ABC of Medically Unexplained Symptoms by Christopher Burton

By Christopher Burton

This fresh identify addresses the advanced concerns confronted via fundamental overall healthiness care practitioners in treating and dealing with sufferers with ‘medically unexplained symptoms'. It goals to enhance directions and ideas to assist determine sufferers with medically unexplained signs, as they're in general underdiagnosed, and to control indicators extra successfully with energetic sufferer involvement.

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Notice how the experience of a symptom, elicited with the ‘what does it feel like’ question can includes emotional or consequential components of the symptom whereas a description of the nature of the symptom is much simpler. Both are of equal value in making a disease diagnosis, but the experiential account gives you greater insight into patient ideas, concerns and expectations without needing to ask additional questions. Asking when the symptoms first began, or when they were worst, can reveal clues to the diagnosis but there is a need to be careful.

Scenario 1 ‘Brian’ is a 36-year-old bank employee suffering from intermittent stomach complaints, mainly a burning sensation in his upper abdomen, sometimes with nausea. Gastroscopy 18 months ago was normal, with no evidence of Helicobacter pylori. Until now the episodes only lasted a few weeks at the most, and he coped by using over-the-counter medications. The reason for visiting his GP is that the symptoms are getting worse and have been present for more than a month now. He has stayed at home for a few days last week, because the symptoms were too bothersome although he doesn’t think recent pressure at work is responsible.

Cephalalgia 2008;28(11):1188–95. uk). Contains UK headache management guidelines. uk. National Institute for Clinical Excellence, CG150, diagnosis and management of headache in young persons and adults, 2012. CHAPTER 9 Gastrointestinal Symptoms: Functional Dyspepsia and Irritable Bowel Syndrome Henri¨ette E. van der Horst General Practice Department, VU Medical Centre, Amsterdam, The Netherlands OVERVIEW • Both functional dyspepsia and irritable bowel syndrome (IBS) are very common in primary care and can generally be managed by the GP • A careful assessment will enable the GP to sort out those patients in whom symptoms may originate from a physical disease, requiring further investigation and/or referral • Addressing patients’ worries and providing information on symptoms and their management is the cornerstone of the GP’s treatment • If psychological factors are an important issue (such as coping with stress or anxiety) cognitive-behavioural therapy (CBT), or some form of relaxation therapy may be helpful Introduction All gastrointestinal symptoms reflect either pain or disturbed function, and in most cases this is not associated with organic disease.

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