Four conditions your primary care provider sees the most

Board-certified family medicine physician Naveed H. Butt, MD, specializes in preventive care and encourages healthy lifestyle changes to help patients avoid chronic medical conditions. He has been in practice for more than 30 years and sees patients at Inova Primary Care – Purcellville.

My measure of success as a primary care physician is based on helping my patients achieve positive health outcomes – not only by treating illness, but ideally by preventing it in the first place. When we use the preventive approach, we are maintaining our patient’s health and our community’s health more broadly. Shared decision making is key. Only by educating, engaging and empowering patients can we move toward better health for everyone we serve.

As a primary care doctor, I help my patients with a broad range of medical issues. Here is a quick overview of a few of the conditions I see most often in my primary care practice.

Four of the most common reasons patients schedule a visit to their primary care provider

1. Enlarged prostate (also known by its medical name, benign prostatic hyperplasia, or BPH)

What it is: Over time, a man’s prostate (a gland that surrounds the urethra) can expand in size. This can cause the urethra to get compressed, making it harder for urine to travel down the urethra.

Symptoms to watch for:

• Poor urinary control
• Urgency
• Dribbling
• Weak urine stream
• Urinary incontinence

Recommended treatments

If you have these symptoms, talk to your primary care provider, so they can be treated effectively. When it comes to treatment, I always emphasize lifestyle modification first, because our day-to-day actions can improve symptoms – sometimes dramatically.

Lifestyle modification for PBH includes:

• Decreasing your fluid intake at bedtime
• Decreasing your caffeine intake
• Using double voiding – wait for the first void of urine, then void a second time
• Reducing alcohol consumption
• Exercising, such as walking

Additional steps your primary care provider might discuss with you include:

• Medications to help control symptoms
• Referral to a urologist for further testing
• Potential referral to a urologic surgeon to consider surgical procedures if other options have been exhausted

2. Colon cancer screening

Nationwide, colon cancer rates are rising among younger people than previously. A few years ago, the U.S. Preventive Services Task Force started recommending that people at average risk of colon cancer start screening at age 45, instead of age 50. Early detection leads to prevention of more colon cancer cases, which is critically important.

What you need to know about colon cancer screening:

• You may need to screen for colon cancer earlier than 45, depending on your specific risk factors and family history
• Colonoscopy is the gold standard – it’s the only test that can both detect and prevent colon cancer (by finding and removing precancerous polyps)
• If you are reluctant to get a colonoscopy, there are other screening options that don’t require time off work for the preparation and procedure
• One is a stool test (brand name Cologuard) that you can do at home
• Stool testing needs to be redone every three years
• The schedule for colonoscopy rescreening depends on the test findings – if the findings are benign, you can wait 10 years between screenings
• Colon cancer screening can save your life
• Talk with your primary care provider and make a plan that works for you

3. Menopause

Menopause is a big hormonal transition that can take five to 10 years or more to complete. During this transition period, called perimenopause, the hormonal changes in women’s bodies cause bothersome symptoms for many women. These symptoms can be disruptive and can affect women’s quality of life at work and at home.

Perimenopause symptoms can include:

• Night sweats
• Hot flashes
• Sleep difficulty
• Vaginal dryness
• Brain fog
• Irritability
• Mood swings

Is testing necessary for perimenopause symptoms?

Individuals should talk with their primary care providers to make a plan together to address their specific situation, but in general, whether or not we do hormone testing depends on a woman’s age when symptoms begin. After age 40 to 45, hormone testing is often not necessary, although testing thyroid function can be key.

Lifestyle modifications for perimenopause symptoms include:

• Maintaining good sleep hygiene
• Exercise – a daily walk for 30 minutes
• Quit smoking

Treatment options:

• Hormone replacement therapy
• Other hormone treatments
• Nonhormonal medication
• Referral to a specialist for additional testing and treatment

4. Low back pain

Back pain is a very common topic, and people are often very anxious about back pain and what it may mean for them. Many are worried about surgery.

A sudden onset of back pain is often a muscle spasm. However, to be sure, it’s always a good idea to call your primary care provider. We can talk you through your symptoms, conduct an exam, and make a plan for next steps.

Treatment options for back pain include:

• Medicine to help with inflammation – including naproxen (Aleve) or ibuprofen (Advil)
• Muscle relaxant medication
• Heat therapy – perhaps a heating pad or hot water bottle
• Light movement – prolonged bed rest has no value and is not recommended
• Gentle exercise – stationary bike, swimming

When to seek emergency care for back pain:

• “Saddle anesthesia” – if you are numb on the parts of your body that would sit on a saddle – the inner thighs, inner side of the buttocks, and the anal area
• If you do not have control of your bowls or bladder
• If you have severe leg or foot weakness
• If you have a fever or chills and severe back pain
• If you have back pain with a history of osteoporosis or cancer

In any of these cases, do not wait for the next day – proceed to the emergency room, so they can be dealt with urgently and prevent further damage.

Stay tuned for part two of our list of top concerns that bring people into their primary care provider’s office.

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