Harry: I'll just kick off with the medical side. Gout is a medical condition and is in fact a genetic disease that is much more common in men. It is characterised by high levels of uric acid, a certain chemical in the blood, which sort of precipitates out and causes this pain. Basically there are two phases in the treatment. One is the treatment of the acute attack that you've spoken about, and there we use certain medicines such as Voltaren, which is an anti-inflammatory. There are a whole variety of anti-inflammatories that you could use. But the most important thing is the second phase because you've got to treat the condition in between the attacks, to prevent more attacks. You've got to treat the underlying problem, which is the high uric acid. That will commonly involve treatment for life. The best medicine to treat this is called alopurenol . That medicine will tackle the basic underlying problem, which is the high uric acid. You have to take that medicine for long periods of time, commonly for life. And it is only in this way that you can prevent more attacks happening. This does not only prevent acute attacks of the joints, but even more importantly it can prevent the high level of uric acid in the blood from damaging the kidneys. That is much more serious, as I'm sure you will agree. Dennis, from a podiatrist point of view is there anything that can be done for the acute inflamed joint, which often involves the big toe.

Dennis: Obviously keeping pressure off the toe by not wearing shoes will help. I'm sure he doesn't wear shoes anyway because of the pain. Also using hot and cold modalities over that red hot joint can help to reduce the pain and discomfort he's having. But as Professor Harry has said, it is really important to control that uric acid by medication and diet and that type of thing.

Maria: What sort of diet should he be on?

Harry:The diet plays a part. I would say that the most important aspect of the diet is not to be overweight. He should avoid rich foods like red meat, but particularly things like liver, kidneys, tripe and so on. He must also drink plenty of water because that helps to flush the kidneys. Especially in the summer time, he should drink eight to ten glasses of water a day. And the last point is that he mustn't drink too much alcohol.