January 7, 2005


Gout in the open: After suffering office ridicule, Mark Tran sets the record straight on a condition often associated with port-swilling old gents
Mark Tran, January 7, 2005, Guardian Unlimited)

It started as a pain in my big toe, forcing me to hobble to the bus stop on my way to work.

As the day wore on, my foot swelled to the point where it felt like it was bursting out of my shoe. The area around the toe had become red and inflamed and my left foot had ballooned to practically twice the size of my right one.

The pain worsened, reaching an excruciating level at night; sleep was impossible. No matter what position I sought, the pain was all-enveloping and constant. Any contact with the duvet only increased the pain, which became so intense that I fantasised about hacking off the offending toe with a machete.

The journey to the doctor was an ordeal in itself. I could not wear shoes as my foot had expanded by so much. So I had to wear sandals. The five-minute walk to the doctor stretched out into a 15-minute endurance test. My doctor's diagnosis was immediate: gout. [...]

Gout in fact is one of the most common forms of arthritis. It is caused by uric acid, a by-product of the body's metabolism. In a gout attack, uric acid builds up in the body to such an extent that the kidneys are unable to flush it out.

The acid crystallises, then collects around joints. In 70% of cases, the first area hit is the big toe, as crystals form in the coolest parts of the body. Once these crystals form, the body's immune system thinks they are foreign and attacks them. The gout is really the body's immune system attacking the crystals.

An increase of uric acid may arise from several reasons. Higher than normal levels may stem from hereditary causes or from the reasons that cause many to associate gout with too much of the good life: obesity; too much drinking (beer more than wine); certain kinds of food (red meat, shellfish, offal foods such as liver, kidneys and sweetbreads).

Although a relatively small number people in the UK suffer from gout, the number is rising. About 0.5% of the UK population suffered from gout in the 1950s; now the figure is around 1%, or 500,000 people.

Gout occurs most frequently in men between the ages of 40 and 60, particularly in those who are overweight or genetically predisposed.

Posted by Orrin Judd at January 7, 2005 6:49 PM

For the rest of my fellow sufferers (OJ, we already covered this last year), FRESH CHERRIES is the way to head off an attack, especially if you catch it early. Canned will work too. I keep a few cans in emergency reserve along with a bottle of 100% pure cherry juice.

Posted by: John Resnick at January 7, 2005 7:49 PM

Dr James Duke swears by celery seed for gout.

Posted by: Jim Yates at January 7, 2005 8:06 PM

Thank goodness: a reason to not eat liver, kidneys and sweetbreads! (I'll just ignore the mention of red meat....)

Posted by: PapayaSF at January 7, 2005 8:53 PM

Beer. Thins out the uric acid and promotes urination. The problem in England is the decline of pub life.

Posted by: Robert Schwartz at January 7, 2005 9:00 PM

I find beer exacerbates the problem more than red wine. One allopurinol(300 mg)/day and NO alcohol keeps me free from attacks.

Posted by: ed at January 8, 2005 11:06 AM

I was on 300 mg allopurinal/day from the age of 26 to 35.

Then I got diabetes and the gout went away, more or less simultaneously.

I don't recommend it.

Posted by: Harry Eagar at January 8, 2005 8:44 PM