Differential Diagnosis

• Single most likely diagnosis
  • Irritable Bowel Syndrome (IBS): The patient's symptoms of GI discomfort and pain, which are exacerbated by stress and improve with a bland diet, are consistent with IBS. The absence of blood in stool, fevers, or chills, and the self-limited nature of the episodes, also support this diagnosis.
• Other Likely diagnoses
  • Stress-induced gastroesophageal reflux disease (GERD): The patient's symptoms coincide with stress-inducing exercises, which could trigger GERD.
  • Functional dyspepsia: The patient's symptoms of GI discomfort and pain, which are not explained by other conditions, could be due to functional dyspepsia.
  • Inflammatory bowel disease (IBD) (less likely due to lack of blood in stool and self-limited episodes): Although less likely, IBD should be considered, especially if the patient's symptoms worsen or do not respond to treatment.
• Do Not Miss
  • Gastrointestinal malignancy: Although rare, gastrointestinal malignancy should be considered, especially if the patient's symptoms worsen or do not respond to treatment.
  • Inflammatory bowel disease (IBD) with a mild presentation: IBD can have a mild presentation, and it is essential to rule out this condition to avoid delayed diagnosis and treatment.
  • Ischemic bowel disease: This condition can present with abdominal pain and should be considered, especially in older adults or those with risk factors for cardiovascular disease.
• Rare diagnoses
  • Eosinophilic gastroenteritis: This rare condition can present with abdominal pain and GI symptoms, but it is often associated with other symptoms such as weight loss and diarrhea.
  • Celiac disease: Although rare, celiac disease should be considered, especially if the patient's symptoms worsen with certain foods or improve with a gluten-free diet.
  • Gastroparesis: This rare condition can present with abdominal pain and GI symptoms, but it is often associated with other symptoms such as nausea and vomiting.