Diagnosis of Patients with Medically Unexplained Symptoms

Gordon Research Institute

November 17, 2009

With the new health care rules most Lyme and Chronic Fatigue patients may simply be labeled and need no treatment. Learn about MUS, as it can save insurance companies tons of money and stop the useless testing for any of the F.I.G.H.T. causes I teach.

Patients with medically unexplained symptoms (MUS) have little or no
demonstrable disease explanation for the symptoms and comorbid
psychiatric disorders are frequent. With this in mainstream literature, the government will save billions, as looking at the causes I fear will not be permitted. This is an easy way to practice medicine, if you have not heard about it in your medical training, IT SIMPLY DOES NOT EXIST.

So there is no need to keep up on the newest retrovirus epidemic, XMRV
that seems to be present in 4% of so called healthy patients and over
60% of Chronic Fatigue patients who with this MUS category will be
lumped into NO ORGANIC DISEASE PRESENT category.

Garry F. Gordon MD,DO,MD(H)
President, Gordon Research Institute
www.gordonresearch.com

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1852906/?tool=pubmed

J Gen Intern Med. 2007 May; 22(5): 685–691.
Published online 2007 January 17. doi: 10.1007/s11606-006-0067-2.
PMCID: PMC1852906

Classification and Diagnosis of Patients with Medically Unexplained Symptoms
Robert C. Smith, MD, ScM  and Francesca C. Dwamena, MD
Department of Medicine, Division of General Medicine, Michigan State University, East Lansing, Michigan 48824 USA

ABSTRACT

Patients with medically unexplained symptoms (MUS) have little or no demonstrable disease explanation for the symptoms, and comorbid psychiatric disorders are frequent. Although common, costly, distressed, and often receiving ill-advised testing and treatments, most MUS patients go unrecognized, which precludes effective treatment. To enhance recognition, we present an emerging perspective that envisions a unitary classification for the entire spectrum of MUS where this diagnosis comprises severity, duration, and comorbidity. We then present a specific approach for making the diagnosis at each level of severity. Although our disease-based diagnosis system dictates excluding organic disease to diagnose MUS, much exclusion can occur clinically without recourse to laboratory or consultative evaluation because the majority of patients are mild. Only the less common, “difficult” patients with moderate and severe MUS require investigation to exclude organic diseases. By explicitly diagnosing and labeling all severity levels of MUS, we propose that this diagnostic approach cannot only facilitate effective treatment but also reduce the cost and morbidity from unnecessary interventions.

Patients with medically unexplained symptoms (MUS), also called somatization, represent one of the most common conditions in medicine.1–3 We define MUS as those physical symptoms having little or no basis in underlying organic disease;4 when organic disease exists, the symptoms are inconsistent with or out of proportion to it.5 We caution that people with MUS are not necessarily abnormal. Many exhibit it but seldom or never seek care.6 MUS becomes a medical issue when it leads to health care–seeking for feared but nonexistent physical illness.7,8
The prevalence of all MUS in the outpatient setting is reported from 25% to 75%, and pain is the most common type, 1–3 i.e., on average, approximately one-half or more of all outpatients have little or no physical disease explanation for their symptoms. Consistent with this, Kroenke and Mangelsdorf found, among all new symptoms, that only 16% had an organic disease basis.9
Limited evidence suggests that treatment in primary care and specialty settings is effective, but MUS patients seldom receive it.10,11 They first must be recognized and diagnosed. In addition to lack of treatment, inadequate identification occasions safety and cost problems: ill-advised lab testing and “trial treatments” can lead to iatrogenic complications and increased costs.12–16 To facilitate diagnosis, we present an emerging consensus that proposes a unitary diagnostic classification system of MUS.4,17–24 We also review the diagnostic approach it requires.

CURRENT WAYS TO CLASSIFY MUS
PROPOSED CLASSIFICATION OF MUS
DIAGNOSIS OF MUS
CONCLUSIONS AND RECOMMENDATIONS
References

Comment from Leslie

It sounds like they are putting the blame on the patient for having MUS instead of the care providers having an understanding of the basic functioning of the body to figure out what is going on.  We have compartmentalized medicine so much that no body has a clue as to what the hell is happening.  An understanding of the interrelationship of the body and all its systems would eliminate MUS.  AND GET RID OF THE DAMN VACCINE AND THE RX DRUGS.

PG

Author: Leslie Carol Botha

Author, publisher, radio talk show host and internationally recognized expert on women's hormone cycles. Social/political activist on Gardasil the HPV vaccine for adolescent girls. Co-author of "Understanding Your Mood, Mind and Hormone Cycle." Honorary advisory board member for the Foundation for the Study of Cycles and member of the Society for Menstrual Cycle Research.