Differential Diagnosis for Left Upper Abdominal Pain
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): The symptoms of sharp shooting pain in the left upper abdomen that radiates downwards, accompanied by nausea and loose stools, could be indicative of GERD, especially if the pain is worsened by food intake or lying down. The absence of constipation and blood in the stool also aligns with GERD.
Other Likely Diagnoses
- Irritable Bowel Syndrome (IBS): The intermittent nature of the pain, loose stools, and absence of blood in the stool could suggest IBS, particularly if the patient experiences relief after bowel movements.
- Gastritis: Inflammation of the stomach lining could cause sharp pains in the upper abdomen, nausea, and changes in bowel habits, making gastritis a plausible diagnosis.
- Functional Dyspepsia: This condition involves recurring signs and symptoms of indigestion that have no obvious cause, which could fit the patient's symptoms of upper abdominal pain and nausea.
Do Not Miss Diagnoses
- Pancreatitis: Although less likely, pancreatitis is a serious condition that requires immediate attention. The sharp, radiating pain and nausea could be indicative of pancreatitis, especially if the pain worsens after eating.
- Splenic Infarction or Rupture: Given the location of the pain, a splenic issue could be a life-threatening condition that needs to be ruled out, especially if there's a history of trauma or underlying conditions affecting the spleen.
- Diverticulitis: Inflammation of a diverticulum in the colon could cause severe abdominal pain, changes in bowel habits, and nausea, making it a critical diagnosis not to miss.
Rare Diagnoses
- Intestinal Obstruction: Although the patient denies constipation, a partial obstruction could cause intermittent symptoms of abdominal pain, nausea, and changes in bowel habits.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis could present with abdominal pain, diarrhea, and weight loss, but are less likely given the absence of blood in the stool and other systemic symptoms.
- Gastroparesis: A condition where the stomach takes too long to empty its contents, which could cause nausea, vomiting, and abdominal pain, but is less common and typically associated with diabetes or other underlying conditions.