Internal Diseases · MU Sofia

Practical · 17. Main symptoms and syndromes of upper gastrointestinal disorders

Covers the main symptoms of upper gastrointestinal disorders, from heartburn, regurgitation and dysphagia through epigastric pain, vomiting and haematemesis to early satiety and bloating. It then sets out the clinical syndromes of the oesophagus, stomach and duodenum, including reflux, functional dyspepsia, peptic ulcer, gastritis, gastric outlet obstruction and upper GI bleeding. It closes with the physical signs worth looking for, such as epigastric tenderness, pallor, postural hypotension and succussion splash.

Inside: 4 sections · 6 labelled pictures · 15 flashcards · 4 min

Topic 74 of 88 in the MU Sofia syllabus for Internal Diseases (Dental Medicine, Year 4). The free AceMed note covers it in 4 sections, about 464 words (4 min of reading), with 15 flashcards.

In this note

  1. 17 – Main Symptoms and Syndromes of Upper Gastrointestinal (GI) Disorders
  2. I. Main Symptoms of Upper GI Disorders
  3. II. Main Clinical Syndromes in Upper GI Pathology
  4. III. Physical Examination in Upper GI Disorders

I. Main Symptoms of Upper GI Disorders

Upper gastrointestinal disorders affect the esophagus, stomach, and duodenum. Symptoms reflect the function or dysfunction of these organs and their mucosal linings.

1. Heartburn (Pyrosis)

  • Burning sensation behind the sternum or in the epigastrium.
  • Often radiates upward into the throat.
  • Typically occurs after meals, worsens with lying down or bending.
  • Suggestive of gastroesophageal reflux disease (GERD).

2. Regurgitation

  • Return of gastric contents to the mouth without nausea or retching.
  • Common in GERD or hiatal hernia.

3. Dysphagia

  • Difficulty in swallowing.
  • Can be:
  • Oropharyngeal (initiation problem, e.g. neurological causes)
  • Esophageal (obstruction or motility problem)
  • Seen in esophageal cancer, achalasia, stricture, esophagitis.

4. Odynophagia

  • Painful swallowing.
  • Often caused by esophagitis (infectious, pill-induced, or reflux).

5. Epigastric Pain or Discomfort

  • Common complaint in gastric and duodenal diseases.
  • Burning or gnawing character.
  • Worsens with fasting in duodenal ulcers; worsens after meals in gastric ulcers.

6. Nausea and Vomiting

  • Non-specific, but common in gastritis, gastric outlet obstruction, pancreatitis.
  • Vomiting in gastric obstruction is typically of undigested food hours after eating.

7. Hematemesis

  • Vomiting of fresh blood or coffee-ground material.
  • Indicates bleeding from the esophagus, stomach, or duodenum.
  • Seen in peptic ulcer, gastritis, Mallory-Weiss tear, or esophageal varices.

8. Early Satiety

  • Feeling full after eating only a small amount.
  • Suggests gastric tumor, gastroparesis, or functional dyspepsia.

9. Bloating and Belching

  • Associated with delayed gastric emptying or aerophagia.
  • Seen in functional dyspepsia, GERD, or gastritis.

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