Know when to call your doctor. What symptoms should prompt you to seek medical attention?

When pain erupts in a novel locate, or the stomach declares its presence with unaccustomed fury, or fever and headache intrude on a humdrum day, the first question we ask ourselves is What's going on? And the second is Should I call a doctor?

It's not always easy to discern serious conditions from those that will pass on their own. One of the best rules of thumb is that if the symptoms divert you from your normal day, get help. Ask your doctor to check out any condition that wakes you from sleep or gets worse over time, even if you're treating it with over-the-counter drugs. And if you have a chronic medical condition--such as diabetes, regular use of steroid drugs, or a disease that compromises your immune system--notify a doctor when new symptoms appear, including the side effects of medication.

Key Symptoms

Headache is one of the most common symptoms. The vast majority of headaches stem from muscle tension, migraine, or sinus and menstrual changes and are of no long-term consequence.

"Most people have a certain pattern of headache," says Soheyla Ghairb, M.D., codirector of the Women's Hospital in Boston. "If something is a change from your normal headache pattern, you should definitely be seen."

In particular, seek help for any headache that lasts for several days, increases in intensity, occurs during sex, prevents you from sleeping, is accompanied by visual changes, or doesn't respond to over-the-counter remedies.

Stomach upset is another nuisance that usually passes without harm. Most stomachaches are mild cases of gastritis, in which a food stimulates excess stomach acid. Abdominal pain that should be brought to a doctor's attention includes pain that doesn't respond to antacids or to a change in diet (it could be a bleeding ulcer), pain that is intense and localized under the right side of the rib cage (possibly gallstones), and pain that is accompanied by vomiting and fever and that involves the inability to have a bowel movement (possibly an obstructed bowel). "If the abdomen becomes taut and the pain is constant and it's getting worse, you need to be seen," notes Richard Pingree, M.D., codirector of the medical walk-in unit at Boston Massachusetts General Hospital.

Fever is one of the body's frontline responses to illness. Any fever that produces shaking, teeth-chattering chills should be treated by a physician right away--it usually means there's a bacterial infection in the bloodstream.

Fever that persists without any indefinable cause, such as a urinary tract infection or flu, must also be checked out--in rare cases it may be caused by lymphoma or tuberculosis. And any time a fever accompanies abdominal pain or diarrhea, call a doctor.

Bleeding should always be brought to a doctor's attention. Bright-red blood after a bowel movement usually means hemorrhoids. A black stool, with a tarry consistency, indicates the presence of blood that has been exposed to stomach acid, which could suggest a bleeding ulcer. Anyone older than 40 who has blood in the stools should be checked, since the symptom could be a sign of colon cancer or polyps, inflammatory bowel disease, or bleeding diverticuli in the intestinal tract. Blood in the urine can be caused by an inflamed bladder or a kidney or urinary tract infection. If a woman is experiencing vaginal bleeding between menstrual periods, accompanied by lower abdominal pain, it could mean an ectopic pregnancy and should be treated at once.

Chest pain perhaps is the most urgent symptom in adults. Though it is most commonly caused by indigestion or a pulled muscle, the great danger is heart attack.

Chest pain from indigestion feels like an intense burning and is usually accompanied by regurgitation and gas. Chest pain caused by a pulled pectoral muscle arises after physical activity and only when you move your torso, take a deep breath, or touch the muscle.

By contrast, the symptoms of heart attack include crushing pain in the middle of the chest, nausea, sweating, breathlessness, and pain running up to the jaw or down the arm, usually on the left side of the body. If you have these symptoms, call 911 or get to an emergency room.

Additional Information

To help your doctor reach an accurate diagnosis when unusual symptoms appear, "it's important to notice what makes your symptoms worse and what makes them better," says Pingree. Does eating help or hurt? How about moving or touching your body a certain way? What's the effect of sitting up or lying down?

"The most important thing is that a person have a good relationship with a doctor and know how to get in touch with them when something is wrong," says Gharib. It's to sustain doctor-patient communication, in fact, that Pingree urges his patients to see him for an annual checkup.

"A lot of people dismiss the idea of a yearly physical," he says. "I look at it as a time to catch up with patients, to let them bounce their symptoms off me and find out which ones they should watch. If you never see a doctor, and you get a new symptom, you may not realize it's the symptom you shouldn't ignore."

Madeline Drexler is a Boston-based writer who covers health.

[C] 1996, Madeline Drexler. Distributed by Los Angeles Times Syndicate.