Key Symptoms

The important GI signs and symptoms are pain, vomiting, diarrhea, constipation, bleeding, jaundice, and masses. Pain

Abdominal pain can be a manifestation of a variety of disease states not necessarily related to the intestinal tract. 23 The origin of the pain may be extraabdominal, such as one might see in a 3- to 6-year old with tonsillitis or pneumonia. Therefore, a careful general physical examination is necessary. One should distinguish between two types of pain—peritonitic and obstructive:

1. Peritonitic pain tends to be exacerbated by motion and thus keeps patients relatively immobile, as, for example, in appendicitis.

2. Obstructive pain is usually spasmodic and associated with restlessness and motion, as, for example, with intussusception.

In the very young (up to 2 years of age), pain is usually described by the caregiver in general terms, such as fussiness, irritability, and inconsolableness. With severe peritonitic pain, the caregiver may state that the child is very irritable or lethargic or seems to be grunting as if in pain. Peritonitis or pain from intussusception may present as lethargy or an altered level of consciousness. Between 2 and 6 years of age, pain of GI origin is usually referred to the periumbilical region, and diagnosis requires correlation of the patient's observations and the physician's visual and tactile evaluation. Youngsters with pain of peritonitic origin walk with obvious discomfort and prefer to lie still. In contrast, youngsters with obstructive pain may be unable to remain immobile on the examining table. The etiologies of pain vary significantly with age (T§ble..,..123.-.1). Every emergency physician must be familiar with and recognize the life-threatening causes of pain ( T§ble...,12.3.-.2). The clinician must provide appropriate supportive therapy while completing the diagnostic evaluation and/or consultation.

TABLE 123-1 Etiology of Pain

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Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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