Sign and Symptoms

Signs are something that can be seen, observed or listened by a doctor examining the patient, while symptoms are activities or feelings that are reported by a patient. Signs can be found out through physical examination (colour, shape, tenderness, reflex etc), while with symptoms it has to be drawn out from the patient either actively or through listening actively to the patient.

If a gastrointestinal problem is present with the patient, some of the possible symptoms might include:

• pain
• vomit
• diarrhoea
• constipation
• distention (bloating)
• anorexia (lack of appetite)

In most gastrointestional problems, pain is one of the most indicative symptoms and hence elaboration of pain is very much sought after in a medical history taking. In doing so, a doctor has to be careful in obtaining a full medical history, and characteristics that a doctor should look for are varied, as follows:

1. Site of the symptom
   ... and also whether the pain stays on the same place or migrate
   
   
2. Onset date / time
   ... when did it start? Any similar experience before this?
   
   
3. Time course and frequency
   ... how long has it been, how frequent is the pain etc
   
   
4. Severity
   ... by comparison with common types of painful sensation or by the scale of 10
   
   
5. Quality / character
   ... whether it’s sharp, dull, colicky, burning, positional etc
   
   
6. Aggravating / relieving factor
   ... what might worsen or relieve the pain
   
   
7. Associated features
   ... is there any vomiting, nausea, weight loss etc?

Sounds interesting? That’s about one quarter of what I was taught in ICM today.