THE COMMON CLINICAL MANIFESTATIONS OF GASTROINTESTINAL DISEASE



A. ABDOMIMAL FAIN

Pain, a subjective sensation that generally her­alds tissue damage, is the most frequent symptom of gastrointestinal disease and the one that usu­ally brings the patient to the physician. Specific patterns of pain are often helpful in suggesting or establishing a correct diagnosis and may be the most sensitive and specific sign of abdominal dis­ease. For example, the diagnosis of acute appen­dicitis is established on clinical findings alone; a characteristic, localized, right lower quadrant pain and tenderness occur at a time when the most sophisticated imaging studies, such as computed tomography, are normal. This section will review the etiology, characteristics, and patterns of ab­dominal pain, concluding with a discussion of the approach to the patient with acute abdominal pain and a brief overview of the irritable bowel syndrome.