Differential Diagnosis for 39-year-old Female with RUQ Pain and Constipation
- Single most likely diagnosis:
- Gallstones (cholelithiasis): The patient's symptoms of right upper quadrant (RUQ) pain radiating to the back are classic for gallstones, especially if the pain occurs after eating fatty foods. Constipation can be an associated symptom due to the potential for decreased bile production or release.
- Other Likely diagnoses:
- Biliary dyskinesia: This condition involves abnormal contractions of the gallbladder, which can cause RUQ pain similar to gallstones. Constipation might be related to decreased bile flow.
- Peptic ulcer disease: Although more commonly associated with epigastric pain, peptic ulcers can cause RUQ pain and may be accompanied by constipation due to decreased gastrointestinal motility or the use of antacids that can cause constipation.
- Hepatitis: Inflammation of the liver can cause RUQ pain and might lead to changes in bowel habits, including constipation.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Pancreatitis: Acute or chronic pancreatitis can cause severe RUQ pain radiating to the back and can be associated with changes in bowel habits. It's crucial to consider this diagnosis due to its potential severity and the need for prompt treatment.
- Cholangitis: Infection of the bile ducts can cause RUQ pain, fever, and jaundice. It's a medical emergency requiring immediate intervention.
- Liver abscess or tumor: Although less common, these conditions can cause RUQ pain and changes in bowel habits. Early diagnosis is critical for effective treatment.
- Rare diagnoses:
- Porphyria: A group of disorders that can cause abdominal pain, constipation, and neurological symptoms. The pain can be severe and may radiate to the back.
- Amyloidosis: A condition characterized by the deposition of amyloid proteins in various organs, including the liver and gastrointestinal tract, leading to a wide range of symptoms including abdominal pain and changes in bowel habits.
- Chronic intestinal pseudo-obstruction: A rare condition characterized by impaired intestinal motility leading to severe constipation and abdominal pain, which could potentially cause RUQ pain if the small intestine or other areas are involved.