SUBTLE SYMPTOMS THAT SIGNAL DANGER
After nearly a year of increasing constipation and two miserable days of repeated vomiting, a 75-year-old retired firefighter came to see me at the insistence of his wife. On examination, I found evidence of acute intestinal obstruction and chronic weight loss. Suspecting colon cancel; I immediately admitted him to the hospital for further work-up.
There, my suspicions were confirmed: The tumor had completely encircled a segment of his intestine, narrowing it to the point that virtually no fecal matter was able to pass. Emergency surgery relieved the obstruction. But by then it was too late. The cancer had already spread to his liver. He died six months later.
Ominous, not always obvious If only he’d known how to read the early warning signs, there would have been a better chance of curing his cancer. But he mistakenly blamed his progressively narrowing stools on his enlarged prostate gland. He attributed his increasing constipation to having eaten less of late. And he figured that’s why he was losing weight.
Unpleasant symptoms of one sort or another are the body’s way of letting you know that something is wrong. Most people don’t think twice about calling the doctor when they’re in pain or running a high fever. But there’s less motivation to seek medical help when you’re not uncomfortable or worried. And indeed, most minor annoyances can be safely ignored, especially if they subside on their own. But some commonplace symptoms that are commonly ignored can signal real danger. Here are a few warning signs to watch out for:
• Bowel changes. Most people would dismiss an occasional bout of stomach upset—such as bloating, cramps, and constipation—as the result of something they ate. And various foods or temporary changes in eating habits can indeed cause such symptoms. However as in the case of my unfortunate patient, altered bowel habits that persist and worsen can also signal colorectal cancer. Ovarian cancer can be heralded by similar symptoms. Basically, any change of bowel habits that doesn’t disappear over a period of several weeks warrants a visit to the doctor.
• Rectal bleeding. People with hemorrhoids may sometimes pass blood in their stool. So it’s easy to dismiss rectal bleeding as just another hemorrhoidal flare-up. But it can also signal benign or malignant polyps. Whatever the cause—even if it turns out to be nothing more than hemorrhoids—rectal bleeding on more than one occasion within a few weeks deserves medical attention.
• Weight loss. Most overweight people would probably be delighted to lose weight without trying. But weight loss that can’t be explained by diet and exercise may be an early sign of conditions such as diabetes, an overactive thyroid gland, or poor absorption of nutrients from the intestinal tract. Those disorders can all cause you to lose weight even if you’re eating more than usual. If you happen to be dieting, the extra weight loss may be mistaken for a sign of success.
• Itching. What may seem like an innocent itch can actually be an ominous symptom, especially if there’s no rash or any other sign of skin irritation. It’s easy to dismiss such itching as “winter skin,” brought on by dry air, but if the itching is worse than you’ve experienced in previous years—or if it’s not winter an underlying disorder may be to blame. Possibilities range from diabetes, iron-deficiency anemia, and an overactive thyroid to more dire diseases, including leukemia, lymphomas, and cancer of the gallbladder, intestinal tract, or liver.
• Leg pains. Tired, achy legs can be brought on by a long day at the mall. But if even a short walk when you’re well rested causes leg pain, it could be something more serious. If the pain is limited to one calf, it could be a sign of narrowing of the blood vessels due to arteriosclerosis. If you have pain in both legs, it could be due to spinal stenosis, an overgrowth of bony tissue that compresses the nerves in the lower spine .
• Red stretch marks. Ordinary stretch marks, which usually appear on the abdomen, flanks, and breasts, are permanent signs of rapid weight gain, often due to pregnancy. Those pale or silvery areas of thinned skin are at worst a cosmetic concern. But stretch marks that are red or purplish may indicate Cushing’s disease, a disorder in which the adrenal glands produce too much of the hormone cortisol, thinning the skin and bones and increasing the risk of infection. Such stretch marks are especially likely to signal Cushing’s disease in people who also have the triad of diabetes, hypertension, and osteoporosis.
WHEN TO CALL THE DOCTOR
That rundown of seemingly benign symptoms shouldn’t frighten you into calling your doctor every time you sneeze. There are a few basic guidelines that can help you decide whether to seek medical attention.
A symptom you might be tempted to ignore should be taken seriously if it:
• Represents a sudden change from your usual patterns of symptoms.
• Persists for more than two or three weeks.
• Gradually gets worse.
• Interferes with your daily routine.
• Seems like an exaggerated version of a familiar symptom that you had previously been able to explain.
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