Differential Diagnosis for Frequent Bowel Movements

The patient presents with frequent bowel movements, wet stool, and urgency after eating, which suggests a gastrointestinal issue. Here's a differential diagnosis organized into categories:

• Single Most Likely Diagnosis
  • Irritable Bowel Syndrome (IBS): The patient's symptoms of frequent bowel movements, wet stool, urgency after eating, and general abdominal discomfort without blood in stool are consistent with IBS. The absence of abdominal pain and the ability to sleep through the night also support this diagnosis.
• Other Likely Diagnoses
  • Inflammatory Bowel Disease (IBD): Although the patient does not report blood in stool, IBD (e.g., Crohn's disease, ulcerative colitis) can cause frequent bowel movements, urgency, and abdominal discomfort.
  • Gastroesophageal Reflux Disease (GERD): The patient's uneasy stomach feeling throughout the day could be related to GERD, which can also cause frequent bowel movements and urgency after eating.
  • Small Intestine Bacterial Overgrowth (SIBO): SIBO can cause frequent bowel movements, bloating, and abdominal discomfort, which align with the patient's symptoms.
• Do Not Miss Diagnoses
  • Infectious Colitis: Although the patient does not report blood in stool, infectious colitis (e.g., Clostridioides difficile, Salmonella) can cause severe diarrhea, abdominal discomfort, and urgency.
  • Colorectal Cancer: Although less likely in the absence of blood in stool and significant weight loss, colorectal cancer can cause changes in bowel habits, including frequent bowel movements.
  • Thyroid Disorders: Hyperthyroidism can cause frequent bowel movements, diarrhea, and abdominal discomfort, making it essential to consider in the differential diagnosis.
• Rare Diagnoses
  • Whipple's Disease: A rare bacterial infection that can cause malabsorption, diarrhea, and abdominal discomfort.
  • Short Bowel Syndrome: A condition characterized by a significant loss of intestinal tissue, leading to malabsorption, diarrhea, and frequent bowel movements.
  • VIPoma: A rare pancreatic tumor that can cause severe diarrhea, hypokalemia, and achlorhydria.

Each of these diagnoses should be considered and investigated further to determine the underlying cause of the patient's symptoms.