Health Decision Guides

Vaginal discharge, itching and irritation are common symptoms that affect every woman at least once in her life. This guide will help you understand what may be causing your symptoms and will help you to know when it is important to seek medical attention.

It is normal for women to have a small amount of vaginal discharge. Normal vaginal discharge is cervical mucous, which is usually odorless and clear or light in color. Vaginal discharge will change over the course of a monthly menstrual cycle. Usually, vaginal discharge gets thicker and increases in quantity for a time between cycles, with these changes beginning about two weeks before the next period is due.

Most women notice less vaginal discharge after menopause than they had before menopause.

Have you already reached menopause?

Yes, I have started menopause or passed through menopause.

No, I have not reached menopause.

There are several infections that can cause vaginal discharge, itching and irritation. We will discuss the most common ones.

Yeast infections are extremely common in women. They can cause discharge, itching and irritation. Frequently, the symptoms of a vaginal yeast infection can be easily recognized:

• Is your discharge thick and white?

• Does the discharge look like cottage cheese?

• Does it smell yeasty, like bread rising in the oven?

• Do you have a lot of vaginal itching?

Yes, I have at least one of these symptoms.

No, I do not have any of these symptoms.

Sores (ulcers), blisters, pimples and lumps can form inside or nearby the vagina. These changes can occur with or without pain. This guide is intended to provide you with a better understanding of what may be causing your problem, if you have one of these changes. This guide is not intended to substitute for an in-office evaluation by your doctor.

Please choose the concern that fits best:

My concern is an ulcer, blister, or pimple.

My concern is a lump, growth, or swelling.

Where exactly is the lump, growth, or swelling?

On the skin outside the vulva

At the entrance to the vagina or on the vulva

Inside the vagina or bulging out from the vagina

Vomiting is very common in babies. Sometimes it can be entirely normal, like when babies spit up mouthfuls of breastmilk or formula after eating. Sometimes it can be a sign of illness or a blockage somewhere in the intestines. Less commonly, it can even be a sign of accidental poisoning or be caused by a bad bump to the head.

If your child is younger than one year and is vomiting, this health decision guide will help you understand more about what may be causing it and help you know when to call your doctor. Please note, this guide is not meant to take the place of a visit to your doctor's office.

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Vomiting sometimes is a sign of serious illness.

Do any of the following statements describe your baby?

• He has a fever (a rectal temperature reading of 100.4F or higher).

• His stomach looks swollen or hard, and is painful to the touch.

• He is acting like his head hurts (touching it, holding it) or he is having difficulty moving his head.

• He is refusing to drink or eat.

• He hasn't had wet diaper for more than six hours.

• He has not had a bowel movement in several days.

• He seems extremely tired or weak.

• He seems confused.

• He is very cranky (irritable).

• He has dark red spots on his skin that don't get paler when you press on them.

Yes, my baby has one or more of these symptoms.

No, this does not describe my baby.

Nausea with or without vomiting is common in children. Most of the time, the cause is not serious. The symptoms usually go away in a day or two and can be managed at home. However, there are times when you should alert your child's doctor immediately.

Nausea or vomiting associated with one or more of the following symptoms should prompt an immediate call to the doctor's office:

• severe abdominal pain

• a bad headache

• a stiff neck

• fever of 102F (39C) or greater

• frequent diarrhea

• appears dehydrated

• not making urine.

Vomiting that seems to be getting worse or that lasts more than one to two days also should be discussed with your doctor.

If your child is older than one year, this health decision guide will help you understand more about what usually causes children to vomit, and help you know when you should contact your pediatrician for medical care. Please note, this guide is not meant to take the place of a visit to your pediatrician's office.

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Your child is vomiting and you are concerned.

When your child vomits, is it a greenish-yellow color, does it contain any blood, or does it look like coffee grounds?

Yes, this describes my child's vomit.

No, that does not describe my child's vomit.

The disappearance of periods in a woman of reproductive age is called amenorrhea.

If menstrual periods never started, this is referred to as primary amenorrhea. When periods have become established and then stop occurring, doctors refer to this as secondary amenorrhea.

Amenorrhea of either type always requires medical evaluation.

This decision guide is designed to help women with secondary amenorrhea understand what may be causing it and the questions your doctor will want to ask.

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The most common cause of amenorrhea is pregnancy. The standard initial test for all women with secondary amenorrhea is a urine or blood pregnancy test. Even if you do a home pregnancy test and it is negative, your doctor will probably want to repeat it.

Assuming that you are not pregnant, the pattern of your periods before they stopped provides clues to possible causes.

Before your periods stopped, had they been fairly regular?

Yes, I used to have regular periods.

No, my periods were never regular.

We're sorry you have wrist pain!

The goal of this guide is to provide information while awaiting evaluation with your doctor, or for additional information after you have seen him or her. Please keep in mind that this guide is not intended to replace a face-to-face evaluation with your doctor. The diagnoses provided are among the most common that could explain your symptoms, but the list is not exhaustive and there are many other possibilities. In addition, more than one condition may be present at the same time. For example, a person with rheumatoid arthritis could also have tendonitis.

The wrist is prone to pain because it is frequently overused and has a complicated anatomy, with many structures packed into a small space.

Please click here to continue.

Certain symptoms suggest a serious cause of wrist pain that requires prompt attention. It's important to ask questions about these symptoms first.

Do you have severe wrist pain and any of the following symptoms:

• fever

• redness

• marked swelling

• inability to use the joint

• recent significant trauma (a fall, car accident, etc.)?

Yes, I have one or more of these symptoms.

No, I do not have these symptoms.

Welcome to our guide, New and Severe Abdominal Pain in a Man.

New and severe abdominal pain always needs to be closely evaluated by a doctor. It is frequently a sign of serious illness. This guide was not designed to substitute for office-based care.

If you are having new and severe abdominal pain, this pain may be frightening to you because of its mystery -- the abdomen contains many important organs that could be the source of your pain. It may seem like a daunting task for a doctor to diagnose the source of your symptom; in fact, there are more than a hundred medical conditions that commonly result in abdominal pain.

Despite the long list of possible causes for abdominal pain, your doctor will be likely be able to narrow down the possibilities to a short list after initial evaluation. Your experience may be less frightening to you if you understand the way that doctors begin to make sense of your symptom, and the reasons for ordering certain tests.

The purpose of this guide is to help you to understand a common way that doctors think through abdominal pain. This guide may also enable you to provide a more helpful medical history during your doctor's evaluation.

This guide was intended for people with new abdominal pain -- pain that has been present for less than two weeks. If your pain has been present for longer or is recurring from previous episodes, please visit our Guide for Recurring Abdominal Pain.

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In this guide, we will start by identifying where you feel the pain most strongly. The middle third refers to an up-and-down stripe from the bottom center of your ribs, down through your navel (belly button) and ending above your pelvic bone. The sides of the abdomen refer to the outer one-third on each side of the middle third.

When your body was first forming as an embryo, a part of your development included the "migration" or rearrangement of several of your body organs. The nerves that connected to your organs did not re-wire as the organs rearranged. For this reason, some organs cause pain in a location different from where they are now located.

A specific location of pain in your abdomen is a very valuable clue, but it does not always lay blame on the organs that are located in its vicinity.

Please select the location where your pain is felt most strongly:

In the middle third of my abdomen

On one side or the other

All over my abdomen

Welcome to our guide, New and Severe Abdominal Pain in a Woman.

New and severe abdominal pain always needs to be closely evaluated by a doctor. It is frequently a sign of serious illness. This guide was not designed to substitute for office-based care.

If you are having new and severe abdominal pain, this pain may be frightening to you because of its mystery -- the abdomen contains many important organs that could be the source of your pain. It may seem like a daunting task for a doctor to diagnose the source of your symptom; in fact, there are more than a hundred medical conditions that commonly result in abdominal pain.

Despite the long list of possible causes for abdominal pain, your doctor will be likely be able to narrow down the possibilities to a short list after initial evaluation. Your experience may be less frightening to you if you understand the way that doctors begin to make sense of your symptom, and the reasons for ordering certain tests.

The purpose of this guide is to help you to understand a common way that doctors think through abdominal pain. This guide may also enable you to provide a more helpful medical history during your doctor's evaluation.

This guide was intended for people with new abdominal pain -- pain that has been present for less than two weeks. If your pain has been present for longer or is recurring from previous episodes, please visit our Guide for Recurring Abdominal Pain.

Let's get started.

Now let's identify where you feel the pain most strongly.

The middle third refers to an up-and-down stripe from the bottom center of your ribs, down through your navel (belly button) and ending above your pelvic bone.

The sides of the abdomen refer to the outer one-third on each side of the middle third.

When your body was first forming as an embryo, a part of your development included the "migration" or rearrangement of several of your body organs. The nerves that connected to your organs did not re-wire as the organs rearranged. For this reason, some organs cause pain in a location different from where they are now located.

A specific location of pain in your abdomen is a very valuable clue, but it does not always lay blame on the organs that are located in its vicinity.

Please select the location where your pain is felt most strongly:

In the middle third of my abdomen

On one side or the other

All over my abdomen

If you have frequent burping or frequent passing of gas from your rectum, this guide can help you to understand where your gas comes from and how you can reduce it.

Burping (belching), a noisy stomach, or passing of gas from the lower bowel can be embarrassing events, but they are rarely caused by a medical problem. More often, gas is the result of the foods that you eat and how much air you swallow. If your gas symptoms are significant, or if you have other unexplained symptoms, it is best for you to consult with your doctor. This guide is intended to be used as a complement to discussions with your doctor, not as a substitute for office-based care.

You will encounter a small number of questions about your experience with gas as you proceed through this program. Your answers to these questions will help us to personalize our recommendations for you.

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Some people who have gas complaints suffer primarily from belching (burping), with or without a noisy stomach. Other people are more bothered by bloating or frequent passing of gas from the rectum (flatulence).

What is your most noticeable gas problem?

Belching (burping) or a noisy stomach

Lower abdominal gas (flatulence) or bloating

Coughs and colds are experienced by most adults two to four times per year and more frequently by children. It is not necessary for you to see a doctor if you are having symptoms of an uncomplicated viral infection in the respiratory tract (ears, nose and sinuses, throat and chest). On the other hand, your doctor should evaluate you if you are having symptoms that suggest a more serious cause, such as a bacterial infection, or if your symptoms aren't manageable with over-the-counter remedies or the passing of time. The purpose of this guide is to review your cough and cold symptoms and to identify specific patterns of illness for which a doctor's evaluation is recommended.

You will encounter a number of questions about your symptoms as you proceed through this program. Your answers to these questions will help give you suggestions most pertinent to you.

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Upper and lower respiratory tract infections commonly cause several symptoms simultaneously. Even so, one symptom probably dominates your illness. Identifying your most dominant symptom can be a good way for us to get started.

What is your most bothersome symptom from the list below?

Cough, wheeze, or breathing difficulty.

Sore throat.

Runny nose, stuffy nose or sneezing.

Hoarse voice or lost voice.

Ear pain.