Differential Diagnosis for Non-Specific Abdominal Pain in a 15-Year-Old Female
Single Most Likely Diagnosis
- Irritable Bowel Syndrome (IBS): This condition is characterized by recurrent abdominal pain associated with a change in bowel habits, such as defecation or a change in stool appearance. The symptoms described, including post-prandial pain that improves with defecation, are classic for IBS.
Other Likely Diagnoses
- Functional Dyspepsia: This condition involves recurring or persistent upper abdominal pain or discomfort that is not explained by other medical conditions. It can be exacerbated by eating and may improve with bowel movements.
- Constipation: Although the patient mentions improvement with defecation, constipation itself can cause abdominal pain, especially if the patient is not having regular bowel movements.
- Gastroesophageal Reflux Disease (GERD): While more commonly associated with heartburn, GERD can also cause non-specific abdominal pain, especially after eating.
Do Not Miss Diagnoses
- Appendicitis: Although the pain of appendicitis typically starts near the navel and then moves to the lower right abdomen, it's crucial to consider this diagnosis due to its potential for severe consequences if missed.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can present with non-specific abdominal pain, changes in bowel habits, and may have extraintestinal manifestations.
- Ovarian Cysts or Torsion: These conditions can cause severe abdominal pain and are important to consider in female patients, especially if the pain is localized to one side.
- Intestinal Obstruction: This is a medical emergency that can cause severe abdominal pain, vomiting, and changes in bowel habits.
Rare Diagnoses
- Celiac Disease: An autoimmune disorder that causes the immune system to react to gluten, leading to inflammation and damage in the small intestine, which can cause abdominal pain and changes in bowel habits.
- Gastroparesis: A condition where the stomach takes too long to empty its contents, which can cause nausea, vomiting, and abdominal pain, especially after eating.
- Mitochondrial Neurogastrointestinal Encephalomyopathy (MNGIE): A rare genetic disorder that affects the digestive system and nervous system, causing abdominal pain, changes in bowel habits, and other systemic symptoms.