Differential Diagnosis for 10 Episodes of Diarrhea Overnight with Cramping and Myalgias

• Single Most Likely Diagnosis
  • Viral Gastroenteritis: This is the most common cause of acute diarrhea and is often accompanied by cramping and myalgias. The high frequency of diarrhea episodes overnight suggests a viral etiology, which is typically self-limiting but can be severe.
• Other Likely Diagnoses
  • Bacterial Gastroenteritis: Caused by bacteria such as Salmonella, Shigella, or Campylobacter, this condition can present with similar symptoms, including diarrhea, cramping, and myalgias. The presence of blood in the stool or a higher fever might lean more towards a bacterial cause.
  • Food Poisoning: This can result from consuming contaminated food and can cause sudden onset of diarrhea, cramping, and myalgias. The history of recent food intake is crucial in diagnosing food poisoning.
  • Medication-induced Diarrhea: Certain medications, such as antibiotics, can cause diarrhea as a side effect. Recent changes in medication could be a contributing factor.
• Do Not Miss Diagnoses
  • Clostridioides difficile (C. diff) Infection: Although less common, C. diff infection is a critical diagnosis to consider, especially in patients who have recently been hospitalized or have taken antibiotics. It can cause severe diarrhea and has significant morbidity if not treated promptly.
  • Inflammatory Bowel Disease (IBD) Flare: While less likely to present acutely without prior history, an exacerbation of IBD (Crohn's disease or ulcerative colitis) could cause severe diarrhea, cramping, and systemic symptoms like myalgias.
• Rare Diagnoses
  • Intestinal Parasites: Infections with parasites such as Giardia can cause chronic diarrhea but might also present acutely, especially in travelers or those exposed to contaminated water.
  • Ischemic Bowel Disease: Although rare, conditions affecting blood flow to the intestines can cause acute abdominal symptoms, including diarrhea and severe pain. This would be more likely in patients with vascular disease or other risk factors.