Approach to the Patient with an External Hernia James M. Richter Abdominal wall hernias are exceedingly common; they often cause occupational disabilities and pose a risk for incarceration and strangulation…
Approach to the Patient with Anorectal Complaints Paul C. Shellito Anorectal complaints are common but often incompletely evaluated. The symptoms are usually the result of minor conditions such as hemorrhoids…
Approach to the Patient with Constipation James M. Richter Constipation affects 15% of adults in Western and industrialized societies and ranks among the most frequent reasons for self-medication, particularly in…
Evaluation and Management of Diarrhea Jenny S. Sauk James M. Richter Diarrhea is clinically characterized by the frequent passage of unformed stools. Episodes that are brief, self-limited, and well tolerated…
Evaluation of Gastrointestinal Bleeding James M. Richter Patients seen in the office setting will often report minor or self-limited episodes of gastrointestinal bleeding. They may complain of melena (tarry black…
Evaluation of Jaundice James M. Richter The onset of jaundice or dark urine usually alerts the patient or the patient’s family to seek medical attention. When associated symptoms are minimal,…
Approach to the Patient with Heartburn and Reflux (Gastroesophageal Reflux Disease) Francis X. Campion James M. Richter Heartburn is a nearly universal experience. In the United States, an estimated 6%…
Evaluation of Dysphagia and Suspected Esophageal Chest Pain James M. Richter Dysphagia is the unpleasant sensation of difficulty in swallowing (see Chapter 20). Odynophagia refers to painful swallowing. Because esophageal…
Evaluation of Nausea and Vomiting Braden Kuo James M. Richter Sonia S. Yoon Nausea and vomiting are common presenting complaints in primary care practice, particularly when acute in onset—estimated prevalence…
Evaluation of Abdominal Pain James M. Richter One of primary care’s most daunting challenges is the outpatient assessment of abdominal pain. When the pain is acute in onset, triage decisions…
