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Donate Join eNewsletter  SearchSearch ... Alarm Symptoms: A Cause for Alarm?  Symptoms & Causes Last Updated: 02 October 2019 Article Index Alarm Symptoms: A Cause for Alarm? Physical Examination All Pages Page 1 of 2 A functional disorder refers to a disorder or disease where the primary abnormality is an alteration in the way the body works. These disorders generally cannot be diagnosed in a traditional way; that is, as an inflammatory, infectious, or structural abnormality that can be seen by commonly used examination, x-ray, or blood test. The lack of an obvious cause, and the absence of a physical abnormality in the gut (stomach, esophagus, and intestines) are features common to all the functional gastrointestinal (GI) disorders. While these disorders are more common than structural diseases, they are not life threatening. However, they often impair quality of life. Nevertheless, the presence of a functional disorder does not exclude the possibility of a co-existing disease, and your doctor will be on the lookout for worrying symptoms and signs. The following discussion describes so-called “alarm symptoms” that are not explained by any functional disorder, and therefore demand further inquiry. Alarm Symptoms Bleeding Bleeding from the gut implies that there is a break in the integrity of the intestinal lining (mucosa). Bleeding can occur throughout the length of the gut and possible causes include: benign and malignant tumors; inflammation such as infectious colitis or inflammatory bowel disease (IBD); ulcers such as peptic ulcers; esophagitis; or a traumatic tear such as may occur in the anus (fissure) or the lower end of the esophagus. Often the source of the bleeding is not obvious, although its nature may offer clues as to its origins. Intestinal bleeding is potentially serious and demands investigation – often as an emergency. Bright red blood covering the surface of the stool means the bleeding is at or just above the anus. It is a common symptom and usually turns out to be a tear of the anus itself (anal fissure), especially if the stools are very hard and painful to pass. Less commonly such bleeding can be due to a proctitis (inflammation of the lower rectum usually due to IBD) or a rectal tumor. Inspection of the anus and sigmoidoscopy can identify these. In those who have a family history of colon cancer, or who are older than 50 years of age, the doctor may order a colon examination to exclude it – usually a colonoscopy. Bright red blood mixed with the stools indicates the bleeding is acute and likely in the colon. Causes include infections, IBD, diverticula, or tumor. If a great deal of blood is lost, an emergency colonoscopy will be necessary. Sometimes bleeding from the stomach can be so perfuse that it appears as bright red blood from the rectum. In this case, the individual may be faint and show signs of blood-loss shock – an emergency situation. Slower bleeding from the upper GI tract (esophagus, stomach, or duodenum) will show as darker blood or even as black, tar-like stools. Bleeding ulcers (often due to NSAIDS), or ruptured esophageal veins seen in liver disease are common causes. Sometimes the bleeding is very slow, and of insufficient volume to discolor the stool. Here the bleeding is said to be "occult," and may be detected if the doctor notices a person is pale or if blood tests reveal an anemia (low blood hemoglobin). Vomiting Vomiting can be a functional or structural disorder, and itself will require investigation. However, vomiting blood is definitely due to a structural cause such as a stomach or duodenal ulcer, stomach cancer, esophageal vein bleeding, or esophagitis. ******* vomiting from any cause, including a functional one, can tear the lower esophagus and initiate bleeding. No matter whether the bleeding is bright red, dark red, black and tarry, or occult, there must be a structural cause. Diagnosis of the bleeding source and control of the bleeding are priori

Donate Join eNewsletter  SearchSearch ... Alarm Symptoms: A Cause for Alarm?  Symptoms & Causes Last Updated: 02 October 2019 Article Index Alarm Symptoms: A Cause for Alarm? Physical Examination All Pages Page 1 of 2 A functional disorder refers to a disorder or disease where the primary abnormality is an alteration in the way the body works. These disorders generally cannot be diagnosed in a traditional way; that is, as an inflammatory, infectious, or structural abnormality that can be seen by commonly used examination, x-ray, or blood test. The lack of an obvious cause, and the absence of a physical abnormality in the gut (stomach, esophagus, and intestines) are features common to all the functional gastrointestinal (GI) disorders. While these disorders are more common than structural diseases, they are not life threatening. However, they often impair quality of life. Nevertheless, the presence of a functional disorder does not exclude the possibility of a co-existing disease, and your doctor will be on the lookout for worrying symptoms and signs. The following discussion describes so-called “alarm symptoms” that are not explained by any functional disorder, and therefore demand further inquiry. Alarm Symptoms Bleeding Bleeding from the gut implies that there is a break in the integrity of the intestinal lining (mucosa). Bleeding can occur throughout the length of the gut and possible causes include: benign and malignant tumors; inflammation such as infectious colitis or inflammatory bowel disease (IBD); ulcers such as peptic ulcers; esophagitis; or a traumatic tear such as may occur in the anus (fissure) or the lower end of the esophagus. Often the source of the bleeding is not obvious, although its nature may offer clues as to its origins. Intestinal bleeding is potentially serious and demands investigation – often as an emergency. Bright red blood covering the surface of the stool means the bleeding is at or just above the anus. It is a common symptom and usually turns out to be a tear of the anus itself (anal fissure), especially if the stools are very hard and painful to pass. Less commonly such bleeding can be due to a proctitis (inflammation of the lower rectum usually due to IBD) or a rectal tumor. Inspection of the anus and sigmoidoscopy can identify these. In those who have a family history of colon cancer, or who are older than 50 years of age, the doctor may order a colon examination to exclude it – usually a colonoscopy. Bright red blood mixed with the stools indicates the bleeding is acute and likely in the colon. Causes include infections, IBD, diverticula, or tumor. If a great deal of blood is lost, an emergency colonoscopy will be necessary. Sometimes bleeding from the stomach can be so perfuse that it appears as bright red blood from the rectum. In this case, the individual may be faint and show signs of blood-loss shock – an emergency situation. Slower bleeding from the upper GI tract (esophagus, stomach, or duodenum) will show as darker blood or even as black, tar-like stools. Bleeding ulcers (often due to NSAIDS), or ruptured esophageal veins seen in liver disease are common causes. Sometimes the bleeding is very slow, and of insufficient volume to discolor the stool. Here the bleeding is said to be "occult," and may be detected if the doctor notices a person is pale or if blood tests reveal an anemia (low blood hemoglobin). Vomiting Vomiting can be a functional or structural disorder, and itself will require investigation. However, vomiting blood is definitely due to a structural cause such as a stomach or duodenal ulcer, stomach cancer, esophageal vein bleeding, or esophagitis. ******* vomiting from any cause, including a functional one, can tear the lower esophagus and initiate bleeding. No matter whether the bleeding is bright red, dark red, black and tarry, or occult, there must be a structural cause. Diagnosis of the bleeding source and control of the bleeding are priori