Tag Archives: colchicine

A Rich Man’s Disease Becomes Middle-Class

I was quite bemused recently to see a regular patient hobble in to the clinic in slip-ons,  a typical scene with which most doctors would be able to diagnose immediately an  attack of acute gout. Bemused because a few weeks earlier he had joked about gout being a ‘rich man’s disease’ and he was sure, given the recession and his financial state, that there was no way he was going to get an attack.

Gout, more accurately acute gouty arthritis, has always been referred to as ‘ the rich man’s disease’ because of its association with rich foods and alcohol once available to aristocrats (like King Henry VIII and Sir Isaac Newton). The scenario today has changed as it extends its hold on the older, sedentary and overweight middle-class workers.  Acute gouty arthritis is caused by  excess uric acid ( a by-product of ingested proteins) being deposited to joints, especially the large toe, causing an excruciatingly painful situation which often wakes one up in the middle of the night.


English caricaturist, James Gillray(1757-1815), himself a gout sufferer, aptly illustrated the misery and pain of Gout


Pain relief requires strong  medications like non-steriodal antiinflammatory analgesics(NSAIDs) or colchicine and once the pain subsides, to take medications on a long-term basis to help prevent forming uric acid (like allopurinol) or to help throw away uric acid via the urine (like probenecid). As these have side-effects, many switch to alternative remedies, like apple cider vinegar, celery and other anti-oxidants.

Just to keep you updated, there has been no new medications for treating gout for the past 40 years(!)….until quite recently, when Uloric was introduced in the market. Touted to be safer than existing medications (which cannot be given to people with kidney disease and also carry death-threatening allergic reactions), the US FDA recently approved its general use.

Stuff which you need to reduce to avoid gout include:


Dairy foods (can be problematic for many with gout.)

Fluoridated and chlorinated (tap) water.

Fried Foods .

Junk foods and baked items have saturated and trans fats.

Meats with high protein levels like Steak, Turkey, Duck, Goose, Pheasant, Herring, Anchovies, and Sardines.

Mushrooms and Mushroom Gravy.

Organ Meats like Kidney and Heart (read pate).

Peas and some beans.

Pizza (white flour, cheese and meat for a triple whammy).

Roasted Nuts.

Sugary foods, esp high-fructose corn syrups.

Tangerines and other citrus fruits.

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