Differential Diagnosis for Abdominal Pain in a Diabetic Age 70

Single Most Likely Diagnosis

• Diabetic Gastroparesis: This condition is a common complication of diabetes, especially in older adults, and can cause abdominal pain, nausea, vomiting, and bloating due to delayed gastric emptying.

Other Likely Diagnoses

• Cholecystitis: Inflammation of the gallbladder is common in older adults and can cause right upper quadrant abdominal pain, especially after eating fatty foods.
• Peptic Ulcer Disease: Diabetics are at increased risk for peptic ulcers, which can cause epigastric pain, especially at night or when the stomach is empty.
• Constipation: Older adults with diabetes may experience constipation due to neuropathy, medication side effects, or decreased mobility, leading to abdominal pain and discomfort.
• Diverticulitis: Inflammation of the diverticula in the colon can cause left lower quadrant abdominal pain, fever, and changes in bowel habits.

Do Not Miss Diagnoses

• Myocardial Infarction: Diabetics are at increased risk for heart disease, and myocardial infarction can present with abdominal pain, especially in women and older adults.
• Mesenteric Ischemia: Reduced blood flow to the intestines can cause severe abdominal pain, and is more common in older adults with atherosclerosis or other cardiovascular risk factors.
• Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain, nausea, and vomiting, and is more common in diabetics.
• Pneumonia: Older adults with diabetes may be at increased risk for pneumonia, which can cause abdominal pain, especially if the pneumonia is located in the lower lobes.

Rare Diagnoses

• Diabetic Ketoacidosis: A life-threatening complication of diabetes that can cause abdominal pain, nausea, and vomiting, although it is more common in type 1 diabetics.
• Celiac Disease: An autoimmune disorder that can cause abdominal pain, diarrhea, and malabsorption, and is more common in people with type 1 diabetes.
• Intestinal Obstruction: A blockage of the intestine can cause severe abdominal pain, nausea, and vomiting, and is more common in older adults with a history of abdominal surgery or other underlying conditions.
• Abdominal Aortic Aneurysm: A rupture of the aorta can cause severe abdominal pain, back pain, and hypotension, and is more common in older adults with atherosclerosis or other cardiovascular risk factors.