Gout and Stigma

For the longest time, gout was called the “disease of kings” or “the rich man’s disease”. Some even referred to it as “lord of disease and disease of lords”. Back then, it was only royalty and the wealthy who experienced gout because they had the best access to trigger foods such as red meat and alcohol.

In earlier times, the Greeks called the gouty toe Podagra, child of Dionysus (god of wine and Aphrodite (goddess of love). Romans use this symbolism to say that gout was caused by too much food, wine, and sex!

Another belief for gout was that it was a cure because it constrained the pain to only one part of the body instead of multiple areas. This was in 16th to 18th century Europe when they believed a person could only experience one disease at a time. Little did they know that gout is associated with a number of comorbidities!

So gout doesn’t exactly have the most demeaning history like say leprosy, but nevertheless, it still carried an unhealthy stigma. The idea is that if you have gout, it was your own doing that caused it. If only you changed your diet and lifestyle, you wouldn’t be having that pain in the first place.

As the number of research on gout grows, we’re learning that the disease can actually be inherited from family. So no matter how diligent you are with your diet, if you eat that one thing, it may set off an unexpected gout flare.

Most people don’t even realize they have gout until they get a diagnosis from their doctor. This is usually done by measuring your serum uric levels. You do a uric acid test where they analyze your blood and if it’s above the normal range (7 mg/dL and above), you may have gout.

The History of Stigma Around Disease

The earliest disease that had stigma surrounding it was leprosy. It was believed to be a sexually transmitted disease and if a person had signs of it, they were shunned or cast out of society. In Jewish culture, you couldn’t be a priest if you had a flat nose. It was seen as a sign of leprosy which indicated sexual contamination. And religious figures couldn’t be associated with that.

Later on, leprosy was replaced by syphilis. It started as a deadly disease that took over someone’s life in a span of months but over time, it became a chronic illness that one lived with for the rest of their life. Physical signs of the disease were unmistakable and society viewed those who had it as unclean. This lasted for five centuries before a cure was found for it in the 1940s.

It wasn’t long before another disease would replace syphilis in terms of getting stigmatized. That disease is called AIDS and the anxiety over it was for mainly three reasons: the method of transmission (sex), its effect (incurable, death), and the place of origin.

AIDS back then would be labelled as the “African disease”, or “Haitian disease”. Another disease having a similar stigma was cholera and it was thought to have come from Asia or India. Westerners believed that these diseases came from “primitive” parts of the world and was attacking the more developed civilizations.

We certainly don’t have the same notions for such diseases today although they have been replaced by a newer one called cancer. Some cancers are already curable but one cannot deny the sinking feeling after finding out they got the big C.

What Effect Does Stigma Have on Diseases?

Opinions on people with gout definitely have an effect. A very recent survey conducted by the Alliance for Gout Awareness revealed very interesting insights:

● 52% of people with gout feel embarrassed of their condition so they don’t talk about it.
● 40% of people look down on people with gout.
● 93% say they don’t know that gout is actually a form of arthritis.
● 46% of gout patients believe that diet alone causes gout.
● One in four patients think they can treat the disease with natural remedies (apple cider vinegar, cherry, etc.)
● 73% find it hard to get proper treatment. This may be because they’re not aware of the symptoms and the stigma surrounding it prevents them from taking action.
● One in four patients think gout can be cured.

Another study conducted on 11 men chronic gout had them saying that because of the stigma around gout, they tend to trivialize the impact of the disease despite its severity. This lack of openness about the condition means there’s limited perspectives about it. The result is that it’s harder to find a more effective treatment for gout.

Gout Stigma: You Are Not Alone

There’s 8.3 million in the U.S. right now that have the same exact disease as you so you’re definitely not alone in facing this stigma. That’s 1 in 25 adults –quite alarming but it’s also comforting to know you’re not the only one being thought of as living proof of the consequences of an opulent life. I mean, it could be worse. Remember the lepers being shunned out of society? Yeah, we’re not as bad as we used to be.

Gout started to become more common around the 1970s to the 1990s. The likely culprit is obesity. It was around this same time that more and more people were becoming obese and the condition is known to be the cause of many conditions like high blood pressure, hypertension, heart disease, metabolic syndrome, and yes, even gout.

If left untreated, gout can complicate your health and lead to more conditions like tophi, joint deformity, kidney stones, cardiovascular disease, cataracts, and more.

As a gout patient, you have a personal responsibility to learn about disease as much as you can. Avoid blaming yourself. This self-defeating attitude that benefits no one. If anything, you should be more open to talking about it. It can break people’s misconceptions about it and possibly lead to a more productive discussion about the best treatments.

What are your thoughts about the stigma on gout? Share your thoughts in the comments below!