5 Often-Missed Ailments

These sneaky maladies elude doctors more than most. Here, tips for how to spot them.
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Diagnosing ailments can be tricky. With over 200,000 known human diseases, even the best-informed doctors are bound to get it wrong sometimes. “It’s often hard to pin a problem down, especially if the symptoms are exotic or you’re not taking into account a broad range of possibilities,” says Stephen Brunnquell, M.D., chief of general internal medicine at Englewood Hospital and Medical Center.

Read on for five of the most misdiagnosed maladies, along with tips on how to sniff them out:

1  CELIAC DISEASE

What it is: This intestinal disorder, also known as sprue, is sparked by an intolerance to gluten (a protein found in wheat) and causes diarrhea, cramping and bloating. Left untreated, it can lead to severe vitamin deficiency and destruction of the small intestine.

Why it’s easy to miss: Symptoms are easily mistaken for lactose intolerance, irritable bowel syndrome or other forms of indigestion.

How to spot it: “Don’t write off ongoing symptoms as mere digestive discomfort,” says Dr. Brunnquell. “Consult your doctor, who can easily identify sprue with simple blood tests and colonoscopies.”

What it means: There is no cure for celiac disease, but patients find relief by following a gluten-free diet (no breads, pasta, cookies or beer) and taking a daily multivitamin.

2  INTESTINAL ISCHEMIA

What it is: Another abdominal disorder, this one is caused by diminished blood flow to the small intestine or colon, resulting in severe yet sporadic stomach pain.

Why it’s easy to miss: “With bellyaches, physicians usually first consider the most common list of ailments: appendicitis, kidney disease, ulcers and colon cancer,” says Dr. Brunnquell. Intestinal ischemia is rare, and thus often goes unnoticed.

How to spot it: If abdominal pain is sudden, ranges in strength from mild to severe and includes nausea or fever, consult your doctor for a thorough medical examination that probably should include an angiogram.

What it means: Since it can become fatal if left untreated, immediate treatment is in order. The goal is to restore adequate blood flow to the digestive tract, which can only be accomplished with surgery.

3  A BLOOD CLOT

What it is: A blood clot is a clump that results from the coagulation of blood, which is a natural part of the healing process. It becomes dangerous, however, when it gets lodged in a blood vessel, blocking the flow of blood to vital organs. This can result in heart attack, stroke, disabling limb injury or pulmonary embolism (a blockage of the lungs).

Why it’s easy to miss: “Blood-clot symptoms can be vague,” says Dr. Brunnquell. “They may include chest discomfort, leg pain, dizziness and swelling, all of which can also be associated with other diseases.”

How to spot it: “Immobility is our one big tipoff,” says Dr. Brunquell. “If you’re experiencing the typical symptoms and you’ve been sitting on an airplane for eight hours, the first thing we check for is a blood clot.”

What it means: An untreated blood clot can be lifethreatening. Surgery is sometimes required in these cases, but most patients are cured with heparin, an anticoagulation medication.

4  LYME DISEASE

What it is: An infection caused by a bacteria often carried by deer ticks, Lyme disease is an outdoor hazard that can cause flu-like symptoms and sometimes other problems. “Bergen County is loaded with deer ticks,” says Dr. Brunnquell, “many of which carry Lyme.”

Why it’s easy to miss: While most of us are familiar with the characteristic “bull’s eye” rash associated with Lyme, this telltale sign is not always present. Other symptoms include fever and musculoskeletal aches, which can easily be confused with influenza.

How to spot it: “People generally don’t get the flu in the middle of the summer,” says Dr. Brunnquell. If you develop an unexplained high fever (103 degrees or more) or a bumpy red rash any time from May to September, consult your doctor and ask him or her to check for Lyme.

What it means: If it’s detected and treated early, Lyme disease is easily eliminated with antibiotics. If not, it can cause pain and swelling in the joints, numbness and weakness in the limbs and inflammation of membranes around the brain, resulting in mood, memory and attention problems.

5  DEPRESSION

What it is: Caused by an imbalance of brain chemicals, depression is a common and serious mental disorder.

Why it’s easy to miss: The myriad symptoms associated with depression—including but not limited to headaches, stomach trouble, joint pain, fatigue and irritability—makes this a very difficult disorder to diagnose correctly. “A doctor has to be a good listener in order to intuit the patient’s true problem from what he or she may not be saying,” says Dr. Brunnquell.

How to spot it: If you’re persistently sad or anxious or you begin to lose pleasure in activities you usually enjoy, it’s a good idea to talk to a medical professional. Other notable signs include feelings of worthlessness, frequent crying, decreased energy, trouble concentrating, difficulty sleeping and general irritability.

What it means: Severity varies by patient, but most find relief through psychotherapy and/or antidepressant medications that elevate mood by increasing serotonin, a hormone that regulates emotion.


3 TIPS FOR PATIENTS

You can help ensure an accurate diagnosis by heeding this advice when talking to your doctor:


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