When you correctly identify a patient as having psychological cause for his/her illness there is a trap in which you can fall into.It happened to me once.
A 60 year old lady was constantly coming to me with symptoms like tummy pain,tendency to pass motion immediately after taking food,bloating sensation etc.My clinical examination and investigations including endoscopy were negative.I labelled her as a case of functional bowel disease due to psychological reasons.My treatment with that diagnosis was successful and she was happy.She came to me less frequently and later stopped all medicines.After 2 years she came to me again with almost similar complaints.I treated her in the same way as before.The response to treatment was not that good but I continued to reassure her .Only after 2 months did i realise that there is something wrong.An endoscopy showed a stomach cancer.Surgical removal was done and chemotherapy started.Unfortunately she succumbed to the disease.
Did I think too much about her mind instead of her body? May be yes.
Thursday, May 15, 2008
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