Irritable Bowel Syndrome: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

• General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore:
  • Inspection (viewing).
    • Skin, mucous membranes and sclerae (white part of the eye).
    • Abdomen (abdomen)
      • Shape of the abdomen?
      • Skin color? Skin texture?
      • Efflorescences (skin changes)?
      • Pulsations? Bowel movements?
      • Visible vessels?
      • Scars? Hernias (fractures)?
  • Inspection and palpation of the thyroid gland [due todifferential diagnoses: hyperthyroidism (hyperthyroidism), hypothyroidism (hypothyroidism)].
  • Auscultation (listening) of the heart.
  • Auscultation of the lungs
  • Examination of the abdomen
    • Percussion (tapping) of the abdomen
      • [Ascites (abdominal fluid): phenomenon of fluctuation wave. This can be triggered as follows: if one taps against one flank a wave of fluid is transmitted to the other flank, which can be felt by placing the hand on it (undulation phenomenon); flank attenuation.
      • Meteorism (flatulence): hypersonoric tapping sound.
      • Attenuation of the tapping sound due to enlarged liver or spleen, tumor, urinary retention?
      • Hepatomegaly (liver enlargement) and/or splenomegaly (spleen enlargement): estimate liver and spleen size.
      • Cholelithiasis: tap pain over gallbladder region and right lower rib]
    • Palpation (palpation) of the abdomen, etc. (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?)[Leading symptoms:
      • Meteorism
      • Recurrent lower abdominal pain]
  • Digital rectal examination (DRU): examination of the rectum (rectum).
• Cancer screening [due todifferential diagnoses:
  • Hormone-active neuroendocrine tumors.
  • Colon carcinoma (colon cancer) (paradoxical diarrhea; alternating with constipation).
  • Gastric carcinoma
  • Ovarian tumors (ovarian tumors)
  • Pancreatic carcinoma (pancreatic cancer)]
  • Gynecological examination [due topossible differential diagnoses: e.g., endometriosis/occurrence of endometrium (uterine lining) extrauterine (outside the uterine cavity), for example, in or on the ovaries (ovaries), tubes (fallopian tubes), urinary bladder, or bowel].
• Orthopedic examination [due topossible secondary disease: osteoporosis (bone atrophy)]
• Psychiatric examination [due topossible sequelae:
  • Depression
  • Somatoform and mental disorders (these are associated disorders)]
• Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.