Dido’s White Flag song was about ‘going down with the ship of love’ with no plans to surrender. A chequered flag heralds the winner of a race as many Formula 1 motor racing fans know and the green flag denotes high standards of parks and green spaces. Red flag symptoms in Medicine are always of concern as they could very quickly convert everyday symptoms to medical emergencies. We recently wrote about Self-Care and advised that ‘red flag symptoms’ require prompt review by a qualified health professional. Let us briefly discuss some of them:
Low Back Pain is a very common problem all over the world. It is not a disease and is one of the main reasons for GP attendance. Regardless of treatment, most back pain resolves within 6-8 weeks. X-rays are largely a waste of time and money. Do you have constant back pain which wakes you up in the night? Problem with passing urine or opening your bowel? Loss of (or abnormal) sensation in your inner thighs or around your private parts or back passage? Get seen straight away!
Haematuria (peeing blood) or hematochezia (blood in the stool) should never be ignored. The former may be caused by an infection of the urinary tract but there are other causes along the genital and urinary system. Black stool may also be a sign of bleeding from the gut. Altered bowel for several weeks could be a warning sign. Get medical advice
Blood is expected to remain within the blood vessels. Bleeding can be retained within the body (internal) or get out of the body (external).
Nose bleed is commonly spontaneous and requires reassurance and education about first aid. It may be a sign of high blood pressure, blood or clotting disorder and in older persons if associated with unilateral blocked nose may signify something more sinister.
Gum bleed suggests gum disease but rarely may be a sign of leukaemia.
Haematemesis (vomiting blood) is often confused with haemoptysis (coughing up blood). Medicines such as Aspirin, Ibuprofen, Diclofenac can erode the walls of the stomach and cause bleeding. Heavy drinking can cause bleeding from the blood vessels in the gullet.
Vaginal bleeding is normal during menstruation and childbirth. Postmenopausal bleeding (occurring more than a year after a woman’s last menstrual period) is always abnormal. Bleeding after sexual activity could be caused by infection or something more worrying. Ectopic pregnancy is another important cause in the sexually active woman of reproductive age with a missed or late period and spotting or vaginal bleeding.
Excessive sweating is one of the common complaints of women who are approaching or have reached menopause. We sweat more in hot weather. However, night sweat symptom, perhaps associated with fever and/or weight loss may suggest tuberculosis. It may be associated with itching or lumps in the neck or armpit as could be seen in Lymphoma. See your doctor.
Cough is such a common problem. It can be caused by infections in the upper and lower airways. It is common in asthma; we have so-called “smokers’ cough” as well as silent or troublesome acid reflux. A particular form of blood pressure medication can cause persistent, irritating cough.
Have you been coughing, lost weight, coughed up blood and/or experienced hoarseness of voice? Are you 50 years or over and had a cough for three weeks or more? Stop procrastinating and book a doctor’s appointment right away.
Are you aged 40 or over and had central or left-sided chest pain lasting longer than 15 minutes? Please don’t ignore it. Seek help.
Last line:
It’s not the doctors or nurses. It’s not the government. Your health is in your hands. Stay well and healthy.
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