6.3 Do you have?
-frequent belching? Results from aerophagia. not from excessive gas formation in the GI tract; in chronic anxiety; rapid eating, bad habit; drinking carbonated beverages; gum chewing; postnasal drip: poorly fitting dentures. Repeated belching also in gastric outlet obstruction
- abdominal fullness? pressure? Accumulation of swallowed air in the stomach may cause postprandial full- ness and pressure (“mage blasé syndrome"). Swallowed air trapped in the splenic flexure of the colon may cause LUQ fullness and pressure
-after lying supine after a large meal? Gastric (swallowed) air "trapped" be- low the gastroesophageal junction by overlying fluid cannot be eructated
- relieved by belching? passing gas? defecation? Aerophagia; irritable bowel syndrome
- diffuse abdominal distention ? bloating? Abnormal intestinal motor activity rather than excessive intestinal gas causes bloating: irritable bowel syndrome. in malabsorption, fermentation of dietary carbohydrate may result in excessive gas production
- frequent bowel sounds? gas? Flatulence: aerophagia; irritable bowel Syndrome; diet containing large quantities of nonabsorbable carbohydrates (some grains, vegetables); increased intraluminal gas production
due to fermentative action of colonic bacteria on nondigestible carbohydrates in carbohydrate malabsorption states
- difficulty swallowing? Esophageal disease (see Chapter l6 “Dysphagia”)
- nausea? vomiting? Peptic ulcer disease or nonnuclear dyspepsia; biliary tract disease
- a loss of appetite? of weight? Excludes irritable bowel syndrome. Serious underlying disease: carcinoma of stomach; Crohn‘s disease; malabsorption
- fever? Chronic cholecystitis; Crohn's disease
- lip swelling? urticarial? asthma? Associated with the abdominal distress? Allergic reaction to food
- a change in your bowel habits? Significant
- constipation? Obstructing lesion in the colon
- watery diarrhea? small loose stools? with mucus?
Irritable bowel syndrome (some patients have Pencil-like" pasty stools rather than diarrhea)