Dr. W. Gifford-Jones: Ignore these troublesome symptoms at your own peril

Dr. W. Gifford-Jones

When should you worry about symptoms? After all, we all have an occasional ache or pain. So how can you separate minor problems from the potentially fatal ones? There’s no 100 percent guarantee, but here are some good guidelines.

• Persistent fever

If you have fever for no apparent reason lasting for several days, see your doctor. A persistent fever can be due to a urinary infection, undetected pneumonia, tuberculosis and malignant conditions such as lymphomas.

• Vision problems

If you need a longer arm to read the newspaper, you’re middle aged and need glasses. Or, if you’ve had spots and cobweb-like objects floating in your vision for years, they’re just an annoyance. But the sudden appearance of floaters and lightning-like flashes can mean a retinal detachment.

• Rectal bleeding

Too many people are ignoring this symptom and dying from colon cancer. If you had a colonoscopy a few months ago, in all probability bleeding is due to a benign problem such as hemorrhoids. Other conditions, such as diverticulitis (small inflamed hernias of the large bowel), can cause bleeding. But unless you’ve had a recent colonoscopy you must assume the bleeding is due to cancer until proven otherwise.

• Diarrhea, constipation

No one goes through life without having an occasional bowel problem. But sudden diarrhea or constipation without apparent cause can signal a serious bowel problem. So can alternating constipation and diarrhea. And if black or tarry stools appear in the toilet bowl, that normally means intestinal bleeding and the need for a hasty visit to the doctor.

• Shortness of breath

You wouldn’t be alive if now and then you didn’t feel a bit short of breath. But if breathlessness is gradually getting worse it could be due to chronic obstructive lung disease, asthma, emphysema, cancer and heart disease. And if there’s swelling of ankles as well, it may be due to a failing heart.

• Chest pain

This is one of the most difficult symptoms to assess, even for doctors. In most cases, overindulgence in eating and drinking results in heartburn, an inflammation of the lower part of the food pipe. If you’ve had this symptom on occasion, it’s safe to assume it’s for the same reason. But if there’s any doubt, it’s safer to seek attention speedily. However, never delay when sudden constricting chest pain strikes, as if there’s a tight rope around you and pain radiating down the left arm or up into the jaw. This symptom usually means heart attack.

• Changes in the head

A sudden loss of vision lasting a second or two, or a short temporary loss of consciousness, called a TIA (transient ischemic attack), may be the prelude to a major stroke. A “thunderclap headache,” often categorized as such because it comes on like a clap of thunder, needs immediate attention. So does a headache that’s accompanied by a fever, stiff neck, mental confusion, weakness, and numbness or speaking problems. These symptoms may be the result of stroke, meningitis or a brain tumour.

• Weight loss

A great deal has been said about the dangers of gaining weight, but losing weight can also signal serious problems. Unexplained weight loss can be the result of cancer, liver disease, hyperthyroidism and depression.

• Menstrual bleeding

The main rule to follow is that any abnormal bleeding should be reported to the doctor. There’s a dangerous tendency to wait and see if bleeding happens again. Often bleeding is due to a benign condition, but if it’s due to cancer you’ve lost valuable time in waiting to see the doctor.