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David Evans

A mysterious lump on her bottom prompted Lily Chung to try self-diagnosis on the internet. 'It was one of those  things you just didn't want to take to a doctor,' says  the 42-year-old teacher, who prefers not to disclose her real name.

On doing a Web search of her ailment, she was presented with several  pictures and descriptions of boils and cysts. For four months she tried the diets, creams and supplements suggested by the  forums she visited in the hope it would disappear. It didn't, so she finally plucked up the courage to visit her doctor.

'It was in a sensitive place, so I'd experienced regular pain,' says Chung. 'And it was getting worse.'

Her doctor diagnosed it as  a sebaceous cyst, and it was subsequently removed in a minor operation under local anaesthetic.

These days, the internet provides an unprecedented amount of information about health-related problems, with numerous websites dedicated to medical issues.

Last year, a study by IBM Research found that 37 per cent of  a core sample of 2,500 Canadians used the internet to find health information. One-quarter of those were looking to confirm a doctor's advice, find people with a similar condition or manage an existing condition. Meanwhile, in Singapore some of the  most popular  health-related online word searches over a six-month period have been for 'pregnancy', 'depression', 'breast cancer', 'HIV', 'chicken pox', 'thyroid', 'herpes' and 'piles', according to Australia-based Web tracker Hitwise. During the same  period, Singapore internet users visited more than 300 local and global health websites.

'The internet is my first point of reference before going to the doctor,' says Chung. 'It's so up- to-date and there are so many opinions you can get.'

Many practitioners in Hong Kong appear to support patients taking the initiative to  research what ails them. However, they  warn  that you should always seek a professional diagnosis.

Hong Kong Medical Association vice-president Louis Shih Tai-cho, a skin specialist, says  practitioners are happy for patients to turn up  with questions gleaned from other sources. He   directs his patients towards websites  that can help them learn more about their  conditions, but he warns against sites that  sell products or  spread fear.

One of the biggest drawbacks of using the internet for self-diagnosis, he says, is that patients with no medical knowledge can be easily misled and become stressed by  what they read on the internet.

That's  what happened to Simon Siu (not his real name) when he searched for information about the   tongue discolouration  he'd had for  a couple of weeks. Presented with about 30 images on the internet, he clicked on the closest match and was re-directed to a site dealing  with HIV. Reading through the symptoms for Aids, he recognised other symptoms, including a persistent rash.  'I've never been so scared,' says the 36-year-old.

Siu disclosed his fears to his doctor and,  after a test for HIV,  was diagnosed with nothing more than overgrowth of  filiform papillae. Otherwise known as black hairy tongue, it's a benign treatable condition, if uncommon.

For Siu, the day he spent on the internet researching his ailment is not one he's likely to repeat. 'I would spend five minutes trying to prove I had Aids, then five minutes trying to prove that I didn't,' Siu says. 'The problem is that whatever you look for on the internet you can find. My symptoms also related to a nasty form of hepatitis that's fatal.'

A team of Australian doctors conducted searches of 26 health cases and found the correct diagnoses in 15, according to a  paper published in the British Medical Journal last year. But patients surfing the internet  who lack medical knowledge may be less likely to reach the correct diagnosis than  specialists, the authors say. Medical practitioner Brian Walker  says people should  take more responsibility for their  health, and if they make mistakes,  so be it.  External sources can help in the discussion and understanding of a  condition when visiting a doctor.

'A recurring issue I have is that people don't take responsibility, and anything that puts [health issues] back into the patient's hands is a good thing,' says Walker.

Many doctors are pro-self diagnosis, but they warn against self-treatment, especially with drugs bought online, alternative medicines or untested theories.

'You can get a lot of crap on the internet and you have to be aware that bad things can happen,' Walker says. 'So  always check in with an expert. Have [the information] filtered by someone who knows what they're talking about.'



Web of terror