Differential Diagnosis for Lower Abdominal Pain
Single Most Likely Diagnosis
- Irritable Bowel Syndrome (IBS): This is a common condition characterized by chronic abdominal pain, bloating, and alteration of bowel habits. The long duration of symptoms (10 years) and the lack of other alarming features make IBS a plausible diagnosis.
Other Likely Diagnoses
- Chronic constipation: Prolonged constipation can cause lower abdominal pain due to the accumulation of feces in the colon.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic abdominal pain, diarrhea, and weight loss.
- Endometriosis: A condition where tissue similar to the lining of the uterus grows outside the uterus, leading to chronic pelvic pain, especially in women.
- Ovarian cysts: These can cause intermittent or chronic lower abdominal pain, especially if they rupture or twist.
Do Not Miss Diagnoses
- Appendicitis: Although less likely given the chronic nature of the pain, appendicitis can present atypically, especially in older adults, and is a surgical emergency.
- Ectopic pregnancy: A life-threatening condition where a pregnancy develops outside the uterus, often presenting with severe abdominal pain and vaginal bleeding.
- Ovarian torsion: A condition where the ovary twists around its ligaments, cutting off blood supply, and is a surgical emergency.
- Diverticulitis: Inflammation of the diverticula in the colon, which can cause severe abdominal pain, fever, and changes in bowel habits.
Rare Diagnoses
- Chronic intestinal pseudo-obstruction: A rare condition where there are symptoms of intestinal obstruction without any physical blockage.
- Malrotation of the intestine: A congenital anomaly that can cause chronic abdominal pain and intestinal obstruction.
- Carcinoid syndrome: A rare condition caused by a neuroendocrine tumor, leading to chronic abdominal pain, diarrhea, and flushing.
- Porphyria: A group of rare genetic disorders that can cause chronic abdominal pain, among other symptoms.