Merck Manual

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Overview of Gastrointestinal Symptoms

By

Jonathan Gotfried

, MD, Lewis Katz School of Medicine at Temple University

Last full review/revision Mar 2020| Content last modified Mar 2020
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Upper gastrointestinal (GI) complaints include

Lower GI complaints include

As with upper GI complaints, lower GI complaints result from physiologic illness or represent a functional disorder (ie, no radiologic, biochemical, or pathologic abnormalities are found even after extensive evaluation). The reasons for functional symptoms are not clear. Evidence suggests that patients with functional symptoms may have disturbances of motility, nociception, or both; ie, they perceive as uncomfortable certain sensations (eg, luminal distention, peristalsis) that other people do not find distressing.

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Hemorrhoids
A 32-year-old woman who is at 30 weeks’ gestation comes to the office because she has had pain on defecation during the past week. She says she also has had pain when attempting to cleanse the anal region as well as pain when sitting. Based on these findings, which of the following types of hemorrhoid is most likely to be noted on further evaluation of this patient?  
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