Supporting Hours : Monday to Saturday - 8am to 10pm
-
DDxProCo@gmail.com -
+ (98) 9128093509
DDxPro
Possible Diagnoses
Peptic ulcer
Acute peptic ulcer
Awakes from sleep
Relief with anti secretory agents
Abdominal pain
Intense pain
More localized pain
Recurs when stomach is empty
Sudden onset
When stomach is empty
Burning pain
Upper abdomen discomfort
At night
Epigastric pain
Hunger-like pain
Sudden severe abdominal pain
Relieved by eating
Relief with antiacid
Awakes the patient from sleep
Hematochezia
Vomiting
Diffused
Peptic ulcer
Centered in epigastrium
Epigastric pain
Awakes the patient from sleep
Relief with anti secretory agents
Recurs when stomach is empty
Burning pain
Upper abdomen discomfort
At night
Relieved by eating
Relief with antiacid
Gnawing pain
Worsens with eating
Dyspepsia
Patient show site of pain with one finger
Vomiting after eating
Radiate to back
Meal related
Recurrent abdominal pain
Weight loss
Anorexia
Gastric ulcer
Awakes from sleep
Relief with anti secretory agents
Recurs when stomach is empty
When stomach is empty
Burning pain
Upper abdomen discomfort
At night
Epigastric pain
Hunger-like pain
Relieved by eating
Relief with antiacid
Awakes the patient from sleep
Discomfort or pain in upper belly
Discomfort or pain near the ribs
Upset stomach
three months
Diarrhea
Burning
Symptom onset at least six months
Abdominal pain
Duodenal ulcer
Awakes from sleep
Relief with anti secretory agents
Recurs several hours after a meal
Recurs when stomach is empty
When stomach is empty
Burning pain
Upper abdomen discomfort
At night
Epigastric pain
Hunger-like pain
Relieved by eating
Relief with antiacid
Awakes the patient from sleep
Vomiting after eating
Radiate to back
Meal related
Epigastric tenderness
Nausea relieved by eating
Severe abdominal pain
Discomfort or pain in upper belly
Dyspepsia
Dyspepsia
Burning
Early satiety
Epigastric pain
No evidence of structural disease to explain the symptoms
Postprandial fullness
Symptom onset at least six months
Discomfort or pain in upper belly
Ribs area pain
Upper belly disomfort
Upper belly pain
Upset stomach
Fullness
Last three months
Meal related
Bloating
Abdominal discomfort
Centered in the upper abdomen
Epigastric pain syndrome
Persistent abdominal pain
Postprandial distress syndrome
Cholangitis
Primary sclerosing cholangitis
Associated with inflammatory bowel diseases
Anesthesia
Increased need for sleep
Lack of stamina
Lethargy
Listlessness
Poor energy
Symptoms of temporal lobe seizures
Muscle weakness
Proximal muscle weakness
Increasing cholestasis
Right upper quadrant pain
Jaundice
Fatigue
Fever
Complication ulcerative colitis
Absence of parenchymal kidney disease
Absence of shock
Amnesia
Anxiety
Brucellosis
Brucellosis
Lethargy
Sweating
Weight loss
Arthralgia
Chills
Fever
Acute febrile illness
Night sweats
Joint swelling
Joint tenderness
Arthlargia
Arthlargia of hips
Arthlargia of knees
Arthlargia of spine
Malaise
Joint bursitis
Intermittent back pain
Pallor
Conjuctival contact with infected brucella material
Inhalation of infected aerosols
Esophagitis
Esophagitis
Substernal region pain
Weight loss
Dysphagia to solid foods
Odynophagia
Episodic dysphagia
Regurgitation
Slowly progressive over years
Unchanged over years
Vomiting
Due to delayed hypersensitiv- ity reaction to food allergens
Centrally located chest pain
Dysphagia
Esophageal food impaction
Chest pain
Chest discomfort
Heartburn
Food impaction
Long standing dysphagia
After radiation therapy
Allergic conditions
None
Giardiasis
Diarrhea
Malaise
Abdominal pain
Flatulence
Foul-smelling stools
Abdominal cramps
Belching
Bloating
Nausea
Frequent belching
Weight loss
Anterior uveitis
Cystic fibrosis
Immunocompromised individuals
Ingestion of contaminated water
Ingestion of raw food
Ingestion of uncooked food
Ingestion of untreated water
Poor sanitary conditions
Travelers
Cirrhosis
Biliary cirrhosis
Anesthesia
Increased need for sleep
Lack of stamina
Lethargy
Listlessness
Poor energy
Symptoms of temporal lobe seizures
Muscle weakness
Proximal muscle weakness
Absence of parenchymal kidney disease
Absence of shock
Amnesia
Anxiety
Ataxic gait
Babinski sign
Bizarre behavior
Clonus
Disorientation for time
Dyspraxia
Euphoria
Liver cirrhosis
Anesthesia
Increased need for sleep
Lack of stamina
Lethargy
Listlessness
Neurological manifestations
Poor energy
Symptoms of temporal lobe seizures
Abdominal swelling
Decreased libido
Jaundice
Muscle wasting
Splenomegaly
Weight loss
Palmar erythema
Spider angiomas
Fatigue
Weakness
Abdominal distention
Afternoon fatigue
Celiac disease
Celiac disease
Diarrhea with bulky
Floating stools
Foul-smelling stools
Weight loss
Autoimmune thyroid disease
Recurrent severe aphthous stomatitis
Flatulence
Diarrhea
Selective iga deficiency
Type 1 diabetes mellitus
Thyroid disease
Bloating
Fatigue
Dermatitis herpetiformis
Neurologic disorders
Osteoporosis
Atopic dermatitis
Esophagitis
Gastritis
Mucosal abnormality
Involuntary Weight Loss
Recent institution of diuretic
Observe Repeat weight at 1–2 mo
Stable weight
Usual follow-up
Documented further IWL
Complete history, mental status, examination, diet and appetite, routine cancer screening tests
Preexisting chronic illness known to cause IWL
Reevaluate and optimize therapy
Review prescription and over-the-counter medications for anorectic side effects
Eliminate or modify offending medications
History or examination findings suggestive of illnesses known to cause IWL
Focus evaluation directed by abnormal findings
No history or examination findings suggestive of cause
CBC, SMA 12 Urinalysis Thyroid-stimulating hormone level Chest x-ray Stool guaiacs
Normal findings(CBC,SMA...)
More detailed psychosocial history: Screen for depression, anxiety, eating disorders...
Probable psychosocial cause detected
Treat Appropriate(psychosocial cause)
No abnormalities detected(psychosocial cause)
Unexplained IWL
Follow at close intervals (high risk)
Abnormal findings(CBC,SMA...)
Follow-up abnormal values
No recent institution of diuretic
Complete history, mental status, examination, diet and appetite, routine cancer screening tests
Preexisting chronic illness known to cause IWL
Reevaluate and optimize therapy
Review prescription and over-the-counter medications for anorectic side effects
Eliminate or modify offending medications
History or examination findings suggestive of illnesses known to cause IWL
Focus evaluation directed by abnormal findings
No history or examination findings suggestive of cause
CBC, SMA 12 Urinalysis Thyroid-stimulating hormone level Chest x-ray Stool guaiacs
Normal findings(CBC,SMA...)
More detailed psychosocial history: Screen for depression, anxiety, eating disorders...
Probable psychosocial cause detected
Treat Appropriate(psychosocial cause)
No abnormalities detected(psychosocial cause)
Unexplained IWL
Follow at close intervals (high risk)
Abnormal findings(CBC,SMA...)
Follow-up abnormal values
Acute Abdominal Pain
History and physical examination
Unstable or Obvious surgical indication
Consider: Hemorrhage Perforation Acute peritonitis Bowel obstruction Ischemia
Resuscitation
Surgical consultation
LAPAROTOMY
Stable
Observation
Exclude: Medical causes
Consider: Inadequate physical manifestations
Further studies
Decreased pain
Observation
Continued pain Increased pain
Surgical Consultation
Chronic Abdominal Pain
History Physical examination, Laboratory tests
Evidence suggestive of visceral organ source
Stomach
Consider: Peptic ulcer Gastric tumor
Endoscopy Upper GI Series
Small bowel
Consider: Inflammation Tumor Obstruction
Small Bowel Follow-Through or Enteroclysis CT
Pancreas
Consider: Pancreatitis Cyst/tumor
Ultrasonography CT ERCP Pancreatic Function Test
Hepatobiliary
Consider: Gallstones Biliary obstruction Tumor/cyst Infiltration Chronic hepatitis Engorgement
Ultrasonography CT ERCP Liver Biopsy
Renal
Consider: Pyelonephritis Nephrolithiasis Tumor/cyst
Ultrasonography CT IV Pyelography
Colon
Consider: Inflammation Tumor Obstruction Diverticulosis
Barium Enema and/or Endoscopy
Abdominal wall source
Referred spinal nerve source
Vascular aneurysm
Ultrasonography CT Angiography
Pelvic source
Ultrasonography Laparoscopy
Nonlocalized or inapparent source
Consider: Metabolic disorders
Functional pain/dysmotility
IBS Nonulcer dyspepsia Postcholecystectomy syndrome
Chronic mesenteric ischemia Vasculitis
Angiography
Consider: Drug effect Lead toxicity
Consider: Tumor/cyst Infection Inflammatory process: Peritoneum Mesentery Omentum Retroperitoneum
Ultrasonography CT Laparoscopy Laparotomy
Anorexia
History Physical examination, Laboratory tests
Non-medical cause
Social factors
Psychological disorders
Depression Dementia Alcoholism Drug abuse Psychosis Anxiety Bereavement
Age-related conditions
Decreased olfactory sense Hypogeusia Visual disorders Hearing disorders Dental disorders
Eating disorders
Medical disease
Medications
Sedatives & psychotropics Digoxin Laxatives Appetite suppressants...see desc...
CNS disease
Endocrine disorders
Thyroid disease, Adrenal insufficiency, Diabetes, Hyperparathyroidism, Hypercalcemia
GI disorders
Malabsorption syndromes, Peptic ulcer, Biliary disease, Hepatitis...see desc...
Diagnostic tests: Stool for blood, fat, parasites Upper GI ...see desc .....
Other medical diseases
Chronic infection Malignancy Cardiopulmonary disease Cerebrovascular disease Abdominal ischemia
Dyspepsia
Assess symptoms
Heartburn and/or regurgitation are presenting complaint, predominant or frequent
Manage as GERD (acid suppression)
NSAID/COX-2 inhibitor use
Consider discontinuing/PPI ... see desc ...
Dyspepsia without obvious GERD or NSAID use
Age >55 yr or alarm symptoms present
Esophagogastroduodenoscopy (EGD)
Age < 55 yr No alarm symptoms
Test for H. pylori
Negative
PPI trial 4–6 wk
Fails
Provide reassurance, Reassess diagnosis
Consider EGD
Abnormal endoscopic findings
Biopsies/treatments based on endoscopic findings
Normal endoscopy
Consider: H. pylori tests ... see desc ...
H. pylori—negative functional dyspepsia (normal endoscopy) and failed adequate trial of PP
Reevaluate the symptoms and diagnosis .. see desc ...
If symptoms persist with no other cause ... see desc ...
Positive
Positive Treat for H. pylori
Fails
PPI trial 4 wk
Fails
Provide reassurance, Reassess diagnosis
Consider EGD
H. pylori—negative functional dyspepsia (normal endoscopy) and failed adequate trial of PP