It’s not always easy to distinguish between a worrying situation and a harmless condition on the basis of symptoms alone. However, a couple of examples will illustrate the approach to adopt.

A slight intestinal disorder that we’ve had for years and hasn’t changed recently is certainly not an alarm signal. By contrast, an intestinal pain that we’ve never had before, which has increased over the last few weeks, and which is accompanied by weight loss, is a danger signal that needs to be investigated. Likewise, a headache that we’ve had for years is generally nothing to worry about, while a headache in a person who has never suffered from headaches, and which is accompanied by double vision, must be investigated urgently and thoroughly (brain CT scan).

The above examples concern several symptoms or disorders which, when taken together, point in the direction of either alarm or reassurance.


By contrast, some symptoms, even when they occur alone, must always be regarded as alarm signals and therefore investigated by means of blood tests and imaging examinations; these are listed below.

  • Dysphagia, i.e. difficulty in swallowing food.
  • Weight loss of more than 4-5 Kg not due to attempts to lose weight.
  • Chest pain that worsens within a few weeks.
  • Cough that differs in intensity and, especially, duration from “the cough I sometimes get”.
  • Dysphonia, i.e. hoarseness, with the same features as the cough described above.
  • Abdominal pain with the same features of intensity and duration as the above cough.
  • Nodules that can be felt, of at least 1-2 cm in size, hard (an important feature), recently noticed.
  • Blood loss, even a small amount, from any opening of the body (except the nose).

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