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Patient complaints
Last reviewed: 04.07.2025
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A conversation with a patient begins with a question about complaints. It is advisable to give the patient the opportunity to speak out on this matter in a form convenient for him. However, often due to a lack of attention to his health or due to other circumstances, the patient does not name all the painful sensations. Therefore, the doctor clarifies the complaints with the help of additional questions.
Among the complaints, it is desirable to immediately identify the main, or primary, and secondary, or additional. However, the significance of a particular complaint is often difficult to determine. Sometimes the patient's unpleasant sensations, even if expressed very sharply, emotionally charged, have no direct relation to the underlying disease.
However, in typical cases, the main complaints with their detailed clarification can have decisive diagnostic value.
Pain usually occupies a special place among complaints. The following should be clarified:
- localization of pain;
- possible paroxysmal nature and duration of the attack;
- time of occurrence and possible cause, including taking into account the functional load on the presumably diseased organ;
- intensity;
- factors that increase and relieve pain;
- irradiation - the spread of pain.
Of particular importance is the connection between pain and the functional load on a particular organ. Thus, in relation to pain behind the sternum ( angina pectoris ) or in the heart region (cardialgia), it is important to establish the provoking effect of physical activity and a rapid decrease at rest and after taking nitroglycerin, which confirms the angina pectoris nature of the pain. In case of pain in the epigastric region (suspected gastric ulcer ), their connection with food intake is clarified, i.e., the appearance 0.5 or 1.5-2 hours after eating (at the height of digestion) or on an empty stomach and a decrease after eating.
Clarification of the main complaint is accompanied by questions about other unpleasant sensations in the area of the same or other organs and systems.
You should always ask about the presence of general manifestations of the disease: general weakness, fever, chills, headaches, irritability, loss of appetite, thirst, weight loss, etc.
Simultaneously with the identification of complaints, the doctor tries to assess the patient's personality traits, his mental state, the likelihood of exaggeration or understatement of complaints. The patient's reaction to the painful manifestations he reports - elements of the internal picture of the disease - is also clarified.
Much less often, patients do not present any complaints at the time of examination, feeling healthy. They may be brought to the doctor by a change in skin color, such as jaundice, discovered by others; changes in the lungs onan X-ray detected during a routine or "random" examination; the appearance of protein or sugar in the urine.
When assessing complaints, the doctor constantly analyzes and comprehends them, which contributes to the emergence of specific assumptions about the nature of the disease. Further study of the anamnesis and objective examination provide additional important information that confirms these assumptions or leads to new conclusions.
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