Allen Crimond, of Ohariu Valley, asks :-

To get quick relief from Gout, a doctor once prescribed Colchicine. This caused me to empty my whole "poisoned" system by vomiting, a horrid heaving experience, and extreme diarrhoea. Would consuming a whole bottle of prune juice, which is much more pleasant and cheaper have the same effect?

Tony Merriman, a biochemist at the University of Otago's School of Medical Science, responded.

Gout is a form of arthritis that is caused when the immune system reacts to urate (uric acid) crystals that are deposited in the joints. This occurs when urate levels get too high in the blood, whereupon the blood becomes super-saturated and the urate precipitates as crystals.

The best way of preventing gout is by taking medications that keep the levels of urate below super-saturation. This can be achieved using urate-lowering drugs (allopurinol for example) that prevent the production of urate in the blood, or those that increase the excretion of uric acid in the urine (probenecid for example).

However when gout occurs there are drugs that can treat the inflammation and pain. Colchicine is one such drug. Its anti-inflammatory properties have been known about for thousands of years and was originally extracted from the autumn crocus (Colchicum autumnale). It works by inhibiting the ability of immune cells called neutrophils to move to the inflammation, and can also prevent release of chemicals that drive inflammation in gout (interleukin-1-beta for example).

Unfortunately, one of its well known side-effects is intestinal toxicity, hence your reaction. To answer your direct question, prune juice will not have the same effect because, while colchicine was causing the unpleasant vomiting and diarrhoea, it was also working directly on the immune cells to stop the gout attack - something prune juice will not do.