Common symptoms you should not ignore

It is not uncommon for us to come across people saying ‘Oh I have this cough for some time-I think its phlegm’, ‘Oh I have a bit of bleeding when I go to the toilet-I think it’s haemorrhoids’. We are very good at assuming things where small aches and pains tend to often get neglected. Yes, true if we feel really ill we would always seek medical advice or get admitted to a hospital without delay, but these little symptoms, which often go unnoticed, can really be the beginning of something disastrous and end up giving us massive trouble. Hence early diagnosis and treatment might be the only way for cure. Today on Health Capsule we are going shed light on 10 common symptoms which are usually left ignored yet worth some considerable attention and awareness. We have obtained the guidance of  Dr. Solith Senanayake, Registrar Internal Medicine, Lecturer, Department of Pharmacology, University of Sri Jayawardanapura for this purpose. 

Headache 
“Headache is a common experience all of us would have had at some point in our lives. The list of causes for headache is numerous with most of the conditions being benign and harmless. Varying from tension headaches to migraine, which can hamper our day to day activities, a headache should worry you when it is associated with the following” says Dr. Senanayake.

• Early morning vomiting 
• Headache worsening with coughing, sneezing
• Worst ever headache you have experienced 
• Changing character of your headache from what you have experienced
• Headache with fever accompanied by difficulty in looking at the light  

Cough 
From a simple common cold to pneumonia and lung cancer, the list of causes for cough can vary where we need to have some sort of  knowledge to identify when to care and when to ignore.  Acute onset cough lasting for a short duration is most of the time self-limiting and often due to viral respiratory tract infections. Long standing cough, even of mild severity should be followed up since it could be the first sign of a lung cancer which might have got neglected for a long time. A persisting cough should worry you when its associated with,

• Unintentional weight loss
• Loss of appetite 
• Drenching night sweats with low grade fever
• Blood stained sputum 
• Greenish sputum 
• Chest pain when coughing
• Bleeding on defecation

“This is not a common symptom experienced by healthy individuals and should grab your attention in no time. The commonest cause for bleeding fresh blood through rectum is haemorrhoids yet should be properly evaluated medically since it could be the only sign of early bowel cancer. Other worrying signs which can be associated with such bleeding include weight loss, abdominal pain and feeling of inadequate defecation, but they are often present during the later stages of cancer” Dr Senanayake highlights.

Un-explained wound 
A wound is a breach in the skin or mucous membrane. Most of the wounds occurring in healthy individuals would result in quick healing yet there are various systemic diseases which result in delayed wound healing.  For an example a lower limb ulcer which does not heal or heals poorly after three months is considered to be chronic and should be investigated. An un-healing wound could be a type of skin cancer and suggests reduced immunity or a complication of undiagnosed high blood sugar levels.

• Better to be watchful on symptoms like increased thirst and hunger, frequent urination or significant weight loss which suggest you 
• have Diabetes.
• Also make sure to be vigilant on pain in the groin or any lumps indicative of enlarged lymph at times which suggest that it could be cancer.

Bleeding after menopause 
Women around the age of menopause usually experience certain changes in their physiology and menstrual cycle and one such change is the cessation of periodic bleeding (menstruation). Bleeding after the cessation of periods is an ominous sign and should be considered as uterine cancer unless proven otherwise. 
Women often tend to ignore such abnormal bleeding patterns especially if they are mild and do not affect the quality of life. Individuals with such symptoms end up in trouble when the cancer reaches the end stages, leaving them with no option for treatment.

Lump in your breast 
According to Dr. Senanayake, a lump on the breast in middle aged woman is definitely not something to be ignored. 
“Most of the breast lumps are benign, but even if they are diagnosed to be cancerous, early diagnosis and treatment can usually promise 100% cure. Unfortunately, most women even after noticing such changes would probably tend to hide behind curtains due to social stigma. What they don’t understand is that ‘early detection is cure’” he further emphasised. 

It is always good to be vigilant especially if there is a positive family history and develop the practice of self-examination and periodic follow up with ultra sound scans or mammography. 

Epigastric pain 
Gastritis is a common problem in the modern community and often experienced due to unaccepted dietary habits. Though usually presented as mere epigastric pain, burning sensation and regurgitation, can all similar presentations be counted as gastritis? 

There is a huge list of causes for pain in the epigastric region and should be properly evaluated with 
timely investigations. 

nIf you have shortness of breath while walking and feel heavy in the chest along with an epigastric pain, it could be a sign of developing ischemic heart disease. 
nIf you have regular epigastric pain with loss of appetite, weight loss or difficulty in swallowing which seem to be worsening over time it could be a sign of an oesophageal cancer or a stomach cancer. 

nIf you’re a regular alcoholic and a smoker or you have very high triglyceride levels, your pain could be due to an inflamed 
pancreas (Pancreatitis). 

Bleeding when passing urine (Haematuria) 
Red colour urine is not a common finding that you see every day.“If you get pain with red coloured urine and fever, it is most likely to be a urinary tract infection or a renal stone. In the elderly, difficulty in passing urine is a common scenario with natural progression of the prostate gland becoming enlarged-rarely turning into a cancer. But if you at least once or twice pass abnormally red coloured urine- especially if it’s painless- urgent medical advice should be sought after. Even in the not so elderly population, bleeding could be a possible sign of an early bladder or kidney cancer” 

Sometimes it could be associated with other rare systemic conditions like glomerular-nephritis which is an inflammatory process of the kidney presenting with high blood pressure, haematuria and body swelling.

Chronic Back pain 
Back pain is a common scenario followed by lifting a heavy object or trauma. Back pain in elderly with red flag signs is definitely something to worry about. 
Back pain which wakes you up from your sleep or is associated with malaise, generalise weakness especially in elderly, needs a proper evolution; firstly to exclude an osteoporotic fracture and secondly to exclude distant metastasis of a cancer where the spine is one of the commonest places.  
Back pain and stiffness are usually experienced in the morning and reduce as the day goes by or improves with exercise- this could be a part of a series of rheumatological disorders. This needs to be evaluated by a specialist rheumatologist to decide on the diagnosis and initiation of the treatments which are crucial in preventing the progression of the disease. 

Other aches, pains, lumps and bumps 
“Any unusual lump, bump, ache or pain which you think is rapidly progressing in severity with time, making a significant impact on the quality of your life should be followed up because it is always better to nip a problem in the bud without allowing it to worsen, which if not might create irreversible trouble” highlighted 
Dr. Senanayake.