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, which seems to alleviate the pain in this case. The post-prandial worsening of symptoms also fits with IBS, as eating can trigger symptoms in some individuals.
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: Given that the pain improves with defecation, constipation could be a contributing factor, especially if the patient has a history of infrequent bowel movements or hard stools.
- Gastroesophageal Reflux Disease (GERD): Although less likely given the improvement with defecation, GERD can cause abdominal pain that worsens after eating.
Do Not Miss Diagnoses
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can present with abdominal pain, changes in bowel habits, and may have extraintestinal manifestations. Missing this diagnosis could lead to significant morbidity.
- Appendicitis: Although the pain typically localizes to the right lower quadrant, early or atypical presentations can mimic other conditions. Appendicitis is a surgical emergency.
- Ovarian Torsion or Other Gynecologic Emergencies: These conditions can cause severe abdominal pain and require immediate medical attention. A history of recent onset of severe pain, especially if associated with vomiting, should prompt urgent evaluation.
Rare Diagnoses
- Celiac Disease: An autoimmune reaction to gluten that can cause abdominal pain, diarrhea, and malabsorption. It's less common but should be considered, especially if there's a family history or other suggestive symptoms.
- Intestinal Obstruction: This is a rare cause of abdominal pain in adolescents without a history of surgery or other predisposing factors, but it's a condition that requires prompt diagnosis and treatment.
- Eosinophilic Gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, leading to abdominal pain, nausea, and vomiting. It's more common in individuals with a history of atopy or allergies.