The bigger picture

It is good that Alek’s GP is reviewing his medical history in light of his recent gout attack, as certain conditions and drugs can increase the risk of the condition. These include drugs for hypertension, kidney disease, diabetes, hyperlipidaemia and osteoarthritis of the feet, hands or knees, antihypertensives, aspirin and diuretics. If Alek is overweight, weight reduction will be beneficial too.

Gout is a type of arthritis in which uric acid accumulates in the body. Uric acid levels may be high because the body is producing too much, or not enough is being expelled via the urine, although not everyone with high uric acid levels will develop gout. In those who do, crystals will eventually build up around joints, most commonly the big toe, causing swelling, inflammation and pain, usually for between one and 10 days.

During an attack, non-steroidal anti-inflammatory drugs (NSAIDs) are usually prescribed, sometimes alongside a proton pump inhibitor. They should be taken at the first symptoms, throughout the attack and for 48 hours afterwards.

Extend your learning

• Take a look at the latest advice for treatment of gout from the National Institute for Health and Care Excellence (NICE)
• Understand how gout is linked to arthritis with Arthritis Action
• Signpost customers to the UK Gout Society.