What is the cause of periumbilical pain in a 47-year-old female?

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Differential Diagnosis for Pain on Both Sides of Umbilicus in a 47-Year-Old Female

Single Most Likely Diagnosis

  • Irritable Bowel Syndrome (IBS): This is a common condition characterized by abdominal pain, bloating, and changes in bowel movements. The pain is often diffuse or around the umbilicus and can be exacerbated by eating or relieved by bowel movements.

Other Likely Diagnoses

  • Constipation: Can cause abdominal pain and discomfort, which may be perceived around the umbilicus due to the distribution of visceral innervation.
  • Gastroesophageal Reflux Disease (GERD): Although more commonly associated with epigastric pain, GERD can sometimes cause mid-abdominal pain.
  • Diverticulitis: Inflammation of a diverticulum in the colon can cause pain, usually on the left side but can be mid-abdominal if the involved segment is near the umbilicus.
  • Peptic Ulcer Disease: Ulcers in the stomach or duodenum can cause epigastric pain that may radiate or be referred to the periumbilical area.

Do Not Miss Diagnoses

  • Appendicitis: Although classically presents with right lower quadrant pain, early appendicitis or a retrocecal appendix can cause periumbilical pain.
  • Intestinal Obstruction: Can cause severe abdominal pain, vomiting, and constipation. Early recognition is crucial for timely intervention.
  • Ovarian Torsion: A gynecological emergency that can cause severe, sudden onset of abdominal pain, often on one side but can be mid-abdominal.
  • Myocardial Infarction: Abdominal pain can be a presenting symptom of a heart attack, especially in women, and should not be missed.

Rare Diagnoses

  • Inflammatory Bowel Disease (Crohn’s Disease or Ulcerative Colitis): Can cause chronic abdominal pain, diarrhea, weight loss, and other systemic symptoms.
  • Celiac Disease: An autoimmune reaction to gluten causing small intestine inflammation, leading to abdominal pain, diarrhea, and malabsorption.
  • Abdominal Aortic Aneurysm: A potentially life-threatening condition where the aorta enlarges, which can cause abdominal pain, back pain, or a palpable mass.
  • Pancreatitis: Inflammation of the pancreas, which can cause severe abdominal pain, often radiating to the back.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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