Various Symptoms Treated in General Internal Medicine
General internal medicine serves as the "first point of contact" for physical ailments, addressing a wide range of issues from acute symptoms like fever, cough, and abdominal pain, to chronic diseases such as high blood pressure and diabetes, as well as abnormal values noted during health screenings. If you're unsure which department to visit, please consult an internal medicine doctor first.
Internal Medicine Physicians are Specialists in "General Practice"
Because the body's organs work in concert, a single symptom can have multiple causes. Our clinic comprehensively assesses symptoms, progression, and test results, and if necessary, provides appropriate referrals to specialists in cardiology, gastroenterology, pulmonology, endocrinology, neurology, orthopedics, and other fields.
Main Symptoms Our Clinic Addresses
Respiratory Symptoms (excluding other pages)
- Persistent phlegm (viscous, discolored)
- Bronchitis, laryngitis
- Chronic cough (including atopic cough, cough variant asthma)
- Shortness of breath, dyspnea on exertion (suspected heart failure, COPD)
Cardiovascular Symptoms
- Palpitations, chest discomfort
- Ongoing management of hypertension
- Initial evaluation of arrhythmia
- Edema (swelling)
- Coldness, numbness in lower limbs (peripheral arterial disease)
Gastrointestinal Symptoms (excluding other pages)
- Loss of appetite, weight loss
- Constipation, diarrhea (excluding functional)
- Abdominal bloating
- H. pylori testing and eradication
- Detailed examination for abnormal liver function
Endocrine/Metabolic Symptoms
- Thyroid dysfunction (Graves' disease, Hashimoto's disease)
- Diagnosis and treatment of diabetes
- Dyslipidemia
- Hyperuricemia, gout attacks
- Adrenal fatigue, chronic fatigue
- Vitamin D, B12 deficiency
Hematologic/Systemic Symptoms
- Anemia (iron deficiency, pernicious anemia)
- Chronic fatigue, malaise
- Unexplained weight loss
- Low-grade fever, fever of unknown origin
- Generalized numbness
Neurological/Head Symptoms
- Headache (migraine, tension headache)
- Dizziness (initial evaluation of floating or spinning sensation)
- Numbness
Management of Lifestyle Diseases
Lifestyle diseases progress without subjective symptoms, posing a risk for myocardial infarction, stroke, and kidney failure. Early detection and continuous management are crucial.
Hypertension
| Classification | Office Blood Pressure | Home Blood Pressure |
|---|---|---|
| Normal Blood Pressure | <120/80 | <115/75 |
| Elevated Blood Pressure | 120-129/<80 | 115-124/<75 |
| High Blood Pressure (Stage 1) | 130-139/80-89 | 125-134/75-84 |
| Hypertension Stage I | 140-159/90-99 | 135-144/85-89 |
| Hypertension Stage II | 160-179/100-109 | 145-159/90-99 |
| Hypertension Stage III | ≧180/≧110 | ≧160/≧100 |
Target blood pressure varies by age and comorbidities. The basic target is <130/80 for young and middle-aged adults, and <140/90 for the elderly.
Diabetes
| Test Item | Normal | Prediabetes | Diabetes |
|---|---|---|---|
| Fasting Blood Glucose | <110 mg/dL | 110-125 | ≧126 |
| 2-hour Post-meal Glucose | <140 | 140-199 | ≧200 |
| HbA1c | <5.6% | 5.6-6.4% | ≧6.5% |
The treatment target for HbA1c is under 7.0% for complication prevention, and under 6.0% for blood glucose normalization. For the elderly or those at risk of hypoglycemia, individual targets are set.
Dyslipidemia
| Item | Management Target Value |
|---|---|
| LDL Cholesterol (primary prevention) | <120-140 mg/dL (depending on risk) |
| LDL Cholesterol (history of coronary artery disease) | <100 (strict management <70) |
| HDL Cholesterol | ≧40 mg/dL |
| Triglycerides (TG) | <150 mg/dL |
Hyperuricemia, Gout
- Serum uric acid level 7.0 mg/dL or higher is diagnosed as hyperuricemia.
- Treatment begins if there is a history of gout attacks, kidney damage, or urinary stones (target <6.0).
- For attacks, NSAIDs and colchicine; for chronic phase, febuxostat and allopurinol.
Thyroid Diseases
The thyroid is a small organ in the neck, but it plays a vital role in regulating the body's metabolism. Dysfunction can cause a variety of symptoms.
| Disease | Main Symptoms | Confirmatory Tests |
|---|---|---|
| Graves' disease (hyperthyroidism) | Palpitations, weight loss, sweating, irritability, hand tremors, exophthalmos | Decreased TSH, increased FT3/FT4, positive TRAb |
| Hashimoto's disease (hypothyroidism) | Fatigue, swelling, weight gain, cold intolerance, constipation, low mood | Increased TSH, decreased FT4, positive TPOAb/TgAb |
| Subacute thyroiditis | Thyroid pain, fever, tachycardia | Increased CRP, TSH fluctuations |
| Thyroid nodule | Lump in the neck (often asymptomatic) | Ultrasound (referral) |
Anemia
Anemia is often noticed by symptoms such as "easy fatigability" or "dizziness," but serious underlying conditions can be hidden. It is crucial to always identify the cause.
Main Types of Anemia
| Type | Characteristics | Causes |
|---|---|---|
| Iron deficiency anemia | Most common, microcytic anemia | Menorrhagia, gastrointestinal bleeding, unbalanced diet |
| Vitamin B12 deficiency anemia | Macrocytic anemia, with neurological symptoms | Post-gastrectomy, pernicious anemia, vegetarianism |
| Anemia of chronic inflammation | Normocytic or microcytic | Rheumatoid arthritis, chronic kidney disease, etc. |
| Hemolytic anemia | Acute jaundice, increased LDH | Autoimmune, drug-induced |
Anemia is a result, finding the cause is key.
Particularly for iron deficiency anemia in middle-aged and older adults, gastrointestinal bleeding (stomach cancer, colon cancer, etc.) may be concealed. If anemia is detected in tests, always investigate the cause.
Dizziness, Headache, Numbness
Neurological symptoms can have diverse causes. Internal medicine first rules out physical diseases and lifestyle-related diseases and then refers to specialists as needed.
Key Points for Assessment
- Sudden severe headache, numbness, paralysis → Emergency visit (suspected stroke)
- Vertigo + tinnitus/hearing loss → Referral to ENT
- Persistent headache, bilateral floating dizziness → Evaluation by internal medicine
- Numbness + suspected diabetes/vitamin deficiency → Evaluation by internal medicine
Tests Available at Our Clinic
| Test | Purpose / What it reveals |
|---|---|
| Blood test (results available same day) | CBC, biochemistry, inflammation markers, blood glucose, lipids, thyroid, vitamins, etc. |
| Urinalysis | Kidney function, glycosuria, urinary tract infection |
| ECG | Arrhythmia, myocardial ischemia |
| Chest X-ray | Pneumonia, cardiomegaly, pleural effusion |
| Rapid tests | Influenza, COVID-19, strep throat, adenovirus, etc. |
| H. pylori test | Urea breath test, stool antigen |
| Fecal occult blood test | Gastrointestinal bleeding screening |
| Blood pressure, pulse wave (ABI, etc.) | Arteriosclerosis evaluation |
When a Referral is Necessary
If your condition cannot be managed at our clinic, we will promptly refer you to a trusted specialized medical institution.
- Endoscopy (gastroscopy, colonoscopy) → Gastroenterology
- Echocardiography, coronary CT, catheterization → Cardiology
- Brain MRI, stroke management → Neurology, Neurosurgery
- Diabetic complications (retinopathy, nephropathy, neuropathy) → Specialized Diabetes Center
- Thyroid ultrasound, fine needle aspiration cytology → Endocrine specialist
- Severe cases requiring psychiatry/psychosomatic medicine
Follow-up After Health Check-ups
If told "re-examination required" or "further investigation required," always visit a doctor.
For abnormal values pointed out during a health check-up, early re-examination and detailed investigation are crucial. Do not neglect it even without subjective symptoms; an early visit can prevent severe progression.
Follow-up Items Our Clinic Can Handle
- Abnormal blood pressure
- Abnormal blood glucose, HbA1c
- Dyslipidemia
- Abnormal liver function
- Abnormal kidney function
- Anemia, polycythemia
- Abnormal uric acid levels
- Thyroid dysfunction
- Minor abnormalities in chest X-ray, ECG
- Positive fecal occult blood test (→ referral for endoscopy)
Basics of Self-Care and Lifestyle Improvement
Diet
- Salt: less than 6g/day (for hypertension, kidney disease)
- Vegetables: 350g/day or more
- Balanced intake of fish, soybeans, and chicken
- Choose brown rice or other grains over white rice and wheat
- Be mindful of sugar and fat in processed foods and beverages
Exercise
- Aerobic exercise: 150 minutes/week or more (walking, swimming, etc.)
- Strength training: 2 times/week or more
- Avoid prolonged sitting (stand up every 30-60 minutes)
Other
- No smoking
- Moderate alcohol consumption (men <20g/day, women <10g/day)
- Sufficient sleep (around 7 hours)
- Stress management
- Regular health check-ups (at least once a year)
Features of Our General Internal Medicine Practice
- Serves as the first point of contact for unclear physical ailments.
- Blood tests, urinalysis, ECG, chest X-rays conducted on the same day.
- Evidence-based treatment for lifestyle diseases (hypertension, diabetes, dyslipidemia, hyperuricemia).
- Detailed examination and treatment for systemic diseases such as thyroid disorders, anemia, and vitamin deficiencies.
- Handles re-examinations and detailed investigations after health check-ups.
- Provides appropriate referrals to specialized medical institutions when necessary.
- Offers one-stop service for internal medicine symptoms and skin conditions, as a dermatology clinic is co-located.
- No appointment necessary / Same-day consultation available / Open daily from 9 AM to 9 PM / 1 minute walk from Jujo Station.
If in doubt, consult internal medicine first.
"I don't know which department to go to," "I have multiple symptoms," "I'm concerned about my test results" - any consultation is welcome. Bridging to the appropriate specialized department is also a crucial role of internal medicine.
