Aisha set out on the road with her newly purchased car. After covering some distance, a warning light in the car turned on, which she didn't recognize. Initially, she didn't pay much attention to this light and continued on her way. However, after a while she needed to tow the car and the mechanics told her that it was a good thing that she came, as ignoring these lights and continuing on the road could have led to a serious malfunction that might endanger her life.

Jason and his family planned for a trip and were going to hit the road early in the morning. After dinner, Jason felt a pain in his abdomen, but he didn't tell anyone. However, the pain intensified, and he began to feel nauseous, so he took a painkiller. The pain did not go away, so he decided it was time to go to the hospital. When they arrived at the hospital, the doctor examined Jason and, the first thing Jason wanted was to get rid of the pain as soon as possible. However, the doctor said that using painkillers wouldn't be right, as it was important to understand the course and type of the pain for diagnosis. When the blood tests and ultrasound results came in, it was revealed that Jason had appendicitis and needed urgent surgery. If they had waited a little longer, there was a possibility of the appendix perforating, which would make the surgery much more complex. Although Jason couldn't go on the vacation he had been waiting for years, he realized the importance of symptoms like pain, nausea, vomiting, and fever, despite their discomfort. Jason gained a newfound appreciation for the delicate balance between listening to the body and understanding its signals.

Aisha’s car had a way of communicating problems through warning lights. Similarly, our body has its own language, expressing issues not through words but through symptoms, as in Jason’s case. What are the signals our body uses, and how can we understand this language?

People may use the words “sign” and “symptom” interchangeably in medical manners. However, a symptom is something an individual experiences, while a sign is something a doctor, or other person, notices. Symptom is defined as something that a person feels or experiences that may indicate that they have a disease or condition. Symptoms can only be reported by the person experiencing them. They cannot be observed by a health care provider or other person and do not show up on medical tests. Symptoms, often considered as the body's alarm system, play a crucial role in the realm of diseases. Symptoms serve as valuable indicators that guide healthcare professionals in the diagnostic process and treatment planning. This article explores the essential usefulness of symptoms in understanding diseases and their importance in healthcare strategies. Frequently seen examples of disease symptoms are pain, fever, nausea, vomiting, fatigue, and loss of appetite.

Pain: Pain is described as a localized or generalized unpleasant bodily sensation or complex of sensations that causes mild to severe physical discomfort and emotional distress, typically resulting from a bodily disorder, such as injury or disease, by the International Association for the Study of Pain.

Pain is always subjective. Each individual learns pain through experiences related to injury in early life. It is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant, and therefore, also an emotional experience.

But many people report pain in the absence of tissue damage or any likely pathophysiological cause; this usually happens for psychological reasons. There is no way to distinguish their experience from pain due to tissue damage if we rely solely on the subjective report. If they regard their experience as pain and if they report it in the same way as pain caused by tissue damage, it should be accepted as pain.

Although the characteristics of pain may differ, the role is still the same; pain is the body’s alert system. For example, pain as a symptom of another illness can be a significant factor in early diagnosis and treatment. Pain is one of the top reasons why people seek emergency care. Therefore, from injuries to heart attacks to cancer, functional pain is associated with identification of these conditions and potentially the prevention of more serious outcomes.

Congenital insensitivity to pain, also known as congenital analgesia, is a rare condition in which a person cannot feel (and has never felt) physical pain. It has been estimated to have a worldwide incidence of approximately 1 in every 25,000 live births. Because feeling physical pain is vital for survival, this insensitivity is an extremely dangerous condition.  Since children and adults with this disorder cannot feel pain, they may not respond to problems, thus are at a higher risk of more severe diseases. Children with this condition often sustain damage both in and around the oral cavity, such as biting off the tip of their tongue, or suffer fractures to their bones.

Fever: A fever is an abnormal rise in body temperature. It is most often a sign of infection but can be present whenever there is tissue destruction, such as, for example, from a severe burn or when large amounts of tissue have died due to a lack of blood supply. Body temperature is controlled by the thermostatic center in the hypothalamus. Fever in humans is a body temperature above the normal range due to an increase in the body's temperature set point in the hypothalamus. Certain protein and polysaccharide substances called pyrogens, released either from bacteria or viruses or from destroyed cells of the body, are capable of raising the thermostat and causing a rise in body temperature. Fever is a highly significant indicator of disease.

Nausea and vomiting: Nausea has been defined as an “unpleasant painless subjective feeling that one will imminently vomit.” While nausea and vomiting are often thought to exist on a temporal continuum, sometimes they may occur in the absence of each other.

In population studies, more than 50% of adults reported at least one episode of nausea, and more than 30% of adults reported one episode of vomiting within the preceding 12 months, with women reporting more episodes of nausea than men. Nausea is considered to function as a protective mechanism, warning the organism to avoid potential toxic ingestion. Nausea and vomiting may also be early warning signs of more serious medical problems, such as appendicitis (like Jason’s case above), a blockage in the intestines, cancer, ingesting a drug or poison, especially by children.

Vomiting is our body’s emergency response to poisoning. It’s kind of a “dump everything!” panic response. When the body detects potentially toxic compounds in the digestive system, it initiates a cascade of physiological responses, including nausea and the urge to vomit. By expelling these substances from the stomach and gastrointestinal tract, the body prevents their absorption into the bloodstream, thereby reducing the risk of poisoning or systemic damage.

Fatigue: Fatigue is a multifaceted and complex phenomenon characterized by a persistent feeling of physical or mental tiredness, weakness, or lack of energy. It transcends mere tiredness, as it often persists even after rest or sleep, significantly impacting an individual's quality of life and daily functioning. While fatigue is a common experience that everyone encounters at some point in their lives, chronic or persistent fatigue can be indicative of underlying health issues or diseases.

In many cases, fatigue acts as the body's alarm system, signaling an imbalance or dysfunction within the body. It can be a prominent feature of various acute and chronic illnesses, including autoimmune disorders, infectious diseases, neurological conditions, and mental health disorders.

Appetite loss: This symptom refers to a diminished desire or interest in eating, often resulting in reduced food intake. It can manifest as a complete aversion to food or a decreased enjoyment of eating, leading to unintentional weight loss and nutritional deficiencies. Appetite loss can stem from various factors, including physiological changes, psychological distress, medication side effects, and underlying medical conditions. While occasional fluctuations in appetite are normal and may occur due to temporary factors such as stress or illness, persistent or severe appetite loss can be indicative of more serious health issues and warrants medical attention.

Understanding appetite loss is crucial in disease prognosis and treatment as it serves as a significant clinical indicator and prognostic factor for various medical conditions. In many cases, appetite loss accompanies acute illnesses such as infections or gastrointestinal disturbances, serving as a protective mechanism that redirects energy towards the body's immune response. However, chronic appetite loss, particularly when associated with unintentional weight loss, can signify underlying chronic diseases such as cancer, chronic infections, autoimmune disorders, or gastrointestinal disorders. Monitoring changes in appetite and nutritional status is essential for disease management, as malnutrition and weight loss can exacerbate disease progression, impair treatment response, and negatively impact overall prognosis

Cough: Coughing is a reflex action that serves as the body's natural defense mechanism to clear the airways of irritants, mucus, or foreign particles. It involves a sudden expulsion of air from the lungs, typically accompanied by a distinctive sound. While coughing is a normal and essential bodily function, persistent or severe coughing can indicate underlying health issues or diseases. Monitoring the onset, duration, severity, and accompanying symptoms of a cough is essential for healthcare providers to determine the underlying cause and appropriate treatment plan, highlighting the importance of cough as a diagnostic tool in the assessment of respiratory health.

Headache, shortness of breath, palpitation, weight loss, rash and swelling are the other most frequent disease symptoms, alongside many others. Although we don't like experiencing these symptoms, they actually help us in many ways, such as:

1. Early detection and diagnosis: Symptoms function as initial indicators, signaling potential health concerns to both individuals and healthcare providers. Prompt action upon symptom onset can significantly enhance the effectiveness of treatment and prognosis.
2. Disease discrimination: Symptoms aid in distinguishing between different diseases. Although some illnesses may share similar symptoms, the specific combination and severity of symptoms can offer valuable insights into the underlying condition, ensuring accurate diagnosis and appropriate treatment initiation.
3. Patient-centered healthcare: Experiencing symptoms places individuals at the forefront of their healthcare journey. Through active reporting and the description of symptoms, patients provide essential information that assists healthcare professionals in comprehending the nature and progression of the disease. This patient-centric approach improves diagnostic accuracy and treatment personalization.
4. Disease progression monitoring: Symptoms serve as dynamic markers of disease advancement. Tracking symptom changes over time enables healthcare providers to evaluate treatment effectiveness, make necessary adjustments, and deliver individualized care. Symptom monitoring is particularly critical for chronic conditions requiring ongoing management.
5. Enabling targeted interventions: Specific symptoms often indicate involvement of particular organs or systems, guiding healthcare professionals towards tailored interventions. For instance, respiratory symptoms may indicate lung issues, prompting targeted investigations and treatments directed at the respiratory system. This precision in addressing symptom origins enhances therapeutic intervention efficacy.
6. Psychosocial considerations: Symptoms impact an individual's mental and emotional well-being in addition to their physical health. Recognizing and addressing symptoms from a holistic viewpoint enables healthcare providers to consider psychosocial factors that may influence overall patient health. This comprehensive approach contributes to a patient-centered care model.

We often do not like some events that happen in our lives at first, and they can make our lives very difficult. However, as time goes by, we often see the positive outcomes of those events. A verse from the holy Qur’an explains this human condition in a very concise way: “Perhaps you dislike something which is good for you and like something which is bad for you. God knows and you do not know” (al-Baqarah 2:216). Similarly, the significance of symptoms in diseases goes beyond mere inconvenience. They act as indispensable indicators, directing healthcare professionals towards early detection, precise diagnosis, and individualized treatment. Without these symptoms as early warnings, we would not be able to understand and respond to diseases in a timely manner. Embracing a holistic understanding of symptoms empowers both patients and healthcare providers to collaborate in managing diseases effectively. Acknowledging symptoms as integral elements of both diagnosis and treatment enhances the overall standard of healthcare, fostering a thorough and patient-centered approach.

References

https://www.britannica.com/science/human-disease

https://en.wikipedia.org/wiki/List_of_medical_symptoms

Santiago V. Painful Truth: The Need to Re-Center Chronic Pain on the Functional Role of Pain. J Pain Res. 2022;15:497-512. Published 2022 Feb 16. doi:10.2147/JPR.S347780

https://en.wikipedia.org/wiki/Congenital_insensitivity_to_pain

Singh P, Yoon SS, Kuo B. Nausea: a review of pathophysiology and therapeutics. Therap Adv Gastroenterol. 2016;9(1):98-112. doi:10.1177/1756283X15618131

https://www.medicalnewstoday.com/articles/161858

https://www.cancer.gov/publications/dictionaries/cancer-terms/def/symptom