Associated symptoms
- Fever and chills: inflammatory/infective diseases or infarction.
- Weight loss suggests malignancy, malabsorption, tuberculosis, IBD ischaemia.
- Nausea/vomiting indicates obstruction, infection, IBD or metabolic disease.
- Dysphagia or odynophagia suggests oesophageal disease
- Haematemesis indicates oesophageal, gastric and duodenal disease
- Jaundice is either due to haemolytic or hepatobiliary disorders.
- Diarrhoea : malabsorption or infection, IBD, secretory tumours (Zollinger- Ellison’s syndrome).
- Dysuria / haematuria suggests urinary diseases
- Vaginal/penile discharge indicates genitourinary disorders.
- Hematochezia indicates colorectal disease
- Skin/joint/eye involvement indicates inflammatory bowel disease.
Predisposing Factors
How to approach a patient with Abdominal painY
What is the site of pain?
• How severe is it?
• Is it continuous or intermittent?
• Does it radiate to any site or direction?
• What is duration of pain?
• Are there any pain-free intervals, if yes, what is their duration?
• Is pain related to meal?
• Does it disturb sleep at night?
• What are the aggravating factors?
• What are relieving factors (e.g. food, vomiting or antacid)?
Appetite
• Is it increased or decreased?
• If reduced, is appetite poor or the patient is afraid of taking food due to pain?
Medical causes of abdominal pain
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Porphyrias: Acute Intermittent Porphyria.
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Lead Poisoning.
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Metabolic and Endocrine Diseases.
- Diabetic precoma
- Pheochromocytoma
- Addison disease
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Familiar hyperlipidemia
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Inferior MI
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Polycythemia, congenital spherocytosis
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Sic;le cell disease
Working diagnosis
