WORDS BY CHERYL FREEDMAN
Nearly all of us have suffered unexplained symptoms at one time or another – a feeling that something is wrong, but we’re not sure what. It could be headaches, gut issues, nausea, dizziness, a crushing tiredness or just a general sense of unwellness. For most of us, they usually pass. But for some, symptoms hang around – sometimes for months or years, and, in certain cases, the physical causes remain a mystery, even after blood tests, X-rays or other scans are done.
Patients who can’t get a diagnosis for these often debilitating symptoms can be left feeling misunderstood or helpless, which can be distressing and hard to cope with.
The NHS has a name for this: ‘medically unexplained symptoms’ – and they’re a massive part of the average GP’s caseload. They’re believed to account for up to 45 per cent of all GP appointments, and half of all new visits to hospital clinics.
‘In no medical textbook is there a chapter on this, and yet as a doctor, that is what you will spend most of your time dealing with’, says Dr Christian Jessen, GP and TV doctor. ‘That’s the great irony.’
Non-specific symptoms vary, but there are certain common ones, says Dr Keith Grimes, a GP with over 20 years’ experience and Clinical Innovation Director at Babylon Health, which offers an online doctor’s service. ‘The sort of things that are difficult to diagnose are those that can feature as the result of many different illnesses: tiredness, muscle aches and pains, headaches, dificulty concentrating, memory problems, palpitations, stomach problems, altered bowel habits and abdominal discomfort. Then, from an ear nose and throat point of view, things like dizziness and imbalance. Tinnitus [ringing in the ears] is another classic one, as well.’
Tiredness is particularly common, says Dr Jessen: ‘So many patients say, “I just lack energy, doctor. I wake up and don’t feel refreshed, or I get exhausted halfway through the day.” Or I see patients with non-specifaic pains, which can be really hard to describe – is it sharp like a knife going in, or like pressure being applied?’
A sub-sector of medically unexplained symptoms is what the NHS terms ‘functional neurological disorder’, which encompasses symptoms such as blurred vision, arm tremors, migraines and tingling hands or feet002E