In this episode of OSCE Talk, Matthew and Peter break down how to approach gastrointestinal (GI) presentations, with a focus on understanding abdominal pain — one of the most common and challenging complaints in both OSCEs and real clinical practice.

We explore how to differentiate visceral vs. somatic pain, how pain location guides diagnosis, and the key symptoms and red flags you must not miss. The episode also clarifies the differences between IBS and IBD, highlights high-yield investigations such as Q-fit testing, and explains how a detailed medical history helps identify causes ranging from adhesions to inflammatory bowel disease.

This structured approach will boost your confidence in OSCEs and help you communicate clearly and safely with patients presenting with abdominal concerns.

• GI symptoms include nausea, vomiting, weight loss, altered bowel habits, and more.

• Pain location and quality are essential for narrowing your differential.

• Visceral pain is vague and poorly localized; somatic pain is sharp and specific.

• Classic appendicitis begins centrally and moves to the right iliac fossa.

• GI red flags can be nonspecific but are vital to identify early.

• Q-fit testing is key when assessing lower GI bleeding or colorectal symptoms.

• IBS is a functional syndrome; IBD (Crohn’s/UC) is an inflammatory disease.

• Always explore previous surgeries, as adhesions can cause recurrent pain.

• Rectal bleeding should prompt careful assessment for serious pathology.

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