Gout is easy to diagnose and effective treatments are available. Despite this, both patients and doctors often struggle to manage it optimally.
John had suffered from intermittent gout for 10 years. His history was classical with the initial episode located in the first metatarsophalangeal joint. He then experienced increasingly frequent attacks involving his feet, elbows and wrists. John usually took indomethacin during flares and had said that he could not take allopurinol because ‘it made things worse’. He refused to take colchicine because in the past, after he had taken colchicine tablets every half hour, he experienced severe diarrhoea within 24 hours. He liked to drink stout beer occasionally and had never received dietary advice to help manage his gout.