes and rice 80g in water till liquid thickens. Add sugar to taste.

Benefits: nourishes the liver and kidneys, and replenishes Qi and blood.

2. 2. Red bean barley porridge

Add red bean 50g and barley 50g into boiling water to make porridge.

Benefits: facilitates urate excretion.

3. 3. Papaya rice porridge

Dice one papaya and simmer for half an hour. Add rice 100g and cook until liquid thickens. Add sugar to taste.

Benefits: improves digestive and musculoskeletal function.

4. 4. Celery rice porridge

Cook diced celery 100g (include roots) and rice 100g in water until liquid thickens. Add salt to taste.