Updated November 19, 2021 at 6:32 PM ET

President Biden's long-time primary care physician, Dr. Kevin O'Connor, declared Biden to be "fit for duty" after receiving his first physical since becoming president on Friday.

"President Biden remains a healthy, vigorous, 78-year-old male, who is fit to successfully execute the duties of the Presidency," O'Connor wrote in a six-page summary of the visit.

The White House physician noted the increasing frequency and severity of Biden's "throat clearing" during speeches and worsening gait, but said the exam showed the president's health to be "fundamentally unchanged" from where it's been previously.

Biden got his first physical as president at Walter Reed National Military Medical Center in Bethesda, Md.

He gained a few pounds since his checkup in 2019. Biden's cholesterol and blood pressure have improved.

The exam came a day before he turns 79.

"I had a great physical," Biden said as he was leaving the hospital.

In his summary, O'Connor cited the coughing and stiffened gait as two "specific observations" that merited detailed investigation.

He said the president experiences occasional symptoms of "gastroesophageal reflux," which likely cause him to clear his throat. He said the symptoms have been more frequent and more pronounced, but an exam found no signs of tumors or polyps and his vocal cords looked and worked normally.

O'Connor appeared to blame Biden's stiffened gait is a result of degenerative "wear and tear" on his spine. He added that his fractured foot last year, which happened while playing with his dog, may also contribute to his stiffness.

"An extremely detailed neurologic exam was reassuring in that there were no findings which would be consistent with any cerebellar or other central neurological disorder, such as stroke, multiple sclerosis, Parkinson's or ascending lateral sclerosis," he wrote. "This exam did, however, reveal a mild peripheral neuropathy in both feet," and the president will try out custom orthotics to ease his foot trouble.

Biden underwent anesthesia, turning power over to Harris in a brief moment of history

O'Connor noted in his summary that a "single, 3mm, benign appearing polyp" was removed from Biden's colon during a routine colonoscopy.

For the procedure, which required Biden to be placed under anesthesia, Biden transferred his powers to Vice President Kamala Harris.

That made Harris the first woman and first Asian American to hold presidential authority, albeit briefly.

Section 3 of the 25th Amendment states that the president must provide a written declaration to the president pro tempore of the Senate and speaker of the House that he is unable to discharge the powers and duties of his office, "and until he transmits to them a written declaration to the contrary, such powers and duties shall be discharged by the Vice President as Acting President."

Harris, the daughter of an Indian mother and Jamaican father, had already reached a higher point in U.S. leadership than any woman or Asian American ever before her, and she is the first Black American to serve as vice president. Her rise has been hailed as an example of the future of the country that is becoming more diverse.

In her first speech as vice president-elect last year, she told young girls to "dream with ambition."

"While I may be the first woman in this office, I won't be the last. Because every little girl watching tonight sees that this is a country of possibilities," she told cheering supporters in Wilmington, Del.

Harris worked from her office in the West Wing during Biden's procedure. Soon after taking back the role of vice president, she left for Columbus, Ohio, to promote the administration's infrastructure legislation.

Biden had his last full exam in December 2019, when doctors described him as a "healthy, vigorous, 77-year-old male, who is fit to successfully execute the duties of the Presidency."

The routine procedure often draws attention because of the importance of the president's health, but Biden's examination has drawn even more interest because of his age. Biden is the oldest person to hold the office.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

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