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The primary symptoms of ulcerative colitis are abdominal pain, bloody diarrhoea and weight loss. The
course of the disease is characterised by frequent exacerbations and many, often severe, complications
including anaemia, and a high frequency of colonic carcinoma. Medical treatment is often unsatisfactory
and many patients will require surgery (colectomy). Crohn’s disease is usually more severe with a poor
quality of life for most patients regardless of treatment.
For both conditions, an assessment as unfit is the rule, although rare cases with mild and infrequent
symptoms and without need for long-term treatment may be considered fit under close monitoring.
HERNIA
The medical examiner, when evaluating an applicant with hernia, should keep in mind that some hernias
might not originate symptoms of an acute pattern, whereas other hernias may cause incarceration or
strangulation, which would compromise flight safety.
To assess an applicant as fit, the medical examiner should be satisfied that the applicant is completely
free from the latter kind of hernias.
In assessing inguinal hernias, distinction should be made between the presence of a hernial orifice only
and the demonstration of a hernial sac. The existence of a hernial orifice per se should not be considered
disqualifying for aviation duties. An applicant with such a condition should, however, be referred for
surgical evaluation.
OTHER DISEASES
Pilonidal disease and haemorrhoids are common diseases. They are usually of a benign character; they
rarely, if ever, give rise to certification problems.
REFERENCES
ICAO Preliminary Unedited Version — October 2008 III-3-5
Marks, Jay W.: Gastro-esophageal reflux disease. MedicineNet.com, 2003.
Rayman, Russell B. et al: Clinical Aviation Medicine, fourth edition, 2006.
————————
ICAO Preliminary Unedited Version — March 2010
Part III
Chapter 4. METABOLIC, NUTRITIONAL AND ENDOCRINE DISEASES
Page
Introduction ............................................................................................... III-4-1
The endocrine system ............................................................................... III-4-1
Diseases of the thyroid .............................................................................. III-4-1
Hyperthyroidism – Thyrotoxicosis ....................................................... III-4-1
Clinical features ............................................................................. III-4-2
Investigation of thyrotoxicosis ....................................................... III-4-2
Management of thyrotoxicosis ....................................................... III-4-2
Operational implications ................................................................ III-4-3
Aeromedical considerations ........................................................... III-4-3
Hypothyroidism .................................................................................... III-4-3
Clinical features ............................................................................. III-4-3
Management ................................................................................... III-4-3
Operational implications ................................................................ III-4-4
Aeromedical considerations ........................................................... III-4-4
Diseases of the pituitary ............................................................................ III-4-4
Diseases of the anterior pituitary ............................................................. III-4-4
Anterior pituitary hypofunction ........................................................... III-4-4
Clinical features ............................................................................. III-4-4
Diagnosis ....................................................................................... III-4-5
Treatment ....................................................................................... III-4-5
Operational implications ................................................................ III-4-5
Aeromedical considerations ........................................................... III-4-5
Anterior pituitary hyperfunction .......................................................... III-4-5
Specific clinical syndromes ....................................................................... III-4-6
Over-production of growth hormone (GH) .......................................... III-4-6
Aetiology and Pathogenesis ........................................................... III-4-6
Clinical features ............................................................................. III-4-6
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Manual of Civil Aviation Medicine 1(119)
