1. Abdominal pain Gastroenteritis

2. Objectives: You students will be able to determine the origin of abdominal pain from particular attention to a detailed description of the pain and associated symptoms. get the DD depending on physical finding and proper diagnostic approach. Recognize and treat GE.

3. Adult Prevalence of GI Conditions percentCondition 50-80 30-70 30-50 20-50 Hemorrhoids (piles) Dyspepsia Abdominal pain Diverticulosis Hiatal hernia

4. Adult Prevalence of GI Conditions percentCondition 14-17 10-32 09-30 08-40 Unreported symptoms of IBS Gallstones Constipation Colonic polyps

5. Acute Abdominal Pain One working definition of acute abdominal pain is pain so bad that the patient cannot wait until tomorrow or next week for a physician appointment.

6. Structural approach to the DD of Acute Abdominal Pain A. Thoracic structure 1. Cardiac (e.g. MI) 2. Pulmonary (e.g. pneumonia) 3. Esophageal 4. Vascular (e.g. aneurysm)

7. DD (cont.): B. Abdominal structures 1. liver 2. Gallbladder 3. pancreas 4. Stomach 5. Small Intestine 6. Large Intestine 7. kidney, ureters, bladder 8. Female reproductive organs 9. Blood vessels 10. Rectum 11. Musculoskeletal 12. Vascular - aneurysm

8. DD (cont.): C. Miscellaneous 1. Psychogenic 2. Metabolic (e.g. diabetes) 3. abscess 4. Infectious 5. Neoplastic 6. trauma/obstruction

9. Final Diagnosis for the PS of AP Pain (Acute and Chronic) in FP offices Frequency (%)Diagnosis 250 (50.4) 51 (9.2) 37 (6.7) 32 (5.8) 21 (3.8) Abdominal pain, cause undocumented Acute GE UTI IBS PID

10. Final Diagnosis (Cont.) Frequency (%)Diagnosis 13 (2.3) 12 (2.2) 9 (1.6) Hiatal hernia or reflux Diverticulosis Diarrhea, cause undetermined Cholelithiasis

11. Final Diagnosis (Cont.) Frequency (%)Diagnosis 8 (1.4) 7 (1.3) 6 (1.1) 5 (0.9) Tumour, benign Duodenal ulcer Urolithiasis Appendicitis Ulcerative colitis

12. Final Diagnosis (Cont.) Frequency (%)Diagnosis 5 (0.9) 53 (9.5) Muscular strain Other (pyelonephritis, peptic ulcer, hepatitis endometriosis, malignant tumors and others.