A past history of previous symptoms may help localize the site of the present problem. Previous symptoms of ulcer disease, gallstone colic, or diverticular disease are especially helpful. A history of gastroesophageal reflux, diarrhea, constipation, jaundice, melena, hematuria, hematemesis, weight loss, mucus, or blood in the stool can help establish a diagnosis. A drug history should include details concerning prescription and illicit drug use. Prednisone or immunosuppressive drugs may increase the chances of perforation of some portion of the GI tract with relatively little pain or leukocytosis.
Anticoagulants can increase the chances of bleeding.
If the symptoms include pain, vomiting, and diarrhea and other family members have just recovered from similar attacks, gastroenteritis is a probable cause. Shock, pallor, sweating, or fainting can accompany abdominal pain and indicates the severity of the pathologic process. BP, pulse, state of consciousness, and degree of shock must be evaluated in severe cases. However, the focus of examination is the abdomen. High-pitched peristalsis or borborygmi in rushes suggest intestinal obstruction.