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U.S. President Joe Biden is “healthy” and remains “fit to successfully execute the duties of the presidency,” his doctors said Friday after he underwent a routine physical exam and colonoscopy just a day before his 79th birthday.

But the president is suffering from a “perceptibly stiffer and less fluid” gait following a series of injuries and is experiencing a more frequent need to clear his throat or cough during public engagements, according to his physician, Kevin O’Connor. And his exam found mild nerve damage in the president’s feet, prompting them to suggest he be fitted with orthotics.

Still, doctors reported no findings “consistent with any cerebellar or other central neurological disorder” or motor weakness. The president is being treated with common prescription and over-the-counter medicines for minor conditions including spinal arthritis and seasonal allergies.

Biden, the oldest person to ever be elected president, has faced extra scrutiny about his health because of his age and some critics’ efforts to undermine him. In addition to a routine physical, the president on Friday underwent anesthesia for a colonoscopy, requiring him to briefly transfer power to Vice President Kamala Harris.

The president told reporters at the White House he felt “good” following his exam. “I feel great, nothing’s changed,” Biden said, before joking about his age.

Republicans — including, most notably, former President Donald Trump — have frequently criticized Biden’s acuity, including making unfounded claims about his mental competence. The attacks appear to have worn on perceptions of the president, with just 40% of respondents in a Politico/Morning Consult poll earlier this month describing Biden as in “good health.”

White House press secretary Jen Psaki on Friday attributed that perception to “quite a bit of of conspiracy theory pushing out there on a range of social media platforms and even through the mouths of elected officials.”

She said the administration is “going beyond” past precedent in providing information about Biden’s health. The memo from O’Conner was significantly more detailed than similar information provided by the Trump White House about the president’s health, offering granular details, including that the president’s colonoscopy revealed a 3 milimeter polyp that doctors believe is benign. It was removed and results of a histology to evaluate the polyp will be completed in the coming days, O’Connor wrote.

Doctors also said they believe Biden’s frequent throat clearing is the result of gastroesophageal reflux, and have recommended he continue taking Pepcid as an acid blocker. Former President Barack Obama similarly struggled with reflux, which in 2014 prompted an hasty examination after a sore throat lasted for weeks.

Biden’s medical team reported that he previously had several sinus and nasal passage operations to address allergies and congestion. Biden takes a nasal spray and over-the-counter allergy medicine to address the issue.

Doctors also treated “several small areas” of Biden’s skin with liquid nitrogen cryotherapy, but did not believe any were suspicious for skin cancer or required biopsy. Biden had several localized skin cancers removed before taking office. Dental and optometry exams were routine, and the president’s contact lens prescription was updated.

Before Friday, his team had provided scant details about his well-being since December 2019, when his presidential campaign released a health report. At the time, his physician described Biden as “a healthy, vigorous, 77-year-old male, who is fit to successfully execute the duties of the presidency, to include those as chief executive, head of state and commander in chief.”

Biden’s 2019 report, signed by O’Connor, who is now the president’s official physician, listed an “irregularly irregular” heartbeat, high levels of fat in the blood, acid reflux and seasonal allergies. At the time, he took three prescriptions — Eliquis and Crestor for his heart and blood issues, along with the allergy and acid reflux drugs.

Since then, Biden and his aides have reported only one major health issue for the president: two foot fractures that took place a few weeks after he was elected. Biden has said the injuries happened while he was playing with his dog, Major, who slid on a throw rug that Biden then slipped on.

He suffered hairline fractures and briefly wore a medical boot. After an X-ray in early February, O’Connor said the president had “completely healed.”

Biden continues to regularly take the same medicines he did before entering office, O’Connor said.

Biden suffered two brain aneurysms in 1988 and had surgery to repair burst blood vessels, but his 2019 medical report said he had no lingering effects from those incidents.

Harris was given the title “acting president” for an hour and 25 minutes under Section 3 of the 25th Amendment to the Constitution, which was ratified in 1967. The clause has only been formally invoked twice before, when then-President George W. Bush had colonoscopies.

But a century ago, another woman took on the role of acting president: Woodrow Wilson’s wife, Edith, functionally ran the executive branch after he suffered a stroke in 1919, but power was never formally transferred to her.

Ronald Reagan actively avoided invoking the amendment when he briefly put his vice president, George H.W. Bush, in charge while under anesthesia in 1985. And Stephanie Grisham, a press secretary to Trump, insinuated in her memoir that the former president underwent a colonoscopy in 2019 but hid the fact from the public.

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