Abdominal pain,weight loss and constipation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]Amandeep Singh M.D.[3]

Abbreviations: RUQ= Right upper quadrant of the abdomen, LUQ= Left upper quadrant, LLQ= Left lower quadrant, RLQ= Right lower quadrant, LFT= Liver function test, SIRS= Systemic inflammatory response syndrome, ERCP= Endoscopic retrograde cholangiopancreatography, IV= Intravenous, N= Normal, AMA= Anti mitochondrial antibodies, LDH= Lactate dehydrogenase, GI= Gastrointestinal, CXR= Chest X ray, IgA= Immunoglobulin A, IgG= Immunoglobulin G, IgM= Immunoglobulin M, CT= Computed tomography, PMN= Polymorphonuclear cells, ESR= Erythrocyte sedimentation rate, CRP= C-reactive protein, TS= Transferrin saturation, SF= Serum Ferritin, SMA= Superior mesenteric artery, SMV= Superior mesenteric vein, ECG= Electrocardiogram

	Abdominal Pain	Fever	Rigors and chills	Nausea or vomiting	Jaundice	Constipation	Diarrhea	Weight loss	GI bleeding	Hypo- tension	Guarding	Rebound Tenderness	Bowel sounds	Lab Findings	Imaging
Disease	Clinical manifestations													Diagnosis		Comments
	Symptoms									Signs				Diagnosis
Irritable bowel syndrome	Diffuse	−	−	−	−	±	±	+	−	−	−	−	N	Normal	Normal	Symptomatic treatment High dietary fiber Osmotic laxatives Antispasmodic drugs
Colon carcinoma	Diffuse/localized	−	−	−	−	±	±	+	+	±	−	−	Normal or hyperactive if obstruction present	CBC Carcinoembryonic antigen (CEA)	Colonoscopy Flexible sigmoidoscopy Barium enema CT colonography	PILLCAM 2: A colon capsule for CRC screening may be used in patients with an incomplete colonoscopy who lacks obstruction
Small bowel obstruction	Diffuse	+	−	+	−	+	−	+	−	+	+	±	Hyperactive then absent	Leukocytosis with left shift indicates complications	Abdominal X ray Dilated loops of bowel with air fluid levels Gasless abdomen	“Target sign”– , indicative of intussusception Venous cut-off sign” – suggests thrombosis

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