What Are the Symptoms of Appendicitis?

Almost every acute appendicitis begins with abdominal pain: initially dull or vague around the umbilicus; in roughly 70-80% of adults it migrates to the right lower quadrant (McBurney point) within 6-8 h and is worsened by coughing, walking, or pressure. Sudden spread suggests possible perforation.

Nausea, vomiting, and loss of appetite accompany the pain; vomitus is usually gastric, and children may vomit more often.

Temperature is usually low-grade (37-38℃); with suppuration or perforation it may exceed 38.5℃ and be accompanied by chills and malaise.

Altered bowel motility causes constipation or diarrhea; a pelvic appendix may irritate the rectum, producing tenesmus and urinary frequency.

When inflammation reaches the peritoneum, rebound tenderness and guarding appear; board-like rigidity with absent bowel sounds signals diffuse peritonitis.

An inflammatory mass or abscess may be palpated in the right lower quadrant with local warmth, indicating peri-appendiceal abscess.

Specific signs include Rovsing (right lower pain on left-side compression), psoas (pain on hip extension), and obturator (pain on hip flexion–internal rotation) signs.

Elderly patients feel less pain and may appear only mildly ill despite gangrene; in pregnancy the appendix is displaced upward, so pain is higher than the classic McBurney point.

Key Symptoms/Signs	Typical Presentation
Migrating RLQ pain	Umbilical → McBurney point, movement/cough ↑
Nausea & vomiting	Anorexia, gastric vomitus
Low-grade fever	37-38℃, rises if perforation
Bowel changes	Constipation or diarrhea
Peritoneal signs	Rebound, guarding, rigidity
Inflammatory mass	Palpable, warm, tender
Specific maneuvers	Rovsing, psoas, obturator positive
Atypical variants	Elderly: subtle; Pregnancy: higher pain

What Are the Symptoms of Intestinal Fistula?

An intestinal fistula is an abnormal passage between the bowel and another organ or the skin, allowing digestive fluid, food residue, or stool to leak, producing a spectrum of clinical manifestations.

The most common symptom is abdominal pain, usually persistent or colicky, located in the segment where the fistula arises.

Diarrhea is frequent, with watery or pasty stools caused by loss of digestive fluid and reduced absorptive surface.

Fever indicates accompanying infection, presenting as remittent or sustained high temperature, often with chills.

Rapid weight loss with fatigue and poor appetite results from malabsorption and hyper-catabolism.

When the tract opens into the bladder, pneumaturia, fecaluria and recurrent urinary tract infections occur; when into the vagina, passage of gas, fluid or stool is noted.

A cutaneous opening on the abdominal wall or perineum drains feculent fluid continuously, causing local pain, erosion, and excoriation.

In the acute postoperative phase sudden severe abdominal pain, guarding, tachycardia and hypotension may signal diffuse peritonitis or sepsis.

#	Symptom / Sign	Description
1	Abdominal pain	Persistent or colicky, localized to the involved segment
2	Diarrhea	Frequent watery or pasty stools from fluid loss & poor absorption
3	Fever	Remittent or sustained high temperature with chills; implies infection
4	Weight loss & fatigue	Rapid loss plus anorexia due to malabsorption & hyper-catabolism
5	Pneumaturia / fecaluria	Gas or stool in urine when fistula opens into bladder
6	Recurrent UTI	Repeated urinary infections from bacterial contamination
7	Vaginal passage of gas/stool	Noted when tract communicates with vagina
8	Cutaneous drainage	Continuous feculent fluid from abdominal/perineal opening
9	Skin erosion & excoriation	Local pain, redness, breakdown caused by effluent
10	Acute post-operative signs	Sudden severe pain, guarding, tachycardia, hypotension → possible peritonitis/sepsis

What are the symptoms of colon cancer？

Early-stage colon cancer may cause no noticeable discomfort; the most common first clue is a persistent change in bowel habits—diarrhea, constipation, or alternating patterns lasting more than two weeks. Stools become narrower, pencil-shaped, or are coated with mucus or blood, which may appear dark red or bright red. As the tumor grows, vague lower-abdominal cramping or bloating worsens after meals; if the lumen narrows, colicky pain and progressive distension develop. Systemic features include unexplained weight loss, fatigue, pallor from chronic blood loss, and low-grade fever. A hard, fixed mass may be palpable in the right or left lower quadrant. Perforation or complete obstruction presents with sudden severe abdominal pain, vomiting, and absence of stool or flatus, requiring emergency care. Late disease can manifest hepatomegaly, jaundice, ascites, or supraclavicular lymph-node enlargement. Any adult over 40 with altered bowel habits, blood in stool, or unexplained anemia should undergo prompt colonoscopy for diagnosis.

Symptom Category	Key Features
Early warning	No discomfort; persistent change in bowel habit (>2 weeks): diarrhea, constipation, or alternating pattern
Stool appearance	Narrow, pencil-shaped; mucus or blood coating (dark red or bright red)
Abdominal signs	Vague lower-abdominal cramping / bloating, worse after meals; colicky pain & distension if lumen narrows
Systemic features	Unexplained weight loss, fatigue, pallor (chronic blood loss), low-grade fever
Palpable mass	Hard, fixed lump in right or left lower quadrant
Acute complications	Perforation / obstruction: sudden severe pain, vomiting, absence of stool or flatus → emergency
Late metastases	Hepatomegaly, jaundice, ascites, supraclavicular lymph-node enlargement
Action for high-risk	Any adult ≥40 years with altered bowel habits, blood in stool, or unexplained anemia → prompt colonoscopy

What Are the Symptoms of Cholecystitis

Cholecystitis is acute or chronic inflammation of the gallbladder wall; 95 % of cases follow stone obstruction of the cystic duct. Core symptoms escalate over time:

Colicky or persistent dull right-upper-quadrant pain, often sudden after a fatty meal, radiating to the right scapula or back
Nausea and repeated vomiting that does not relieve the pain
Fever ≥38 °C with chills, marking advancing inflammation
Classic Murphy sign: inspiratory arrest when the examiner presses below the right costal margin
Pain persisting >6 h suggests acute cholecystitis
In severe cases jaundice, tachycardia or hypotension signals risk of suppuration or perforation
Chronic cholecystitis presents as intermittent bloating, eructation and fatty-food intolerance, often mistaken for “gastritis”

Seek immediate care if right-upper pain >6 h is accompanied by fever or jaundice; early surgery (within 72 h) markedly reduces complications.

Symptom group	Typical features	Time/sign clues
RUQ pain	Colic→dull ache, refers to shoulder/back	Sudden after fat meal, >6 h unrelieved
GI	Nausea, repeated vomiting, no pain relief	Appears almost with biliary colic
Fever	≥38 °C with chills	Marker of advancing inflammation
Murphy sign	Inspiratory arrest on RUQ palpation	Classic physical finding
Jaundice	Yellow skin/sclera	Impacted stone or CBD compression
Systemic	Tachycardia, hypotension	Warn of pus, gangrene or perforation

What Are the Symptoms of Bile Reflux Gastritis

Bile reflux gastritis is chronic inflammation caused by duodenal contents (bile, pancreatic juice) flowing back into the stomach. Core symptoms result from bile irritation and breakdown of the gastric mucosal barrier:

Burning or persistent dull upper-abdominal pain, worse after meals and poorly relieved by antacids
Frequent belching with bitter or sour taste; bitter mouth noticeable on waking or when fasting
Nausea and occasional bilious vomiting—yellow-green fluid without blood
Early satiety and post-prandial fullness: reduced gastric accommodation, feeling full after small meals
Loss of appetite and weight: decreased intake due to prolonged discomfort
Epigastric heat: located higher than typical heartburn, aggravated at night or when lying flat
Emotional link: anxiety or stress may trigger or worsen symptoms

Symptoms overlap with acid reflux but respond poorly to acid suppression; morning bitterness and bilious vomiting are fairly specific clues. Chronic reflux can produce erosions and metaplasia; diagnosis requires gastroscopy.

Symptom group	Typical description	Difference from acid reflux
Upper pain/burn	Persistent dull or burning, worse post-prandial	Poor response to antacids
Bitter mouth/bile vomit	Strong bitter taste, yellow-green vomitus	Rare in acid reflux
Early fullness	Full after small meals, frequent belching	Similar but more stubborn
Appetite/weight	Gradual decrease	Correlates with discomfort
Night/supine	Heat and bitterness increase	Similar

Symptoms and Manifestations of Fatty Liver

Most patients with metabolic-dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD) are asymptomatic in early stages; findings are often incidental on health check-ups. Key features relate to metabolic disturbance and hepatic fat accumulation:

Splenomegaly, thrombocytopenia: congestive hypersplenism
Fatigue: commonest, linked to hepatocyte energy impairment
Right upper-quadrant dull pain or discomfort: from stretched Glisson capsule
Loss of appetite/early satiety: reduced gastric accommodation with post-prandial fullness
Weight gain or central obesity: background of metabolic syndrome
Skin pruritus: retained bile acids irritating peripheral nerves
Spider naevi, palmar erythema: decreased oestrogen clearance → peripheral vasodilatation
Ascites, leg oedema: combined hypoalbuminaemia and portal hypertension (advanced stage)
Jaundice: impaired bilirubin uptake/conjugation/excretion (significant fibrosis/cirrhosis)
Poor concentration, somnolence: rising blood ammonia, subtle hepatic encephalopathy

Symptom group	Typical description	Stage seen
Metabolic fatigue	Easy tiring, reduced exercise tolerance	Early
RUQ discomfort	Vague ache/fullness worse after meals	Early-mid
Dyspepsia	Early satiety, belching, nausea	Early
Skin signs	Itch, spider naevi, palmar erythema	Mid
Fluid retention	Ankle oedema, ascites	Mid-advanced
Bleeding tendency	Epistaxis, gum bleeding	Advanced
Neuro-psychiatric	Poor focus, sleepiness	Advanced

Symptoms of Alcoholic Liver Disease

Patients often present with features linked to impaired hepatic metabolism and inflammation:

Oliguria, rising creatinine: hepatorenal syndrome
Fatigue: earliest and most common, easily overlooked
Anorexia, nausea, vomiting: lead to weight loss
Dull or dragging right upper quadrant pain: enlarged liver stretches Glisson capsule
Jaundice: yellow skin/sclera indicate cholestasis
Low-grade fever: cytokine-driven
Ascites, leg edema: portal hypertension plus hypoalbuminaemia
Spider naevi, palmar erythema: failed oestrogen clearance
Confusion, somnolence: early hepatic encephalopathy
Haematemesis, melaena: ruptured oesophageal/gastric varices

Symptom group	Typical picture	Pathogenesis
Fatigue	Early, persistent	Impaired hepatocyte energy metabolism
GI	Anorexia, nausea, RUQ ache	Capsular stretch from hepatomegaly
Jaundice	Yellow skin/sclera	Reduced bilirubin uptake/conjugation
Bleeding	Spider naevi, epistaxis, melaena	Decreased clotting-factor synthesis
Ascites/oedema	Distended abdomen, pitting ankle oedema	Portal hypertension + hypoalbuminaemia
Neuro-psychiatric	Drowsiness, disorientation	Elevated ammonia & toxins
Renal	Oliguria, rising urea	Hepatorenal syndrome

Symptoms of Gastroptosis

Patients often experience recurrent upper-abdominal discomfort related to the low position of the stomach, delayed emptying and secondary reflux:

Epigastric pain or dull ache, usually within 1 h after meals, worsened by standing or activity and eased by bending forward or hugging the knees
Marked fullness: feeling distended after only a small meal, accompanied by frequent belching
Dyspepsia: acid regurgitation, nausea, occasional retching with gastric (non-bilious) content
Delayed gastric emptying leads to loss of appetite and, in the long term, weight loss and fatigue
Some cases report retro-sternal or back radiation, linked to reflux gastritis
Symptoms are aggravated by prolonged standing, fatigue, post-prandial exertion or emotional stress, and are usually relieved by lying flat or at night

Persistent or recurrent complaints should prompt upright barium meal or gastroscopy for confirmation.

Symptom group	Typical description	Precipitating/relieving factors
Epigastric pain	Post-prandial dull or distending ache, may radiate to back	Standing↑ Bending↓
Fullness	Feeling filled after small intake	Post-meal↑ Supine↓
Belching/acid	Frequent sour eructations	Activity↑ Knee-hug↓
Nausea/appetite↓	Occasional retching, reduced food intake	Stress↑ Rest↓
Weight loss	Result of chronic inadequate intake	Fatigue↑ Small-frequent meals↑

What Causes Colitis

Inflammation of the colonic mucosa can be triggered by infection, immune dysregulation, impaired blood supply, drugs or radiation.

Diet and lifestyle: High intakes of red meat, emulsifiers and sweets, together with smoking and obesity, are considered modern “Western-style” pro-inflammatory factors.

Infection: Salmonella, Shigella, Clostridioides difficile, Mycobacterium tuberculosis and Entamoeba histolytica directly invade the epithelium, causing acute diarrhoea and bloody stools.

Immune factors: Ulcerative colitis and Crohn’s disease are autoimmune disorders in which genetically susceptible individuals mount an abnormal T-cell response that continuously attacks the bowel wall.

Microbial dysbiosis: Long-term antibiotics and a high-fat, low-fibre diet reduce protective flora and increase pro-inflammatory bacteria, driving chronic inflammation.

Ischaemia: Hypotension, arteriosclerosis or thrombosis can lead to ischaemic colitis with sudden left-lower-quadrant pain and bloody diarrhoea.

Drugs and radiation: NSAIDs, aspirin, chemotherapeutic agents and pelvic radiotherapy directly injure the epithelium or induce local vasculitis.

Category	Main mechanism	Common triggers	Clinical clues
Infectious	Pathogen invasion	Contaminated water/food, C.diff after antibiotics	Acute fever, bloody pus stool
Immune	Auto-immune attack	Genetic susceptibility + environmental triggers	Chronic relapses, mucus-blood stool
Ischaemic	Inadequate blood flow	Arteriosclerosis, thrombosis, shock	Sudden pain + bloody diarrhoea
Drug/Radiation	Direct toxicity or vascular injury	NSAIDs, chemotherapy, pelvic radiotherapy	Diarrhoea after drug/RT course
Dysbiosis	Protective ↓ pro-inflammatory ↑	High-fat low-fibre diet, long-term antibiotics	Bloating, watery diarrhoea, recurrent

What Causes Reflux Esophagitis

The core issue is retrograde flow of gastric contents (acid, pepsin, bile) into the esophagus, leading to mucosal erosion. Key mechanisms include:

Reduced lower-esophageal-sphincter (LES) pressure or frequent transient LES relaxations (TLESRs) that disable the anti-reflux barrier
Hiatus hernia, which weakens the diaphragmatic crus and creates an acid pocket
Impaired esophageal clearance (weak peristalsis, reduced saliva) that prolongs acid exposure
A damaged mucosal barrier (widened intercellular spaces, thinner mucus layer) lowering resistance to aggressive factors

Obesity, pregnancy, late-night meals, high-fat diet, smoking, alcohol and drugs such as aspirin raise intra-abdominal pressure or directly relax the sphincter, aggravating reflux. Chronic reflux activates inflammatory mediators, inducing erosions and ulcers that may progress to circumferential disease or columnar metaplasia (Barrett esophagus).

Key step	Main change	Precipitating factors
Anti-reflux barrier ↓	Low LES pressure, TLESRs, hiatus hernia	High-fat meals, smoking, alcohol, obesity
Clearance function ↓	Weak peristalsis, low saliva, long acid dwell	Dehydration, supine position, ageing
Mucosal barrier ↓	Widened intercellular spaces, less mucus	Bile acids, NSAIDs, prolonged acid
Aggressive factors ↑	Acid, pepsin, bile reflux	Large meals, coffee, aspirin

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What Are the Symptoms of Appendicitis?

What Are the Symptoms of Intestinal Fistula?

What are the symptoms of colon cancer？

What Are the Symptoms of Cholecystitis

What Are the Symptoms of Bile Reflux Gastritis

Symptoms and Manifestations of Fatty Liver

Symptoms of Alcoholic Liver Disease

Symptoms of Gastroptosis

What Causes Colitis

What Causes Reflux Esophagitis

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