Gastrointestinal symptoms and diseases are quite common. History and physical examination are often sufficient to make a statement in a patient with mild discomfort; in other cases, tests are necessary. With open history, interview similar questions identified the doctor the location and quality of the symptoms as well as all the factors that worsen or improve. Abdominal pain are common gastrointestinal complaints (Chronic and recurrent abdominal pain and Acute abdomen pain). When diagnosing the determination of the region in which the pain occurs can be helpful. For example, pain may indicate problems of the pancreas, stomach or small intestine epigastric. Pain in the right upper quadrant can be used for problems of the liver, gallbladder and bile ducts, such as cholecystitis or hepatitis stand. Pain in the right lower quadrant may indicate an inflammation of the appendix, terminal ileum or cecum, suggesting appendicitis, ileitis or Crohn’s close. Pain in the left lower quadrant may indicate diverticulitis or constipation. Pain in either the left or right lower quadrant may indicate colitis, ileitis or causes in the ovary (in women). Questions for radiation of pain can help in diagnosis. For example, radiating in the shoulder pain may reflect cholecystitis because the gallbladder can irritate the diaphragm. Radiating pain in the back can stand for pancreatitis. Statements about the character (d. H. Pungent and persistent, dull pain periodically) and insertion (suddenly inserting as resulting from a perforated viscus and a ruptured ectopic pregnancy) of pain can be helpful in differentiating the causes. Patients should be asked about changes in diet and excretion. In terms of diet, patients should be asked about difficulty swallowing (dysphagia, dysphagia), loss of appetite and occurrence of nausea and vomiting (nausea and vomiting). If the patient vomit, they should be asked about the frequency and duration and whether they have blood or coffee-ground-like material that points to gastrointestinal bleeding found (Overview of gastrointestinal bleeding). In addition, patients should be asked about the type and amount of liquids that they – if at all – to drink tried and whether they could stop by. In terms of precipitation, patients should be asked about the last bowel movement, the bowel movement frequency and whether they deviate from their typical frequency. It makes more sense to ask for specific, quantitative information about the bowel movements than simply to inquire as to whether a blockage or diarrhea is present, because these terms have different meanings for different people. Patients should also be asked to describe the color and consistency of the chair, as if the stool black or bloody (indication of gastrointestinal bleeding), purulent or looked slimy. Patients who have noticed blood should be asked if it was attached to the chair, was mixed with the chair or whether the blood was discarded without chair. A gynecological history (General gynecological examination: anamnesis) is important for women because gynecological and obstetrical disorders can manifest by gastrointestinal symptoms. Accompanying non-specific symptoms such as fever or weight loss must be evaluated. Weight loss is an accompanying symptom that may indicate a more serious situation such as cancer, the physician should then initiate a more extensive diagnostics. Patients report depending on their personality, of the importance of the disease for their living conditions and socio-cultural influences differently about their symptoms. For example, nausea and vomiting may downplayed by a severely depressed patients or are described only indirectly, by a hysterical contrast with dramatic clarity. Important elements of history are newly diagnosed could cause gastrointestinal diseases, previous surgery on the abdomen and taking medications and substances that gastrointestinal symptoms (eg. As NSAIDs, alcohol). Physical examination The physical examination may begin with the inspection of the mouth and throat to assess hydration, ulcers or inflammation possible. The inspection of the abdomen in the supine position shows a bulging of the abdominal wall with intestinal obstruction, ascites or rarely in the presence of a large mass. Using auscultation analyzes the bowel sounds and found the presence of other sounds. Use the percussion can detect a hyperresonant (tympanic) sound with intestinal obstruction and attenuation at ascites and determine the liver size. On palpation procedure is followed systematically by starting careful with the acquisition of pressure-sensitive regions and if it tolerates the patient, remain cautious palpate deeper to locate a mass or detect organ enlargement. If the abdomen is painful, care should be taken in patients on peritoneal signs such as guarding and rebound tenderness. The guarding is an involuntary contraction of the abdominal muscles, which is slower and more durable than the fast arbitrary flinch in vulnerable and anxious patients. Rebound tenderness is a clear flinch in response to a rapid retraction of the hand of the examiner. The inguinal and all operative scars should be palpated for the presence of hernias. A digital rectal examination with testing for occult blood and (in women), a pelvic exam complete the evaluation of the abdomen. Tests in patients with acute, nonspecific symptoms (eg. As dyspepsia, nausea) and little more remarkable physical examination should be used rarely more tests. Findings that justify the suspicion of a significant disease (alarm symptoms) should give rise to further clarification: anorexia anemia blood in the stool dysphagia fever hepatomegaly require Persistent nausea and vomiting weight loss Chronic and recurrent symptoms (macroscopic or occult) pains that wake the patient even with an essentially unremarkable examination also further clarification. Diagnostic and therapeutic procedures in the gastrointestinal tract for specific gastrointestinal tests.