1. Irritable Bowel Syndrome
Chiefly a motility disorder
Pain / cramps often relieved with BM
Chronic constipation, chronic diarrhea, or some combination, with change in stool appearance
Cause(s)
Treatments: anti-spasmodics, anti-diarrheals, anti-constipation agents, SSRIs, reassurance

2. Diverticular Disease Fairly common in those over 60
Due to fiber-deficient diet
Diverticulosis
Diverticulitis

3. Appendicitis Signs Periumbilical pain, migrates
Iliopsoas and obturator signs
Rovsing’s sign
McBurney’s sign
Cutaneous hyperesthesia
Periumbilical pain, migrates
N / V, anorexia, obstipation, fever
Tx: surgical. Complicated with perforation

4. Gallbladder disease Cholecystitis Cholelithiasis Cancer / Tumor
Female, fat, forty, flatulent, fertile
Tx: medical, surgical
Cholelithiasis
Cancer / Tumor
Gallstone pancreatitis
Biliary tract obstruction

5. Hepatitis N / V, anorexia, malaise, fever, jaundice
Causes: viral, EtOH, drugs, autoimmune, toxins
Exam: check for liver tenderness, hepatomegaly, caput medusa
Tx: remove offending agent, tx viral types if possible

6. Inflammatory Bowel Diseases
Crohn’s disease
Bouts of fever, RLQ pain, diarrhea
Perianal abscess, fistulas
Extra-colonic manifestations
Tx: diet, 5-ASA, steroids, anti-TNF drugs
Ulcerative colitis
Bloody diarrhea, fecal urgency
Tx: 5-ASA, steroids, surgery
Increased risk of colon CA

7. Ulcers Gastric – usually worse with intake
Duodenal – often relieved with intake

8. Gastritis Usually benign and self-limiting with proper approach
Nausea, vomiting, cramping, fever
Caused by GI irritants, infection, stress
Tx: clear fluids for hrs, then BRAT

9. Pancreatitis EtOH abuse # 1 cause Also due to large fatty meals
Exam: Cullen’s sign, tender LUQ
Tx: IV fluids, NPO

10. GERD
EtOH, chocolate, tobacco, caffeine, mint, tomato sauce/salsa, lying flat
Problem with LES
Often abdominal obesity, poor eating habits
Sour brash, retrosternal pain, cough, voice changes
Tx: H2 blockers, PPIs, diet changes, wt loss