Diseases & Conditions Archive

Irritable bowel syndrome (IBS) is a chronic disorder characterized by recurrent bouts of constipation, diarrhea, or both, as well as abdominal pain, bloating, and gas. IBS is a functional disorder, which means that it's not attributable, as far as we know, to any underlying disease process or structural abnormality. It's thought to involve various, often interacting, factors — infection, faulty brain-gut communication, heightened pain sensitivity, hormones, allergies, and emotional stress.

The good news is that IBS doesn't increase the risk for more serious conditions, such as ulcerative colitis or colon cancer. On the other hand, a disorder resulting in (at best) annoying and (at worst) debilitating and worrisome symptoms with no known cause can be difficult to diagnose and treat, not to mention live with. Managing IBS typically involves some trial and error, which can be challenging for patients and clinicians alike. Various tests or procedures may be ordered to rule out other conditions. Many diverse therapies, not all of them proven, are used in treating the symptoms, including antibiotics, antispasmodics, antidepressants, dietary changes, relaxation techniques, and psychotherapy, as well as drugs to relieve constipation and diarrhea.

Acne

Questions to Discuss with Your Doctor:

• At what age did your problem with acne begin?
• Do you have blackheads, whiteheads, pustules, or cysts?
• If so, what areas are involved: your face, chest, back?
• What is your skin-care routine?
• What products do you use? Do any of them help?
• What medications have you tried (e.g., benzoyl peroxide, Retin-A, antibiotics, Accutane)?
• If you are female, does your acne get worse around the time of your menstrual period and do you have regular menstrual periods?
• What medicines do you take, including over-the-counter medicines and birth-control pills?
• Have you been developing extra body or facial hair?

Your Doctor Might Examine the Following Body Structures or Functions:

• Skin exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Blood tests (liver function tests, cholesterol, or if you are female, perhaps a pregnancy test if you are taking the medicine Accutane)

Acoustic Neuroma

Questions to Discuss with Your Doctor:

• Do you have trouble hearing out of one ear or both?
• Do sounds seem distorted in one ear?
• Are sounds different between your two ears?
• Is the hearing loss getting progressively worse?
• Do you have difficulty understanding others when they are talking? For example, do you have trouble hearing people on the other end of the telephone?
• Do you have ear pain?
• Have you been dizzy or lightheaded? If so, does it seem as if the room is spinning?
• Do you feel unsteady when you walk?
• Have you heard ringing or unusual noises in one or both of your ears?
• Do the muscles on one side of your face feel weaker compared to the other side?
• Is there any weakness of your face?
• Have you lost your ability to taste certain foods?
• Have you had headaches? Nausea? Vomiting?
• Have you had double vision or unusual eye movements?

Your Doctor Might Examine the Following Body Structures or Functions:

• Ear, nose, and throat exam, including a screening test of your hearing in each ear
• Neurological exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Audiometry (formal hearing test) by a certified audiologist
• Brain-stem auditory evoked potentials
• MRI or CT scan of the head

Bell's Palsy

Questions to Discuss with Your Doctor:

• Do you have weakness or paralysis of the muscles in your face?
• Can you still raise your eyebrows?
• Can you close your eyelids?
• Have you had ear pain? If so, on which side?
• Are your eyes watery?
• Have you noticed any change in your sense of taste?
• Have you had problems hearing?
• Have you had problems chewing?
• Over what period of time did your symptoms develop?
• Have you had a recent upper respiratory tract infection (for example, a cold)?
• Could you have had a tick bite in the recent past?
• Do you have diabetes?

Your Doctor Might Examine the Following Body Structures or Functions:

• Neurological exam focusing on the strength of the facial muscles
• Examination of the ears, nose, and throat

Your Doctor Might Order the Following Lab Tests or Studies:

• Blood tests for blood sugar and possibly Lyme disease
• Hearing test (if you report difficulty hearing)
• MRI computed tomography (CT) of the head (if your history and exam are concerning for a stroke or tumor)

Crohn's Disease

Questions to Discuss with Your Doctor:

• Do you have abdominal pain or cramping?
• Do you have diarrhea, fevers, fatigue, rectal pain, or bloody stools?
• Have you recently lost weight?
• Is there a family history of inflammatory bowel disease?
• How many times a year do you get pain flare-ups?
• Do you have episodes of joint pain or swelling?
• Are you taking any medications?

Your Doctor Might Examine the Following Body Structures or Functions:

• Temperature, blood pressure, heart rate
• Careful abdominal exam
• Rectal exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Sigmoidoscopy or colonoscopy
• Stool sample to look for the presence of blood, white blood cells, and to culture
• Complete blood count and other blood tests
• CT scan or MRI of the abdomen

Gallstones

Questions to Discuss with Your Doctor:

• Do you have pain in the mid- or upper-right portion of your abdomen?
• Do fatty meals worsen the pain?
• Does the pain occur after eating?
• Do you have nausea, vomiting, or bloating?
• Does the pain ever go through to your back?
• Is the pain steady or intermittent?
• Have you had fevers?
• How long does it take for the pain to go away?
• Do you take any medications (for example, birth-control pills or hormone therapy)?
• Have you had any rapid weight loss?
• Have you noticed darkening of your urine or yellowing of the eyes?

Your Doctor Might Examine the Following Body Structures or Functions:

• Abdominal exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Blood tests of liver function
• Complete blood count
• Abdominal ultrasound
• Cholescintigraphy (HIDA scan)

Gastroesophageal Reflux Disease (GERD)

Questions to Discuss with Your Doctor:

• Do you get a burning sensation in your chest or throat after eating?
• Do you ever have a bitter or sour taste in your mouth?
• Do you ever have bloating or nausea after you eat?
• How often do you get these symptoms?
• What do you do to relieve the symptoms?
• Are the symptoms related to physical exertion?
• Are the symptoms worse when you are lying down or sitting up?
• Have you noticed any black stools?
• Do you have a persistent cough?
• Do you have a history of ulcer disease?
• Are you taking any medications, especially ones that can irritate the esophagus or stomach, such as aspirin, ibuprofen, naproxen or tetracycline?
• Do you drink alcohol or smoke?
• How soon after you eat at night do you go to bed?
• Have you tried any over-the-counter medications? If so, do they help?

Your Doctor Might Examine the Following Body Structures or Functions:

• Chest and lung exam
• Abdominal exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Upper endoscopy (internal examination of the esophagus and stomach)
• pH probe (to assess the acid level in the esophagus and stomach)
• Manometry (to measure the pressure of the sphincter between the esophagus and the stomach)
• Stool testing for blood
• Complete blood cell count

Hearing Loss

Questions to Discuss with Your Doctor:

• Is your hearing loss on one side or both?
• For how long have you noticed the problem?
• Has your hearing loss been getting worse over time?
• Do you have difficulty understanding other people when they speak?
• Do you say "what?" a lot?
• When you turn on the television, do others say that it is too loud?
• Have you had any kind of ear surgery?
• Have you flown in an airplane recently?
• Do other people in your family have trouble hearing?
• Do you hear ringing in your ears?
• Do you suffer from dizziness or loss of coordination?
• Have you had multiple ear infections in the past?
• Do you currently have an upper respiratory infection (for example, a cold) or other infection?
• Have you had any head injuries or strokes in the past?
• Are you taking any medications?

Your Doctor Might Examine the Following Body Structures or Functions:

• Examine your ears, nose, and throat.
• Test your balance, coordination, and walking.

Your Doctor Might Order the Following Lab Tests or Studies:

• Test your ability to hear.
• Formal hearing testing by an audiologist (hearing specialist)

Insomnia

Questions to Discuss with Your Doctor:

• Are you particularly stressed at work or at home?
• Are you depressed or anxious?
• Do you have any underlying medical problems such as hyperthyroidism or sleep apnea?
• Do you snore?
• Do you have chronic pain or difficulty breathing at night?
• Do you have restlessness or twitching of your legs at night?
• Do you drink caffeine-containing beverages after noon (such as coffee or sodas)?
• Do you use stimulants? Drink alcohol? Take sedatives? Smoke cigarettes?
• Do you take any medications?
• What time do you usually go to bed?
• What time do you get up in the morning?
• Do you eat or work before going to bed?
• Have you noticed changes in your sleep patterns?
• Do you wake frequently at night?
• Do you feel tired during the day?
• How long do you stay in bed before you fall asleep?
• Do you have worries about not sleeping?

Your Doctor Might Examine the Following Body Structures or Functions:

• Blood pressure, heart rate, weight
• General physical exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Complete blood cell count
• Thyroid function
• Sleep study with monitoring of heart rate, respiratory rate, oxygen level, eye movements, and brain waves

Inguinal Hernia

Questions to Discuss with Your Doctor:

• Do you have pain in the lower abdomen or groin area?
• Have you noticed a bulge in your lower abdomen or groin area?
• Does lifting heavy objects, coughing, sneezing, or straining increase the size of the bulge?
• Can you push the bulge back in?
• Do you suffer from constipation?
• Have you had bloody stools?

Your Doctor Might Examine the Following Body Structures or Functions:

• Careful abdominal exam
• Groin exam (including testicular and scrotal exam in men)

Your Doctor Might Order the Following Lab Tests or Studies:

• Stool sample
• Abdominal/Pelvic ultrasound
• Abdominal/Pelvic CT scan