It’s that time of year when we’re plagued by coughs, sneezes and often a headache or gut pain due to festive overindulgence.
And while in most cases it will be just a minor ailment rearing its head, how do you know when your symptoms could be a sign of something more serious?
No-one likes to consult a doctor unnecessarily, but there are times when you should always seek medical advice.
It’s always better to be seen than dismiss the signs and delay an important diagnosis until the condition has become worse – or it’s even too late to treat.
Here, I reveal the top 10 top symptoms you should never ignore – and why:
Some things are as bad as they seem. Dr Brewer explains how to spot a serious concern
1. WEIGHT LOSS FOR NO APPARENT REASON
Most of us love losing weight and if it’s achieved through sensible diet and lifestyle changes, then great.
What concerns medical professionals is unexplained weight loss – where there is no obvious reason for the pounds to be falling off someone, i.e. there has been no change to your normal diet or levels of activity.
As a rough guide, if you lose five percent of your body weight (e.g. eight pounds if you weigh 175 pounds) in less than six months without following a weight loss diet, then it’s time to let your doctor know – especially if it’s associated with fatigue, tiredness or other persistent niggling symptoms.
Unexplained weight loss could be a sign of an undiagnosed illness such as gut problems that affect absorption of nutrients, an overactive thyroid, undiagnosed diabetes, depression or the big worry for everyone – cancer. While in most cases it won’t turn out to be cancer, unexplained weight loss is a red flag symptom and may not always be accompanied by loss of appetite.
2. AN UNUSUAL THICKENING OR LUMP ANYWHERE ON THE BODY
If you notice an unusual lump anywhere on your body, you should always tell a doctor. While a lump in areas such as the breast or scrotum is likely to send you promptly to the doctor, don’t ignore lumps elsewhere, either.
While most lumps are due to a non-serious condition such as benign (non-cancerous) growths (e.g. lipoma, fibroma or cysts) they all need to be checked and diagnosed. It is often difficult for even a doctor to tell different lumps apart and you may need a biopsy so the lump can be examined under a microscope and diagnosed accurately.
Soft lumps, such as a hernia (in which a part of the body such as a loop of intestine pushes through a weakness in the muscle or tissues that normally contain it) also need assessment as some types can get trapped and painful, and can even lose their blood supply (a strangulated hernia) which needs urgent treatment. If a lump becomes increasingly painful, seek medical advice straight away.
As for thickening of the skin, this is where you run a finger over an area and feel that underlying tissues are thickened or hardened – or feel different to the surrounding area – without necessarily forming a lump.
3. CHEST PAIN
Chest pain can be caused by many conditions, some of which are serious (e.g. heart attack or a clot on the lung) and some not (e.g. spasm of tiny muscles between the ribs, or an inflammation of rib cartilage called costochondritis).
Chest pain can be due to acid reflux, or heartburn, and an estimated 20 per cent of cases are mistaken for a heart attack – but it is often difficult for even doctors to tell these apart.
While angina (heart pain) and heart attack can cause different symptoms in different people of different ages, chest pain or tightness is the main warning sign for both men and women. The pain may feel like an aching discomfort, tight pressure or burning, and can be sharp, dull or feel like a bear hug or an elephant sitting on your chest.
Sudden chest pain should always be taken seriously and medical assistance sought without delay. NHS Choices recommends that you call 999 for an ambulance if you develop sudden severe chest pain, especially if it:
- feels heavy, pressing or tight
- lasts longer than 15 minutes
- spreads to your arms, back or jaw
- is accompanied by breathlessness, nausea, sweating or coughing up blood
If chest pain is less severe, or resolves, contact your doctor or attend a local walk-in center for assessment. You could have had an episode of angina for example (heart pain due to lack of oxygen reaching heart muscle) which needs treatment to prevent a future heart attack.
4. A CHANGE IN BOWEL HABIT
Many people feel embarrassed talking about their bowels with someone else, but it’s a conversation that really could save your life.
Bowel cancer is one of the biggest killers and it’s striking more people at a younger age than ever, so don’t ignore a change in your bowel movements – it’s one of the few ways your intestines can show that something is wrong.
A change in bowel habit means a persistent change in opening your bowel so it is more or less frequent than is usual for you.
Your stools may also change in consistency, so you develop constipation, or a general slowing down of bowel movements, or diarrhea and a speeding up of your intestines.
If this continues for more than a week or two, seek medical advice – earlier if you develop abdominal pain or notice blood or slime in your motions. Try not to feel embarrassed – your doctor is used to dealing with problems like this.
5. UNEXPECTED BLOOD LOSS FROM ANY PART OF THE BODY
This is a frightening symptom that you are unlikely to ignore. You should let your doctor know as soon as possible if you:
- cough up blood (a possible sign of a blood clot on the lung or lung cancer)
- notice redness or dark flecks like coffee grounds in your vomit (a possible sign of bleeding in the stomach)
- pass black, unpleasant smelling stools vomit (a possible sign of bleeding in the intestines)
- develop bleeding in between your periods or after making love (a possible sign of cervical or womb bleeding – often due to a polyp but cancer needs to be ruled out)
- have an episode of post-menopausal bleeding after you thought your periods had stopped (a possible sign of womb cancer)
- see blood in any fluid or discharge from any orifice (exit from the body) – a possible sign of tissue inflammation, e.g. from inflammatory bowel disease, but cancer needs to be ruled out
6. DIFFICULTY SWALLOWING OR FEELING FULL DESPITE EATING VERY LITTLE
Problems with swallowing are commonly associated with sore throat or tonsillitis, but if you have persistent or increasing difficulty swallowing – with or without pain – tell your doctor. This can indicate a problem with the swallowing mechanism, throat, esophagus (gullet) or stomach.
Difficulty swallowing can result from many different conditions and becomes more common with age due to poor muscle tone. This can make it difficult to swallow tablets, and is a common cause of not taking medicines as often as prescribed. Let your doctor know you have difficulty swallowing so that other formulations (e.g. patches, liquids) can be prescribed.
Apart from age, difficulty swallowing can result from neurological problems, but if you also feel full despite eating very little, have a sensation of food getting stuck in your throat, keep bringing food back up, or cough or gag when swallowing, see your doctor. The cause is usually due to problems with the esophagus – and esophageal and stomach cancer also needs to be ruled out.
7. A PERSISTENT, NAGGING COUGH OR SHORTNESS OF BREATH
At this time of the year it can seem as though you are never free from coughs and colds.
Most coughs clear up within three weeks and don’t require any treatment (although I recommend Pelargonium as the most effective treatment for coughs and colds if they do strike). If you suffer from a persistent, nagging cough or shortness of breath however, you should always tell a doctor so they can investigate the cause.
A cough is caused by irritation of the airways, while breathlessness suggests that your lungs are not working as well as they might – most likely due to asthma, COPD or other lung diseases or heart failure.
Both symptoms need checking out – urgently if you also notice chest pain, cough up blood or lose weight/have a change in voice or notice a swelling in your neck.
Smoking is the leading cause of cough. Chemical irritation is responsible — but the same noxious chemicals that cause the simple smoker’s cough can lead to more serious conditions, such as chronic obstructive pulmonary disease (COPD due to bronchitis and emphysema), pneumonia, and lung cancer.
Other than smoking, a persistent cough can be due to:
- a long-term respiratory tract infection, such as chronic bronchitis but TB is another possible cause
- asthma – especially if accompanied by wheezing, chest tightness and shortness of breath
- allergies e.g. to mould, dust mites
- bronchiectasis – where the airways of the lungs become abnormally widened
- postnasal drip – mucus dripping down the throat from the back of the nose, due to inflammation of the nose (rhinitis) or sinuses (sinusitis)
- gastro-oesophageal reflux disease (GORD) – where the throat becomes irritated by leaking stomach acid
- some prescribed medicines, especially angiotensin-converting enzyme inhibitor (ACE) inhibitors used to treat high blood pressure and cardiovascular disease
Rarely, a persistent cough can be a symptom of a more serious condition, such as lung cancer, heart failure, a pulmonary embolism (blood clot on the lung) or tuberculosis.
8. PAIN THAT KEEPS COMING BACK
We all get aches and pains from time to time. But if you notice a recurrent pain that keeps coming back (e.g. for more than 3 weeks) or is getting more frequent or persistent (e.g. headaches, indigestion, abdominal pain, testicular ache or chest ache) you should always tell a doctor. This is especially important if you also have other related symptoms such as weight loss, tiredness all the time, lethargy or change in bowel habit.
9. A SKIN BLEMISH THAT CHANGES IN ANY WAY OR A SCAB, SORE OR ULCER THAT FAILS TO HEAL WITHIN 3 WEEKS
Check your skin regularly for any blemish that seems to be changing – ask someone to examine your back and other places you cannot see yourself.
While in many cases, the lesions will turn out to be harmless, it can be difficult for even a doctor to know for certain whether or not a skin blemish is due to skin cancer until the patch has been biopsied and examined under a microscope.
If diagnosed early, the majority of skin cancers can be removed and the problem cured.
Warning signs to look out for are an ulcer or sore that gets worse or fails to heal within three weeks, or a mark that starts to:
- get bigger
- turn darker
- go scaly
- crust over or scab without healing
- develop a raised, rolled edge
10. HOARSE VOICE OR SORE THROAT LASTING MORE THAN 3 WEEKS
A sore throat, often the result of a viral infection, which are common at this time of year, is usually nothing to worry about and disappears within about a week.
If it lasts longer, you should bring it to a doctor’s attention. A throat swab can check for bacterial infections (e.g. Strep sore throat) that needs antibiotics.
In some cases, a blood test may be needed to check for immune disorders (e.g. abnormal production of white blood cells) that can present with sore throat – especially if you also have swollen glands (to rule out bone marrow abnormalities, lymphoma, leukemia).
Hoarseness may be due to problems with the muscles or nerves around the voice box (larynx) or with the vocal cords themselves.
For example, hoarseness due to thickening of the vocal cords can be due to growths (nodules) that, in some cases, are cancerous (especially in long-term smokers).
Never ignore hoarseness or unexplained mouth ulcer or soreness lasting more than three weeks – these always need a full assessment by a healthcare professional.
Most mouth cancers that have no symptoms are detected by dentists who examine soft tissues of the mouth to look for abnormal areas such as white patches, redness, lumps or ulceration.
With mouth cancers becoming more common, this is an excellent reason for regular dental check-ups, even if your teeth are perfect.