Differential Diagnosis for Left Sided Abdominal Pain Worse After Eating

• Single Most Likely Diagnosis
  • Diverticulitis: This condition is characterized by inflammation of the diverticula in the colon, which can cause left-sided abdominal pain that worsens after eating, especially if the meal is large or high in fiber. The pain is typically constant and can be accompanied by changes in bowel habits, fever, and nausea.
• Other Likely Diagnoses
  • Irritable Bowel Syndrome (IBS): IBS can cause abdominal pain that is exacerbated by eating, particularly if the individual has specific food intolerances. The pain associated with IBS can be crampy and is often relieved by bowel movements.
  • Constipation: Severe constipation can cause left-sided abdominal pain that worsens after eating due to the increased bulk of stool and gas in the colon.
  • Gastroesophageal Reflux Disease (GERD): Although GERD typically causes heartburn and regurgitation, it can also lead to left-sided chest or abdominal pain that worsens after eating, especially if the meal is large or contains trigger foods.
• Do Not Miss Diagnoses
  • Mesenteric Ischemia: This is a life-threatening condition caused by reduced blood flow to the intestines. It can present with severe abdominal pain that worsens after eating due to increased demand for blood flow to the intestines. Early diagnosis is crucial.
  • Ectopic Pregnancy: In women of childbearing age, an ectopic pregnancy can cause severe, unilateral abdominal pain. Although the pain is not typically described as worsening after eating, it's a critical diagnosis to consider due to its potential for severe consequences if missed.
  • Splenic Infarction or Rupture: Conditions affecting the spleen, such as infarction or rupture, can cause severe left upper quadrant abdominal pain. While these conditions might not directly relate to eating, they are emergencies that require prompt diagnosis and treatment.
• Rare Diagnoses
  • Intussusception: This is a condition where a part of the intestine slides into an adjacent part, potentially causing bowel obstruction. It's more common in children but can occur in adults, causing abdominal pain that might worsen after eating due to increased intestinal movement.
  • Left Ovarian Torsion: In women, torsion of the left ovary can cause severe, acute left lower quadrant abdominal pain. While not directly related to eating, it's a rare but serious condition that requires immediate medical attention.