Patient Presentations Related to the Gastrointestinal System and Nutritional Health
Patient presentations span all ages and gender identities, reflecting patients from diverse backgrounds, cultures, and abilities and their reasons for presenting to osteopathic physicians in varied clinical settings.
This clinical presentation may include items testing the application of research, professionalism, and systems-based practice involving this body system.
| 7.1 Jaundice | |
| 7.2 Ascites | |
| 7.3 Anorexia (Loss of Appetite) | |
| 7.4 Nausea, Vomiting, and Hematemesis | |
| 7.5 Disorders of Bowel Frequency and Evacuation | |
| 7.6 Abdominal Pain | |
| 7.7 Abdominal, Gastrointestinal, and GI Tract Masses, Cancers, and Organomegaly | |
| 7.8 Melena/Hematochezia/Anorectal Bleeding and Pain | |
| 7.9 Gastroesophageal Reflux | |
| 7.10 Oropharyngeal and Dental Pain and Lesions | |
| 7.11 Conditions Related to Nutrition and Weight | |
| 7.12 Abdominal Trauma | |
| 7.13 Dysphagia and Odynophagia | |
| 7.14 Foreign Body in Gastrointestinal Tract | |
| 7.15 Abdominal Wall Abnormalities | |
| 7.16 Physical Exam Findings Related to the Gastrointestinal System and Nutritional Health | |
| 7.17 Laboratory and Diagnostic Testing Related to the Gastrointestinal System and Nutritional Health |
Clinical presentations in this category may include, but are not limited to, the following conditions or situations prompting patients to present for osteopathic medical care:
| Abdominal injury | blunt trauma • penetrating trauma • splenic rupture |
| Anorectal disorders | abscess • fissure • fistula • hemorrhoids • pruritus ani |
| Bowel disorders | bowel obstruction • congenital conditions (Hirschsprung disease, Meckel diverticulum) • constipation • diverticular disease • fecal impaction • gastroparesis • ileus • inflammatory bowel disease • intestinal adhesions • irritable bowel syndrome • ischemic bowel • polyps • volvulus |
| Dental disorders | abscess • gingivitis • periodontal disease |
| Esophageal disorders | Barrett esophagus • esophageal rupture • esophageal stricture • esophageal varices • foreign body ingestion • gastroesophageal reflux disease • laryngopharyngeal reflux • Mallory-Weiss tear |
| Gallbladder and biliary tract disorders | bile duct obstruction • cholecystitis • choledocholithiasis • cholelithiasis • primary biliary cholangitis |
| Hernias | abdominal wall • diaphragmatic • esophageal • femoral • hiatal • inguinal • umbilical |
| Infections | |
| bacterial: | Campylobacter • Clostridioides difficile • Escherichia coli • Helicobacter pylori • Salmonella • Shigella • Vibrio |
| parasitic: | Cryptosporidium • Entamoeba histolytica • Giardia |
| viral: | adenovirus • norovirus • rotavirus |
| by site: | appendicitis • duodenitis • esophagitis • gastritis • gastroenteritis • mesenteric adenitis • pancreatitis • peritonitis |
| Intestinal malabsorption and hypersensitivity | celiac disease • hypersensitivity reaction to food • lactose intolerance • short bowel syndrome |
| Liver disorders | cholestasis • cirrhosis • fatty liver • hepatitis |
| Neoplasms | colon • esophagus • liver • mouth • pancreas • rectum • stomach |
| Ulcers | duodenal • gastric • oral • peptic |
CONSTITUTIONAL SIGNS AND SYMPTOMS
- anorexia
- chills
- fatigue
- fever
- generalized weakness
- jaundice
- malaise
- night sweats
- unintentional weight loss
PHYSICAL EXAMINATION FINDINGS AND EVALUATION
- abdominal auscultation
- abdominal distention
- abdominal percussion
- abdominal rigidity
- abdominal tenderness
- asterixis
- caput medusae
- Chapman reflexes
- Cullen sign
- fluid wave
- Grey Turner sign
- gross blood
- guarding
- hematochezia/melena
- hepatomegaly
- jaundice
- masses
- Murphy sign
- pallor
- peritoneal signs
- puddle maneuver
- rebound tenderness
- rectal tone abnormalities
- shifting dullness
- spider angiomas
- splenomegaly
- tender points
- viscerosomatic/
somatovisceral reflexes
LABORATORY AND DIAGNOSTIC TESTING
- ALT, AST, GGT levels
- amylase level
- carcinoembryonic antigen level
- Clostridioides difficile testing
- complete blood count
- C-reactive protein level
- CT scanning
- endoscopy (upper and lower GI)
- erythrocyte sedimentation rate
- esophageal manometry and pH monitoring
- fecal occult blood testing
- fluoroscopy
- gastrointestinal endoscopy
- Helicobacter pylori stool antigen or breath testing
- hematocrit
- hemoglobin levels
- lipase level
- MRI
- nuclear medicine imaging
- pancreatic function testing (e.g., fecal elastase)
- radiography
- SIBO culture
- stool culture
- stool for ova and parasites
- tissue transglutaminase antibody and antimicrobial antibody levels
- ultrasonography
- viral hepatitis panels