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Gastrointestinal symptoms and physical signs 

Gastrointestinal symptoms and physical signs
Gastrointestinal symptoms and physical signs

Huw Llewelyn

, Hock Aun Ang

, Keir Lewis

, and Anees Al-Abdullah

Page of

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date: 24 October 2017

Unintentional weight loss over weeks or months - Weight gain - Vomiting - Vomiting with weight loss - Vomiting without weight loss - Vomiting shortly after food - Vomiting with abdominal pain and fever - Vomiting with abdominal pain alone (unrelated to food and no fever)—non-metabolic causes - Vomiting with abdominal pain alone (unrelated to food and no fever)—metabolic causes - Vomiting with headache alone (unrelated to food and no abdominal pain) - Vomiting alone (unrelated to food and without abdominal pain or headaches) - Jaundice - Pre-hepatic jaundice due to haemolysis - Hepatic jaundice due to congenital enzyme defect - Hepatocellular jaundice (due to hepatitis or very severe liver failure) - Obstructive jaundice - Dysphagia for solids that stick - Dysphagia for solids (that do not stick) > fluids - Sore throat - Dysphagia for fluids > solids - Acute pain in the upper abdomen - Acute central abdominal pain - Acute lateral abdominal pain - Acute lower central (hypogastric) abdominal pain - Acute abdominal pain in children - Recurrent abdominal pain in children - Sudden diarrhoea, fever, and vomiting - Recurrent diarrhoea with blood ± mucus—bloody flux - Acute bloody diarrhoea ± mucus—‘dysentery’ - Watery diarrhoea - Recurrent diarrhoea with no blood in the stools, no fever - Chronic diarrhoea in children - Constipation - Change in bowel habit - Haematemesis ± melaena - Passage of blood per rectum - Tenesmus - Anorectal pain - Distended abdomen - Distended abdominal veins - Abdominal bruising - Poor abdominal movement - Localized tenderness in the hypogastrium (suprapubic area) - Localized tenderness in the right upper quadrant - Localized tenderness in the left upper quadrant - Localized tenderness in the epigastrium or central abdomen - Localized tenderness in the left or right loin - Localized tenderness in left or right lower quadrant - Hepatomegaly—smooth and tender - Hepatomegaly—smooth but not tender - Hepatomegaly—irregular, not tender - Splenomegaly—slight (<3 fingers) - Splenomegaly—moderate (3–5 fingers) - Splenomegaly—massive (>5 fingers) - Bilateral masses in upper abdomen - Unilateral mass in right or left upper quadrant - Mass in epigastrium (± umbilical area) - Mass in right lower quadrant - Mass in hypogastrium (suprapubic region) - Mass in left lower quadrant - Central dullness, resonance in flank - Shifting dullness - Silent abdomen with no bowel sounds - High-pitched bowel sounds - Abdominal/loin bruit - Lump in the groin - Scrotal swelling - Anal swelling - Enlargement of prostate - Melaena on finger - Fresh blood on finger on rectal examination

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