When you experience strange pains, mysterious indigestion, or
other seemingly disconnected symptoms, your first hope is that a trip to the
doctor will solve your health woes. However, doctors are human, and humans make
mistakes.
"A lot of symptoms are nonspecific and variable, depending on
the person," says Dr. David Fleming, president of the American College of
Physicians and a professor of medicine at the University of Missouri. "On
top of that, many diagnostic tests are expensive and aren't done routinely, and
even then they don't always give us a black and white answer."
The
following 10 conditions are notoriously difficult to pin down according to
Health.com.
1. Irritable bowel syndrome (IBS)
Some
conditions, like IBS, don’t have any sort of real test to prove their
existence; rather, they require a "diagnosis of elimination," says
Fleming, as doctors rule out all other possibilities. IBS is a chronic
condition that affects the large intestine and causes abdominal pain, cramping,
bloating, diarrhea, and/or constipation. According to diagnostic criteria, IBS
can’t be taken into consideration unless symptoms persist for at least six
months. Discomfort should typically be present at least three days a month
before being diagnosed with IBS.
2. Celiac disease
There is
a lot of confusion around celiac disease -- an immune reaction to gluten that
triggers inflammation in the small intestine. It can take an average patient 6
to 10 years to be properly diagnosed. Those with celiac would have digestive
problems when eating gluten-containing foods like diarrhea, cramping
indigestion, weight loss, itchy skin, headaches, joint pain, and acid reflux or
heartburn. All of the above symptoms can also be attributed to something else.
The good news: a blood test can diagnose celiac disease regardless of what
symptoms are present, and an endoscopy can determine any damage that's been
done to the small intestine.
3. Fibromyalgia
Fibromyalgia,
characterized by widespread musculoskeletal pain, involves "medically
unexplained symptoms" -- a term doctors use to describe persistent
complaints that don't appear to have an obvious cause. When doctors can't find
a root cause for a patient's chronic pain and fatigue, they often end on this
diagnosis. This may involve seeing a variety of specialists to rule out other
diseases, says Dr. Eugene Shapiro, deputy director of the Investigative
Medicine Program at Yale University. "There are studies that show that
people with certain symptoms who show up at a rheumatologist will be diagnosed
with fibromyalgia, but if the same patients show up at a gastroenterologist
they'll be diagnosed as having irritable bowel syndrome."
4. Multiple sclerosis (MS)
This
autoimmune disease occurs when the immune system attacks the body's own nerve
cells and disrupts communication between the brain and the rest of the body.
Some of the first symptoms of MS are often numbness, weakness, or tingling in
one or more extremity, but that's not always the case.
"Multiple
sclerosis can be episodic; the disease waxes and wanes," says Shapiro.
Depending
on the number and location of lesions in the brain, signs and symptoms may be
more or less severe. Once a doctor does suspect MS, however, a sample of spinal
fluid or MRI imaging can help confirm the diagnosis.
5. Endometriosis
Like
appendicitis, vague stomach pain can go unnoticed. However, women with
endometriosis (in which uterine tissue grows outside the uterus) often report
pelvic pain, cramping, and heavy bleeding that are far worse than usual. A red
flag: this bleeding gets worse over time. A pelvic exam can sometimes detect
endometrial tissue or cysts that have been caused by it. In other cases, an
ultrasound or laparoscopy is required for a definite diagnosis.
6. Appendicitis
Typical
appendicitis symptoms include nausea, pain and tenderness in the abdomen, and
possibly a low-grade fever. These symptoms are vague, and especially easily to
go ignored in females.
"Some
people have an appendix that points backward instead of forward in the body, so
the symptoms present in a different location," says Shapiro. "And
sometimes people do have pain, but then the appendix ruptures and the pain is
relieved so they think they're fine." In this case, he says, intestinal
fluids can leak into the entire abdomen and cause a potentially
life-threatening infection -- but it can take days or even weeks before these
symptoms appear.
7. Lyme disease
You
probably know to look out for tick bites and the characteristic rash that can
form if a person is infected with Lyme disease. However, not everyone develops
this rash and tick bites can be hard to spot. Lyme disease's other symptoms of
fatigue, headaches, joint pain, and flu-like symptoms can also easily be
confused for other conditions.
A blood
test can check for Lyme disease, but the test usually doesn’t show positive
until a few weeks after infection when more antibodies are present in the blood.
If you do find a tick and/or tick bite on yourself or a loved on, it's
important to remove the tick immediately and see a doctor right away. Quickly
removing a tick can possibly prevent the transfer of dangerous bacteria.
Moreover, antibiotics for Lyme disease are most effective when given
immediately.
8. Inflammatory bowel disease (IBD)
There are
primarily two types of IBD: Crohn's disease and ulcerative colitis. Both cause
inflammation of the digestive tract, as well as pain, diarrhea, and possibly
even malnutrition. There's no one test for IBD, and again it can appear as
vague stomach pain.
"If
a patient comes in with severe abdominal pain, we might first think it's their
gallbladder," says Shapiro. "If he comes in with loose stools, we
might think it's an infection. So we go through a litany of tests -- imaging,
blood tests, assessments -- and sometimes we finally come down to the fact that
we've ruled out every other possibility, so this is what we're going to treat
you for and we'll see if it works."
9. Cluster headaches
A rare
headache disorder that's often extremely painful and extremely misunderstood—cluster
headaches currently affect less than 1 million Americans. Cluster headaches
tend to occur close together and last on average 30 minutes to three hours.
Scientists aren't sure why, but cluster headaches tend to occur when seasons
change or during periods of high stress.
10. Diabetes
Unlike
Type 1 diabetes, Type 2 diabetes may be diagnosed later in life. If left
untreated, it can cause life-threatening damage to major organs. Before signs
of diabetes develop, says Fleming, adults can have diabetes for years without
knowing it.
"There
are a lot of people out there with elevated blood sugar levels who aren't
getting to the doctor regularly, so they aren't getting checked for it,"
he says. "They won't realize it until it gets severe enough that they
start developing side effects, like problems with their vision or numbness in
their feet or hands."
Watch for
earlier symptoms like increased thirst, frequent urination (particularly at odd
hours of the night), sudden weight loss, and fatigue.
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