In Search of the Perfect Torture…

In Search of the Perfect Torture…

There is nothing that annoys me more than the internet.  Don’t get me wrong.  I like looking at Facebook just as much as the next person.  I also like the ability to look up a last minute dinner recipe, and watching the latest viral video on YouTube.  I mean who doesn’t love watching a laughing baby or a woman in a Chewbacca mask?  But on most days, the Internet is the bane of my existence.  Why you ask?  Let me illustrate a typical visit in my office on any given day:

Me:  “What brings you in to see me today?”

Patient:  “Well, I have this pain in my stomach.  It’s been happening after I eat, and sometimes I have heartburn too.”

Me:  “Are there any particular foods that make this worse?”

Patient:  “Well, spicy foods make it worse.  But it really hurts, and I looked up my symptoms on the internet and it says to see my doctor right away because it could be a sign of cancer.”

So, you see my problem.  By the way, in the above scenario the patient is a young, otherwise healthy, 25 year old patient.  In other words, very little in terms of risk factors for cancer.  You don’t need a medical degree to diagnose this problem (I don’t think).  Stomach pain, heartburn, indigestion after eating spicy foods.  Hmmm.  Sounds like a classic case of acid reflux to me.  I think many of us would have just tried some Tums or stopped eating the offending foods.  But in medicine, we have the same problem right now as in many other aspects of our life.  We are on information overload courtesy of the Internet.  And unfortunately, many of the resources out there on the Web are just downright incorrect.  There is no one out there policing website content; people can put up anything that they feel like.

But what about the reputable websites out there?  I often will direct my patients to these, websites like WebMD or The Mayo Clinic, which are certainly going to have fairly accurate information.  But let’s take a closer look.  For example, I went to WebMD and searched for back pain.  Immediately, I am shown a picture of what a back surgery looks like, and am instructed that if my back hurts at night this may be a sign of a dangerous problem.  I am also told that a possible complication is something called Cauda Equina Syndrome, which could cause permanent damage to the bowels or bladder.  Now, if I had back pain and read all of that, you better believe that I would high tail it to my doctor’s office ASAP!!  The trouble is, back pain is a very common problem.  Some estimates would indicate that back pain is the cause of up to 20% of visits to primary care doctor’s offices.  Safe to say that I treat a lot of patients with back pain!  Do you know how many cases of Cauda Equina I’ve seen?  Zip.  Zero.  Nada.  The trouble with some of these websites is that they will tell you of possible complications, but don’t always tell you what the actual frequency of these are.  The vast majority of people with a sore back have a musculo-skeletal problem, and recover on their own.

Let’s take another example.  A search for abdominal or belly pain reveals the following possible diagnoses:  indigestion/heartburn, menstrual cramps, gas, gallbladder problems, kidney stone, and also ulcers, esophageal cancer, stomach cancer, bowel obstruction, torsion of testicle and ovary, appendicitis, strangulated hernia, abdominal aneurysm, pancreatic cancer, ovarian cancer, and colon cancer.  Yikes!!  As a lay reader, I don’t even know what a strangulated hernia is but it sounds bad!!  But, how many of you have had abdominal pain?  And how many of you have had any of the above problems?  My guess is the number is very small.  I have had patients in my career and training with all of the above diagnoses, unfortunately for some.  But, the vast majority of people with abdominal pain just have indigestion.

Don’t get me wrong.  It’s never a good strategy to ignore symptoms.  If you have a problem that doesn’t seem to be going away, or is not responding to simple remedies, don’t ignore it.  It will never hurt you to see your doctor and get checked out (but I will likely be laughing at you in secret if you come to see me thinking that your weight gain after eating fast food for a month is caused by a hormone problem you read about on the internet!).

Bottom line, if you are experiencing symptoms, do all of us in the medical community a favor and DON’T look up your symptoms on the internet.  If there is something that concerns you, keep your wits about you, see your doctor, describe your symptoms, and let them do what they were trained to do:  Diagnose you.  It will save everyone involved a lot of anxiety and angst.

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