Gastrointestinal Pain

Gastrointestinal Pain
A 50-year-old male complains of burning pain starting at the abdomen and rising to the
middle of his chest. He describes the pain as a gnawing feeling that begins after meals,
especially when lying down.
With regard to the case study assigned:

  • Consider what history would be necessary to collect from the patient in the case study
    you were assigned.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more
    information about the patient’s condition. How would the results be used to make a
    diagnosis?
  • Identify at least five possible conditions that may be considered in a differential diagnosis
    for the patient.
    Write a description of the health history you would need to collect from the patient in the
    case study to which you were assigned. Explain which physical exams and diagnostic tests
    would be appropriate and how the results would be used to make a diagnosis. List five
    different possible conditions for the patient’s differential diagnosis, and justify why you
    selected each.
    Use current resources of less than five years old.
    Possible Resources may include:
    Dains, J., Baumann, L., & Scheibel, P. (2012). Advanced health assessment and clinical
    diagnosis in primary care (4th ed.). St. Louis, MO: Elsevier Mosby.
    Chapter 2, “Abdominal Pain” (pp. 8-29)
    Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
    (2011). Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.
    Chapter 7, “Assessment of Pain” (pp. 140-149)
    Chapter 17, “Abdomen” (pp. 482-534)

Assessing the Abdomen

Assessment is very important to determine exactly what the patient is suffering from.
Various aspects must be factored including the history of the problem, diagnostic tests and

ASSESSING THE ABDOMEN 2
differential diagnosis. This paper is based on the case study of a 50-year-old male suffering from
gastrointestinal pain. The pain starts from the abdomen and rises to the middle of the chest.
Historical information is required from the patient to help in ascertaining the condition
the patient is suffering from. Examples of information that will be required include; the onset of
the pain and the task the patient was doing when symptoms manifested, palliative factors or
factors that improve or exacerbate the symptoms such as defecation, food and antacids (Dains,
Baumann & Scheibel, 2012). Others include the characteristics of the symptoms/pain; that is
whether it is constant of comes and goes.
Various physical and diagnosis tests can also be done to help in finding more information
about the patient’s condition. Physical tests include allowing the patient to point using a finger
where it hurts more. The patient is also asked about the way the pain is being experienced
whether it is radiating or moving anywhere. The nature of pain can also be observed through the
body language/movement. Usually burning pain is explained using an open hand moving
upwards while clenched fist describes colic.
Diagnostic tests include assessing the bowel functions such as fecal incontinences, color
of motion and systematic inquiries such as changes in appetite. The level of discomfort can also
be rated using a severity scale of 1-10. Other diagnostics tests include, abdominal radiograph,
ultrasound, CT scan among many others (Seidel, Ball, Dains, Flynn, Solomon, & Stewart, 2011).
Possible conditions considered in a differential diagnosis for the patient include, ingestion
or cardiac problems that causes epigastria and chest pain. Another condition is thyrotoxicosis,
which is caused by weight loss (Baron et al., 2013). The third condition may be dissecting
abdominal aortic aneurysm that also causes abdominal pain to the patient. The fourth is

ASSESSING THE ABDOMEN 3
metabolic conditions such as porphyria that causes pain in the abdomen. The last is
gynecological condition among women as it also causes pain outside the pelvis.

References

ASSESSING THE ABDOMEN 4
Baron, J et al., (2013). Gastrointestinal Adverse Effects of Short-Term Aspirin Use: A Meta-
Analysis of Published Randomized Controlled Trials. Drugs in R&D, 3(1): 9-16.
Dains, J., Baumann, L., & Scheibel, P. (2012). Advanced health assessment and clinical
diagnosis in primary care (4th ed.). St. Louis, MO: Elsevier Mosby. (pp. 8–29)
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011).
Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.

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