In the first case of the abdominal pain the health history on the appendix should be checked on for any chances of the appendicitis, information surrounding gastroenterologic, pneumologic conditions and also the gynecologic history. Physical check such as pain at the percussion, guarding and rigidity, clubbing, jaundice, hepatomegaly (Scanlon & Sanders, 2014). Diagnostic tests should include: test for alkaline phosphate, albumin, and bilirubin ALT, AST, Rectal examination should be conducted on the patient to evaluate the patient for possible appendicitis (Mehta, 2010). However the child may be having problem with the gallbladder due to gallstones, hernia condition due to the twisted bowel at the right side of the abdomen leading to cramping at the right lower quadrant, inflammatory bowel disease that leads to chrohns disease, right ovarian cyst or even stomach ulcers at the right lower quadrant, Hepatic problem if abnormal levels of enzymatic substances are detected for example the ALT and AST.
Gastrointestinal pain may have resulted due to some health history such as previous acute onset, past abdominal surgery, foregone pelvic inflammatory disease, presence of chronic condition in the past. Physical checkup should involve, careful examination of the femoral and inguinal areas for chances of hernia, rectal examination to help rule out impaction of the fecal and the GI bleeding, bloating, difficulty in eating, diet consumption, and alcohol intake. Bloating is useful in determination of any case of the food poisoning, difficulty in eating could lead to malnutrition and hence gastric ulcer while alcohol consumption would also result to high pancreatic synthesis (Boyce, 2016). Additionally Electrolyte test should also be carried out, low K+ levels that would result from vomiting and diarrhea after meal, Liver function test is also performed due to increased cholangitis, hepatitis and cholelithiasis (Blaser, 2002). The patient would be subject to Peptic ulcer disease that increases with age, due to heavy smoking and alcohol intake, Diverticulitis whose presence increases with increase with age and mostly impacts sigmoid, it also results from low fiber diet. Gastritis that is often associated with alcohol intake and cigarette smoking, in this condition patient regularly complains of gnawing, nausea and burning pain (Hall, 2015). Acute pancreatitis that results due to alcoholism history and pain becomes worse with food thou better with upright position (Rizzo, 2015). Cholecystitis that could be accompanied by empty calorie intake apart from fatty intake.
In case 3 nausea and vomiting could due to inheritance from family members who could have some shell fish allergy, cases of diseases caused due to contact with contaminated food and water, intake of chemotherapy drugs, resistance to antibiotics, magnesium contained in antacids as the main ingredient, intake of drugs that removes internal parasitic worms (Sporns, 2013). Physical examination should include dehydration checkup that include signs of weakness, reduced frequency of urinating, dried mouth. Diagnosis can be made by examination of the stool samples in the clinical laboratory for the presence of bacteria, viruses, parasites and white blood cells (Rizzo, 2015). Additionally if the symptoms becomes so severe a sigmoid scope test should be performed in the large intestines that helps observe the lower section of the digestive tract. The patient could be subject to diseases such as cholera or typhoid as a result of eating contaminated shell fish, it could also be allergy to shell fish, however ulcerative colitis could be the problem affecting the colon. Gastroenteritis could also be a problem due to swelling of the stomach epithelium and the ileum and colon due to ingestion of a toxic substance, or by infection caused by a microorganism. In addition parasitic infection could be the case and particularly Giardia intestinalis that attach along the intestine resulting to nausea and vomiting and causes a general feeling of sick.
Blaser, M. (2002). Infection of the gastrointestinal tract (2nd Ed.).
Boyce, T. (2016). Overview of Gastroenteritis. Merck Manuals Consumer Version. Retrieved 23 September 2016, from http://www.merckmanuals.com/home/digestive-disorders/gastroenteritis/overview-of-gastroenteritis
Hall, J. E. (2015). Guyton and Hall textbook of medical physiology. Elsevier Health Sciences.
Mehta, M. (2010). Assessing the abdomen. Nursing 2016 Critical Care, 5(1), 47-48.
Rizzo, D. C. (2015). Fundamentals of anatomy and physiology. Cengage Learning.
Scanlon, V. C., & Sanders, T. (2014). Essentials of anatomy and physiology. FA Davis.
Sherwood, L. (2015). Human physiology: from cells to systems. Cengage learning.
Sporns, O. (2013). The human connectome: origins and challenges. Neuroimage, 80, 53-61.
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