Differential Diagnosis for 37 y/o F with Chronic Intermittent Generalized Lower Abdominal Pain
- Single Most Likely Diagnosis
- Irritable Bowel Syndrome (IBS): This condition is characterized by chronic abdominal pain, bloating, and changes in bowel habits, which aligns with the patient's symptoms. The intermittent nature and the combination of abdominal pain with bloating and urinary frequency are common in IBS.
- Other Likely Diagnoses
- Urinary Tract Infection (UTI): The symptoms of increased urinary frequency could suggest a UTI, especially if accompanied by dysuria or urgency. However, the chronic intermittent nature of the abdominal pain might suggest a more complex condition.
- Endometriosis: This condition can cause chronic pelvic pain, bloating, and urinary symptoms, especially if the endometrial implants are located near the bladder or bowel.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can present with chronic abdominal pain, changes in bowel habits, and sometimes urinary symptoms due to the systemic nature of the disease.
- Do Not Miss Diagnoses
- Ovarian Torsion: Although less likely given the chronic nature of the symptoms, ovarian torsion can present with intermittent abdominal pain and should be considered, especially if there's a history of ovarian cysts.
- Ectopic Pregnancy: In women of childbearing age, ectopic pregnancy is a critical diagnosis to consider, even though the patient's symptoms have been present for two months, which makes this less likely.
- Appendicitis: Chronic or intermittent appendicitis can present with atypical symptoms, including generalized lower abdominal pain.
- Rare Diagnoses
- Celiac Disease: An autoimmune reaction to gluten can cause abdominal pain, bloating, and changes in bowel habits, but it's less common and typically associated with malabsorption symptoms.
- Interstitial Cystitis: A condition causing bladder pressure, bladder pain, and sometimes pelvic pain, which could explain the urinary frequency but is less likely to cause the abdominal bloating.
- Adhesions or Bowel Obstruction: These can cause chronic or intermittent abdominal pain and bloating but are less common without a history of surgery or other predisposing factors.