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Physical Examination

When a new gut complaint is present, a physician will normally do a physical examination, which in this case will include inspecting and examining the abdomen and anus.

In particular, he or she will look for an abdominal mass, which might be due to inflammation as in Crohn’s disease or diverticulitis, or a tumor. In addition, the physician will check that the liver, spleen, kidneys, and pelvic organs are not enlarged.

Intense tenderness may also indicate structural disease. In the case of bright red blood from the rectum, especially if it is painful to pass stools, the doctor may see a tiny tear in the anus, like a paper cut. By inserting a gloved finger into the rectum, the physician can feel the prostate, the uterine cervix, and detect any tumors or tender spots.

While such findings are signs rather than symptoms, like the alarm symptoms discussed above they cannot be explained by functional gut disorders and should prompt appropriate tests.


The functional gastrointestinal disorders are characterized by gut symptoms emanating from any level of the gut with no observable structural or biochemical abnormality.

Alarm symptoms such as those described above indicate structural disease and cannot be attributed to a functional disorder. On the other hand, they do not exclude the coincidence of a functional disorder. Alarm symptoms and physical signs in the abdomen require investigation in their own right.

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