Quinton: I would like to know what treatment you can suggest for gout. It comes back continuously within a space of two months.

Harry: Now you are a male and it is males who suffer mainly from gout. It is not a very common condition at all in ladies. Gout is usually a genetic or inherited condition. Do any of your family have gout?

Quinton: My brother has it.

Harry: The condition is as a result of an increased amount of what we call uric acid in the blood and this uric acid often assumes needle-like forms and these forms or crystals are what cause the pain and attacks of gout. Where have you had this - in your big toe?

Quinton: I used to have it there and now it goes to the ankle.

Harry: It can involve virtually any joint in the body but classically and most typically it involves the big joints. Now the approach to this is firstly, if you've got an acute attack of gout you must treat that with an anti-inflammatory of one type or another. You must treat that until the pain completely disappears.

Quinton: What kind on anti-inflammatory?

Harry: There are various kinds such as Brufen, Indocid and Voltaren. So you treat the acute attack with an anti-inflammatory and when the pain has completely disappeared, what you've then got to consider is to prevent further attacks. So you've treated the acute attack and now you've got to prevent further attacks. And the way to tackle this is to get the uric acid down. You see the anti-inflammatory doesn't cause the uric acid level to fall in the blood. So you then use a medicine called Allopurinol and that will reduce the amount of uric acid in the blood and hopefully prevent any further attacks. The one thing I must caution you about is that in the first few weeks or even months of taking the Allopurinol, you may get more acute attacks. So what you should then do is combine the Allopurinol with some or other anti-inflammatory agent. And then over the weeks and the months if you've had no further attacks you can then stop the anti-inflammatory and carry on with the Allopurinol, which you'll have to use for the rest of your life.

Quinton: Thank you very much.