Would a 51-year-old female with a 2-month history of right-sided non-specific abdominal pain, who had constipation (but was treated and improved), still require evaluation for a kidney stone (nephrolithiasis) as a cause of her persistent pain?

Differential Diagnosis for 51-year-old Female with Abdominal Pain

Single Most Likely Diagnosis

• Irritable Bowel Syndrome (IBS): The patient's initial presentation of non-specific abdominal pain and constipation, which improved with treatment, suggests a possible diagnosis of IBS. The ongoing pain could be due to persistent IBS or another underlying condition.

Other Likely Diagnoses

• Gastroesophageal Reflux Disease (GERD): Abdominal pain and constipation can be symptoms of GERD, especially if the patient experiences reflux or dyspepsia.
• Diverticulitis: The patient's age and symptoms of abdominal pain could suggest diverticulitis, especially if the pain is localized to the lower abdomen.
• Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis could cause abdominal pain, constipation, and other gastrointestinal symptoms.

Do Not Miss Diagnoses

• Kidney Stone: As you mentioned, kidney stone is a crucial diagnosis not to miss, as it can cause severe, persistent pain. Although the patient's symptoms have been present for 2 months, it's possible that a kidney stone could be causing the ongoing pain.
• Ovarian Torsion or Ovarian Cyst: These conditions can cause severe, sudden abdominal pain and are important to rule out, especially in female patients.
• Appendicitis: Although the patient's pain is not typically localized to the right lower quadrant, appendicitis can present with non-specific abdominal pain and should be considered.
• Bowel Obstruction: A bowel obstruction can cause abdominal pain, constipation, and other symptoms, and is a potentially life-threatening condition if not promptly diagnosed and treated.

Rare Diagnoses

• Celiac Disease: An autoimmune disorder that can cause abdominal pain, constipation, and other gastrointestinal symptoms.
• Intestinal Lymphoma: A rare type of cancer that can cause abdominal pain, constipation, and other symptoms.
• Endometriosis: A condition in which tissue similar to the lining of the uterus grows outside the uterus, causing abdominal pain and other symptoms.