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EARLY MORNING SYMPTOMS

OP Kapoor

Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.

There are many symptoms which appear early in the morning; the following is the list:-

GI System

1. Alcoholic vomiting due to gastritis occurs in the mornings.

2. Pregnancy vomiting occurs always early in the morning.

3. Symptoms due to gastritis related to tension and anxiety occur early in the morning.

4. Diarrhoea and bowel complaints due to irritable bowel disease -occur early in the morning. Thus the patient passes 2-4 stools early in the morning.

Respiratory System

1. Most of the symptoms of allergic rhinitis (sneezing and watering nose) occur early in the morning.

2. Most of the symptoms of cough and dyspnoea due to bronchial asthma occur early in the morning.

CNS

1. Migraine attacks occur early in the morning after a good night rest.

2. Alcoholic tremors usually occur early in the morning and thus the patient is tempted to take a drink in order to control this symptom.

Psychiatric

Most of the symptoms of endogenous depression occur early in the morning.

Endocrine

Most of the symptoms of hypoglycaemia (iatrogenic) occur in the early hours of morning.

Cardio-vascular symptoms

Many patients get an attack of myocardial infarction early in the morning.

Musculo-skeletal system

1. early morning joint pains and stiffness lasting for more than 1 hour are diagnostic of rheumatoid arthritis specially if 3-4 joints are involved in both the limbs including hands.

2. In young men complaining of chronic pain in the low back and severe stiffness early in the morning - think of spondylo-arthropathy.

3. An elderly person complaining of severe pain around the shoulder girdles and stiffness early in the morning with other systemic complaints - points towards the diagnosis of poly-myalgia rheumatica.


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