A

• Anorexia

  • Definition: Loss of appetite.

  • Clinical relevance: May indicate systemic illness (e.g., malignancy, chronic infection), GI inflammation, or metabolic disorders.

  • Red flags: Persistent anorexia with weight loss.

• Achalasia

  • Definition: Esophageal motility disorder causing impaired relaxation of the lower esophageal sphincter.

  • Presentation: Progressive dysphagia to both solids and liquids, regurgitation of undigested food, weight loss.

B

• Bloating

  • Definition: Sensation of abdominal fullness or distension.

  • Common causes: Irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), lactose intolerance, constipation.

  • Clinical tip: Ask about relation to meals, flatulence, or changes in bowel habits.

• Borborgymi

  • Definition: Audible bowel sounds due to gas movement.

  • Significance: Hyperactive sounds seen in diarrhea, early obstruction; absent sounds may indicate ileus or peritonitis.

C

• Constipation

  • Definition: Infrequent (<3 per week) or difficult passage of stool.

  • Causes: Functional (diet, inactivity), obstructive lesions, medications, metabolic diseases (hypothyroidism).

  • Associated symptoms: Straining, hard stools, sensation of incomplete evacuation.

• Chronic Diarrhea

  • Definition: Diarrhea lasting >4 weeks.

  • Causes: Inflammatory bowel disease, malabsorption syndromes (celiac disease), infections (e.g., Giardia), medications.

• Colic

  • Definition: Intermittent, cramping abdominal pain.

  • Examples: Biliary colic (gallstones), renal colic, intestinal obstruction.

D

• Dysphagia

  • Definition: Difficulty swallowing; categorized as oropharyngeal (difficulty initiating swallow) or esophageal (sensation of food sticking).

  • Causes: Neurological disorders (stroke), structural lesions (esophageal cancer), motility disorders (achalasia).

• Dyspepsia

  • Definition: Upper abdominal discomfort or burning sensation, often postprandial.

  • Differential: GERD, peptic ulcer disease, gastritis, functional dyspepsia.

• Diarrhea

  • Definition: Increased stool frequency and liquidity.

  • Duration: Acute (<2 weeks), chronic (>4 weeks).

  • Red flags: Bloody stools, weight loss, nocturnal symptoms, systemic signs.

E

• Emesis (Vomiting)

  • Important details: Timing (early morning in pregnancy or increased intracranial pressure), contents (bile, blood), frequency, and triggers.

  • Causes: Gastroenteritis, obstruction, CNS disorders, pregnancy.

• Early Satiety

  • Definition: Feeling full after eating a small amount.

  • Causes: Gastric outlet obstruction, malignancy, gastroparesis.

F

• Fecal Incontinence

  • Definition: Loss of voluntary control over defecation.

  • Causes: Anal sphincter injury, neuropathy, diarrhea, spinal cord disease.

• Fever

  • Significance: May suggest infectious or inflammatory causes such as gastroenteritis, appendicitis, or diverticulitis.

G

• Gastroesophageal Reflux Disease (GERD)

  • Symptoms: Heartburn, regurgitation, sour taste.

  • Aggravating factors: Meals, lying down, bending forward.

• Guarding

  • Definition: Involuntary muscle contraction on abdominal palpation.

  • Clinical importance: Sign of peritoneal irritation or acute abdomen.

H

• Hematochezia

  • Definition: Passage of fresh blood per rectum.

  • Common causes: Hemorrhoids, diverticular bleeding, colorectal cancer.

  • Urgency: Large volumes warrant urgent evaluation.

• Hematemesis

  • Definition: Vomiting of blood.

  • Causes: Peptic ulcer, varices, Mallory-Weiss tear.

• Hepatomegaly

  • Clinical clue: Suggests liver pathology, right heart failure, or infiltrative diseases.

I

• Icterus (Jaundice)

  • Definition: Yellow discoloration due to bilirubin accumulation.

  • History points: Onset, associated pruritus, stool and urine color changes, abdominal pain.

• Incontinence

  • See fecal incontinence.

L

• Liver Function Symptoms

  • Fatigue, easy bruising, spider angiomata, ascites — suggest chronic liver disease.

• Lactose Intolerance

  • Symptoms after dairy ingestion: bloating, diarrhea, flatulence.

M

• Melena

  • Definition: Black, tarry stools due to digested blood.

  • Cause: Upper GI bleeding (peptic ulcer, varices).

• Malabsorption

  • Symptoms: Diarrhea, weight loss, steatorrhea, vitamin deficiencies.

  • Causes: Celiac disease, pancreatic insufficiency, small bowel bacterial overgrowth.

N

• Nausea

  • Common symptom with various GI and systemic causes.

O

• Odynophagia

  • Painful swallowing; suggests esophageal mucosal inflammation or infection (e.g., candida, herpes).

• Obstruction

  • Symptoms: Vomiting, abdominal distension, constipation, colicky pain.

P

• Pain (Abdominal)

  • Characterization: Location, quality (sharp, dull, colicky), timing, radiation, exacerbating/relieving factors.

  • Important: Differentiate visceral, parietal, or referred pain.

• Pallor

  • Sign of anemia from chronic GI blood loss.

• Peritonitis

  • Severe abdominal pain with guarding and rigidity, suggesting surgical emergency.

R

• Rectal Bleeding

  • Requires differentiation from hematochezia; important to clarify source and urgency.

• Regurgitation

  • Passive return of food or acid; often in GERD or motility disorders.

S

• Steatorrhea

  • Fatty, foul-smelling stools; hallmark of malabsorption.

• Strangulation (Bowel)

  • Severe ischemic pain; surgical emergency.

• Stool Characteristics

  • Color, consistency, presence of mucus, blood — crucial for diagnosis.

• Syncope

  • May result from hypovolemia due to GI bleeding.

T

• Tenesmus

  • Urge to defecate despite empty rectum; common in proctitis or IBD.

• Tenderness

  • Localized pain on palpation indicating inflammation.

• Trauma

  • Important history in acute abdomen.

V

• Vomiting

  • See emesis.

• Vomiting Blood

  • See hematemesis.

W

• Weight Loss

  • Unintentional, alarming symptom suggesting malignancy, chronic infection, or malabsorption.

Y

• Yellowing of Skin/Eyes

  • See icterus/jaundice.

Additional History Tips:

• Chronology and Progression: Always document onset, duration, and progression of symptoms.

• Associated Symptoms: Fever, night sweats, rash, joint pains may indicate systemic disease.

• Risk Factors: Alcohol use, NSAID use, travel history, sexual history (for hepatitis), family history of GI diseases.

• Impact on Daily Life: Weight loss, fatigue, and ability to eat should be explored to assess severity.