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Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"

Case study ( 8907 views as of December 21, 2024 )

George is a 46-year-old plumber who recently has developed episodes of pain and swelling in his big toe. George is on medication for high blood pressure. The most recent episode came after a birthday celebration where he probably had more alcohol than he should have. He is pretty sure he has gout and wants to get it under control as soon as possible as he cannot afford to miss work.

George could benefit from seeing his family doctor and asking what is gout and how can it be prevented. A nutritionist may help by suggesting ways to change his diet in order to prevent his gout, and a personal trainer can help George maintain a consistent exercise program to promote heart health and good circulation. He may also benefit from seeing a cardiologist to check that his blood pressure is controlled and that his heart is healthy.

Author: Dr. John Wade

Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"

Case Introduction

Understanding the Effects of Gout

How Does Gout Affect You?

Presented by

Dr. Kam Shojania

MD, FRCPC

Rheumatologist

Treatments

Lowering High Blood Pressure To Reduce Risk of Gout

Practitioner help from:

Dr. Brett Heilbron

MD, FRCPC

Cardiologist
How Reducing Saturated Fats Can Help Reduce Risk of Gout

Practitioner help from:

Erin Meloche

Registered Dietitian
How Is Gout Diagnosed?

Practitioner help from:

Dr. Jude Rodrigues

Rheumatologist

Treatments

Heart Disease Risk Reduction and Gout

Practitioner help from:

Dr. Brett Heilbron

MD, FRCPC

Cardiologist
Regular Exercise In Reducing Risk of Gout

Practitioner help from:

Tommy Caldwell

Personal Trainer
Treating Gout and Possible Side Effects

Practitioner help from:

Dr. Jude Rodrigues

Rheumatologist

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Conversation based on: Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"

Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"

K. Michael 05 May 2016

Can gout occur in other joints ? or is it just the toe ?

Reply to: Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"
- AllieS 31 May 2016
  
  Gout is a type of arthritis that can happen in any joint. The big toe is most common, but it can also present itself in the wrist, ankle, elbow, fingers etc.
Michelle Kaarto, BScK, CSEP CEP 16 November 2015

You're right @K.Michael about the overindulgence and the link to gout. More men are affected by gout, and it is the leading cause of inflammatory arthritis in men.

Reply to: Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"
Joy 14 May 2015

What brings on gout symptoms?

Reply to: Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"
- AllieS 10 June 2016
  
  @K.Michael to build off what you said, uric acid accumulates because it has either been produced in excess when a certain compound (purine) gets broken down or it does not get excreted effectively by the kidneys. Each person is different in that sense, though lifestyle factors can increase the likelihood of having high uric acid in the blood (ex. too much alcohol). Uric acid crystals then get deposited on joints which leads to the painful swelling symptom.
- K. Michael 17 August 2015
  
  Gout is caused by high levels of uric acid in the blood. Some of the things that can cause that are drinking too much alcohol, eating too much red meat and being overweight.
Healthymama 27 February 2015

My father in law suffers from gout. It's a lifestyle ailment for sure.

Reply to: Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"
ShirleyG 30 January 2015

What can we do to prevent gout ?

Reply to: Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"
- K. Michael 12 October 2015
  
  Gout seems to be a disease of overindulgence. So too much alcohol, too much cheese, too much fat.......all of those would increase your likely hood of developing gout
- Healthymama 27 February 2015
  
  And do more men get gout than women?
ShirleyG 30 January 2015

A friend's father with gout has been told to eat cherries as this will help with inflammation and pain. What does a cherry have that helps with the gout ?

Reply to: Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"
- AllieS 31 May 2016
  
  It does seem like cherries help with reducing risk of gout flare-ups, but the mechanism behind it isn't very well known yet. It may be that they trigger an improved filtration response through the kidneys, or their anti-inflammatory properties might be significant enough to help reduce swelling caused by the uric acid deposits on joints.
- Healthymama 27 February 2015
  
  Cherries for gout?? Never heard of this. I will tell my father in law!
- K. Michael 02 February 2015
  
  That's very interesting that they were told cherries could help with gout. I've only ever heard of foods to avoid with gout
Carrie Cooke 15 January 2015

Is Gout curable? Or is it something that you have and the symptoms just come and go?

Reply to: Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"
- AllieS 10 June 2016
  
  I don't believe gout is necessarily curable, but symptoms can be managed through a combination of diet and lifestyle alterations.
K. Michael 06 December 2014

Alcohol is something that people with gout definitely want to avoid overindulging in

Reply to: Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"
- Healthymama 27 February 2015
  
  Henry the 8th had gout and he was a big alcohol drinker!
K. Michael 28 November 2014

Diet changes are vital for controlling the pain and discomfort from gout

Reply to: Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"
- Ms. Sarah Ware RD Registered Dietitian, North Vancouver, BC 23 December 2014
  
  Diet changes can be a big help for those suffering from gout. A dietitian, nutritionist or naturopath should be able to analyze George's diet and suggest ways, along with alcohol reduction, to help manage his symptoms.
- Yuan Lew, MSc MBA 01 December 2014
  
  So true, my father-in-law had painful gout, with high uric acid bloodwork results. He benefited from dietary changes.
Yuan Lew, MSc MBA 26 November 2014

I have had a swelling by my big toe for years plus I am hypertensive. I assumed it is a bunion. What is the difference between gout and a bunion?

Reply to: Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"
- K. Michael 29 November 2014
  
  @Yuan Lew - I believe bunions grow from the bone on the side of the foot whereas gout is a painful swelling of the big toe itself

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