Differential Diagnosis

The patient presents with symptoms of bloating, changes in bowel habits, feeling full after smaller meals, and back pain, with a family history of ovarian cancer. Here's a differential diagnosis organized into categories:

• Single Most Likely Diagnosis:
  • Irritable Bowel Syndrome (IBS): This is a common condition that can cause bloating, changes in bowel habits, and discomfort after eating. The symptoms are non-specific and can be seen in various conditions, but IBS is a common cause of these symptoms in the general population.
• Other Likely Diagnoses:
  • Gastroesophageal Reflux Disease (GERD): This condition can cause bloating, discomfort after eating, and back pain due to acid reflux.
  • Functional Dyspepsia: This is a condition characterized by recurring symptoms of upper abdominal discomfort or pain, bloating, and early satiety.
  • Diverticulitis: This condition can cause changes in bowel habits, bloating, and back pain, especially if the diverticula are located in the sigmoid colon.
• Do Not Miss Diagnoses:
  • Ovarian Cancer: Given the patient's family history of ovarian cancer, it's essential to consider this diagnosis, although it's less likely in the absence of other symptoms like pelvic mass, abnormal vaginal bleeding, or significant weight loss.
  • Colon Cancer: This is another important diagnosis to consider, especially with changes in bowel habits and back pain.
  • Pancreatic Cancer: This can cause back pain, bloating, and changes in bowel habits, although it's less common than other diagnoses.
• Rare Diagnoses:
  • Celiac Disease: This is an autoimmune disorder that can cause bloating, changes in bowel habits, and abdominal discomfort due to gluten intolerance.
  • Gastroparesis: This is a condition characterized by delayed gastric emptying, which can cause bloating, nausea, and discomfort after eating.
  • Inflammatory Bowel Disease (IBD): This includes conditions like Crohn's disease and ulcerative colitis, which can cause changes in bowel habits, bloating, and abdominal pain.

It's essential to conduct a thorough evaluation, including a physical exam, laboratory tests, and imaging studies, to determine the underlying cause of the patient's symptoms. A referral to a specialist, such as a gastroenterologist or an obstetrician-gynecologist, may be necessary to further investigate the patient's symptoms and family history.