Differential Diagnosis for Left Side Abdominal Pain

The patient presents with left side abdominal pain, spanning from the hip bone to the lower rib, which is exacerbated by certain foods. Here's a categorized differential diagnosis:

• Single Most Likely Diagnosis

  • Irritable Bowel Syndrome (IBS): This condition is characterized by abdominal pain, changes in bowel movements, and is often triggered by specific foods. The pain pattern described, along with the food trigger, makes IBS a plausible diagnosis.

• Other Likely Diagnoses

  • Gastroesophageal Reflux Disease (GERD): Although more commonly associated with heartburn, GERD can cause abdominal pain that may be exacerbated by certain foods, especially those that trigger acid reflux.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause abdominal pain, changes in bowel habits, and may be worsened by certain foods.
  • Diverticulitis: Inflammation of the diverticula in the colon can cause left-sided abdominal pain, and while not typically associated with food triggers, certain diets may exacerbate symptoms.

• Do Not Miss Diagnoses

  • Pancreatitis: Acute or chronic inflammation of the pancreas can cause severe abdominal pain that radiates to the back and may be triggered by fatty foods. Missing this diagnosis could lead to severe complications.
  • Splenic Infarction or Rupture: These conditions can cause sudden, severe left upper quadrant pain and are medical emergencies. Certain foods may not directly trigger these conditions, but the pain pattern and potential for severe outcomes warrant consideration.
  • Ectopic Pregnancy: Although more commonly associated with right-sided pain due to the typical location of the ectopic pregnancy, it's crucial to consider this diagnosis in women of childbearing age presenting with abdominal pain, as it is a medical emergency.

• Rare Diagnoses

  • Intestinal Obstruction: While not typically associated with food triggers in the traditional sense, certain foods may exacerbate symptoms in the context of an obstruction.
  • Mesenteric Ischemia: This condition involves insufficient blood flow to the intestines and can cause severe abdominal pain. It's less likely to be directly triggered by specific foods but is a critical diagnosis to consider due to its high mortality rate if untreated.
  • Gastric Volvulus: A rare condition where the stomach twists abnormally, which can cause severe abdominal pain and may be associated with eating certain foods that trigger the volvulus.