Differential Diagnosis for 14M with Stomach Pains and No Past Medical History
- Single Most Likely Diagnosis
- Functional dyspepsia or irritable bowel syndrome (IBS): This is a common cause of stomach pain in adolescents, often related to stress, dietary factors, or bowel habits, and is likely given the absence of a past medical history.
- Other Likely Diagnoses
- Gastroesophageal reflux disease (GERD): Symptoms can include stomach pain, especially after eating, and is common in adolescents.
- Viral gastroenteritis: Could be a cause of acute stomach pain, possibly accompanied by nausea, vomiting, and diarrhea.
- Constipation: A frequent cause of abdominal pain in children and adolescents, often due to dietary habits or bowel routine.
- Lactose intolerance or other food intolerances: Can cause stomach pain, bloating, and gas after consuming certain foods.
- Do Not Miss Diagnoses
- Appendicitis: Although less common, appendicitis can present with stomach pain that may initially be diffuse or around the navel before localizing to the lower right abdomen. It's crucial to consider due to the potential for severe complications if not promptly treated.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic stomach pain, changes in bowel habits, and other systemic symptoms. Early diagnosis is important for management.
- Peptic ulcer disease: Can cause significant stomach pain, especially related to eating, and may be associated with bleeding or perforation if not addressed.
- Intussusception: A condition where a part of the intestine slides into an adjacent part, which can cause severe abdominal pain, vomiting, and bloody stools. It's more common in younger children but should be considered in any child with severe abdominal pain.
- Rare Diagnoses
- Pancreatitis: Inflammation of the pancreas, which can cause severe stomach pain, usually radiating to the back, and is often associated with elevated pancreatic enzymes.
- Gastric or intestinal obstruction: Conditions that can cause severe abdominal pain, vomiting, and constipation due to a blockage in the intestines.
- Eosinophilic gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, leading to abdominal pain, nausea, and vomiting.
- Abdominal malignancies: Although extremely rare in adolescents, certain cancers like lymphoma can present with abdominal pain and should be considered if other diagnoses are ruled out and symptoms persist or worsen.