Patient c/o Nonsignificant symptoms.....

      As a general practioner you will always come across patients complaining of nonfocal pain in abdomen, limbs, whole body, complaints of gas and related gaseous problems, burning sensation in every possible surfaces and orifices in body, lack of well being, decreased apetite, an array of urinary complaints and toilet complaints.
      We will do a clinical examination, which wont dig out anything in 99 percent of these cases. Then we go to our array of lab and imaging investigations. This may reveal some unrelated hidden pathology in its early stages ; like a fatty liver or prostatomegaly or a small fibroid or a mild splenomegaly ( even called scanomegaly) and blood reports will follow the bell shaped curve of normal distribution. Marginal reports will end up in repeating the test to confirm whether its normal.
     Multiple urine cultures, sputum microscopies, chest xrays, ECGs, CT scans, USG s by different radiologists- all being reported in various levels of normalcy.
    Sometimes the GP has to pin up the cough to a small umbilical hernia or dysuria to mild splenomegaly or hiccups to fibroid, so that the patient could be distracted and  directed to some specialist. Now a days Gastroenterologists doesnot wait for the Psychiatrist to start for antidepressants when they find no reason for the bloating and dyspepsia after required tests and PPI trials. Good thing is that so many of this symptoms get relieved too.
   But it actually takes little experience with patients to divide their complaints to significant and non significant. I think its always better to leave the decision to an expert in the field of suspected disease. Expert doesnot necessarily mean a doctor with degree, but one who sees a lot a such cases.
    My professor always tell, never ignore a complaint made by a patient. Its unlikely that any person in normal mind will complaint of a pain anywhere in body, unless there is a clear advantage of malingering. Everybody wants to be in goodhealth. But somany times we cannot explain the cause of these symptoms or to be exact, find a  treatable cause. Many of them are attributed to neuropathy. Naturally it should be, because most of these sensations are transmitted by nerves only.
   I had many instances like that. Instances when  I could not comeup with a diagnosis which explains the symptoms or treatment that could alleviate the symptoms even after an array of checkups, logical thinking and lab tests. Then I tell the patients " I am sorry that I am not able to find a specific reason for your symptoms. But I can assure you that, you dont have any serious illness that you should be worried of. So take these medicines ( probably painkiller or vitamin placebo) and hope rest of it will subside of its own ( which means you have to live with it....and now getoff my clinic !!)" Majority are happy to hear that, but those with that 'psychiatric face' or with peculiar personalities will be  unhappy.