Survival is the most important drive for human existence. Thus, eating, digesting, and eliminating are very important to human beings. Any disruption of any of these functions causes much concern to the individual.

Patient complaints may be directly related to gastrointestinal (GI) dysfunction, such as difficulty or painful swallowing, keeping foods down or difficulty in eliminating (i.e., having diarrhea or constipation). The complaints may be indirectly related to the GI system, such as pain in the chest from gastroesophageal reflux (GER), or pain in the abdomen or pelvis or from an intestinal disorder. Change in color, consistency, or shape of one’s stool, unexplained weight loss, jaundice, or abdominal swelling may bring the patient to the health care professional.

A patient and a physician may differ in their perspectives on the patient’s complaints. The physician’s orientation generally is in terms of disease categories. The physician wants to make as accurate a diagnosis as possible and treat accordingly. On the other hand, the patient comes to the physician with one or several complaints that usually describe signs or symptoms perceived as “abnormal.” A patient may complain of food sticking on swallowing; the physician thinks of an esophageal disease. A patient complains of yellow eyes or jaundice; the physician wonders if the patient has hemolysis or liver disease or biliary obstruction.