Ace the 2026 ROSH GI Challenge – Master the Gut and Own the Exam!

When considering the potential gastrointestinal causes of pelvic pain, a history of constipation can be particularly indicative. Constipation leads to the accumulation of stool in the bowel, which can cause significant distension and pressure on surrounding structures, including the pelvic region. This pressure can result in pain that may be localized in the pelvis. Moreover, chronic constipation can lead to conditions such as fecal impaction, which also presents with pelvic discomfort.

In contrast, although nausea and vomiting can occur with gastrointestinal disturbances, they are more nonspecific symptoms that can arise from multiple systems without pointing specifically to a GI source. Ovarian cysts are primarily associated with gynecological issues and are less indicative of a gastrointestinal problem. The presence of sheets of white blood cells is indicative of inflammation or infection but does not directly correlate with GI issues in the context of this question. Thus, a history of constipation is the most relevant factor suggesting a potential gastrointestinal cause of pelvic pain.