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#fm

Red flags

  • New onset of pain, Change in pain, Altered bowel habits in elderly

    • Check if all 3 are particular to elderly, or just the altered bowel habits

  • Wt loss (GI malignancy)

  • Pain radiating to back (pancreatitis, AAA)

  • Appendicitis (from highest to lowest PPV)

    • RLQ PAIN, pain migration from periumbilical to RLQ, fever, anorexia

  • Pain radiating to groin (testicular torsion, hernia, renal colic)

  • Bleeding per rectum, melena stool (GI bleed, Meckel’s, malignancy in elderly)

  • Anemia

  • Supraclavicular nodes

  • personal/family hx of serious bowel patho

  • Pain waking pt at night

  • Current abx/steroids (can mask peritoneal sx’s)

  • Cardiac hx incl. Afib, HTN (ischemic bowel, AAA, MI)

  • Bowel obstruction (highest to lowest PPV)

    • CONSTIPATION, abdo distention, ↓ pain after vomiting, colic, prev abdo surg

  • Antipsychotic use (ileus, obstruction, toxic megacolon)

  • EtOH (risk factor for pancreatitis, varices)

  • Sexually active (ectopic pregnancy, STIs)

  • Cholecystitis (highest to lowest PPV)

    • RUQ pain, fever, jaundice

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Abdo Pain
ief w/ bowel mvnt, More freq stools w/ onset of pain, Loose stools w/ onset of pain, Passage of mucus, Sensation of incomplete evacuation, abdo distention Manning criteria (3 or more of) for IBS <span>Red flags New onset of pain, Change in pain, Altered bowel habits in elderly Check if all 3 are particular to elderly, or just the altered bowel habits Wt loss (GI malignancy) Pain radiating to back (pancreatitis, AAA) Appendicitis (from highest to lowest PPV) RLQ PAIN, pain migration from periumbilical to RLQ, fever, anorexia Pain radiating to groin (testicular torsion, hernia, renal colic) Bleeding per rectum, melena stool (GI bleed, Meckel’s, malignancy in elderly) Anemia Supraclavicular nodes personal/family hx of serious bowel patho Pain waking pt at night Current abx/steroids (can mask peritoneal sx’s) Cardiac hx incl. Afib, HTN (ischemic bowel, AAA, MI) Bowel obstruction (highest to lowest PPV) CONSTIPATION, abdo distention, ↓ pain after vomiting, colic, prev abdo surg Antipsychotic use (ileus, obstruction, toxic megacolon) EtOH (risk factor for pancreatitis, varices) Sexually active (ectopic pregnancy, STIs) Cholecystitis (highest to lowest PPV) RUQ pain, fever, jaundice IBS algorithm Objective General inspection Change in men


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