Modern medicine seeks to determine the disease process (pathology) accounting for a patient's symptoms. Once the disease process has been identified, treatment can focus on counter measures, which have proven benefit (evidence based -Q33.22).Table 3. 1 indicates the main groups of disease causation. This has been applied to the potential causes of recurrent miscarriage(recurrent miscarriage).

Table 3. 1 (Click on the appropriate Question Number)

DISEASE PROCESS

General Example

Gynaecological Example

CONGENITAL

Hole in the heart

Absent uterus

TRAUMA

Road traffic accident

Pelvic floor injury during childbirth

INFLAMMATION

Influenza

Pelvic  infection

metaBOLIC

Malnutrition

Absent periods due to malnutrition

HORMONAL

Diabetes

Menopause

AUTOIMMUNE

Rheumatic Disease

Recurrent miscarriage

TUMOUR

Lung cancer

Fibroid / Cancer of cervix

AGEING

Osteoarthritis

Menopausal vaginal symptoms

PSYCHOLOGICAL

Depression

Premenstrual tension

 

Frequently, a patient has two or more unrelated problems. You could, for example, have heavy periods and an abnormal cervical smear result. Sometimes there may be a combination of related processes:  a lady may feel tired and lethargic due to anaemia(Q 24.10) resulting from heavy periods associated  with fibroids  (14) and, as a result of these problems, she may feel depressed.

The medical profession recognises that there may be a collection of inter-related problems. The concept that a patient should be treated as a whole person rather than as a disease process is part of the basic training of doctors although the term holistic approach seems to have been adopted by those who advocate alternative medicine to suggest that they invented the idea.



Women's Health



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