#Abdominal Pain

***inciting factor, food poisoning, sick contacts, alcohol

***fevers, chills, night sweats, BRBPR, melena, constipation, diarrhea, nocturnal diarrhea

***heartburn/regurgitation? dysphagia/odynophagia (reflux induced stricture, cancer, food impactions), involuntary weight loss >5%, persistent vomiting  7-10 days, recurrent symptoms after endoscopic/surgical anti-reflux procedures, Anemia/Melena/BRBPR, older age with sudden reflux, no response to 8-week PPI trial, Barrett's (GERD > 5 years, >50, smokers, obesity, 1st degree relative with GI malignancy)

***nausea, vomiting, bloody vomiting

***NSAIDs?

***in relation to food?

***unintentional weight loss/how much, FamHx of GI cancer

***previous endoscopies?

***Non GI causes: trauma, bloody urine/hematuria, recent surgery, cough/dyspnea (pneumonia) STD's, dysuria, back pain, jaundice, sexual history

***recent surgery

***does patient have gallbladder? Gallbladder related pain?

***Rule out: large bowel/small bowel obstruction, perforation, vascular eruption, or ectopic pregnancy, diverticulitis

***RUQ: Liver: inflammation, congestion, infiltration; Biliary: colic, cholecystitis, cholangitis

***RLQ: appendicitis, colitis

***Epigastric: GERD/dyspepsia, gastritis, gastroparesis, peptic ulcer disease

***Pancreatitis, abdominal aortic aneurysm, constipation

***Infection, IBD, ischemia, infiltration

***LUQ: spleen: increased size, infarct, abscess

Colitis

***LLQ: diverticulitis, colitis from IBD/UC

Plan:

-f/up CBC to r/o infection

-f/up CMP

-follow-up lipase

-f/up H. Pylori

-f/up RUQUS

-f/up CT A/P with IV contrast

-f/up fecal calprotectin

-daily bowel regimen to ensure regular BM's

***PPI