Differential Diagnosis for Abdominal Distress in a 5-Month-Old Baby
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This condition is common in infants, causing abdominal distress due to the reflux of stomach acid into the esophagus. Symptoms include spitting up, vomiting, and irritability.
Other Likely Diagnoses
- Gas and Colic: Infants often experience gas and colic, leading to abdominal distress. This is usually due to swallowing air during feeding or sensitivity to certain foods in the mother's diet if breastfeeding.
- Constipation: Although less common in infants, constipation can cause significant abdominal distress. It may be due to a change in diet or an underlying condition affecting bowel movements.
- Lactose Intolerance or Milk Protein Allergy: These conditions can lead to abdominal distress, diarrhea, and vomiting in infants who are sensitive to lactose or milk proteins.
Do Not Miss Diagnoses
- Intussusception: A serious condition where a part of the intestine slides into another, causing bowel obstruction. It's crucial to diagnose early as it can lead to ischemia and necrosis of the bowel tissue if not treated promptly.
- Volvulus: A condition where the intestine twists, cutting off its blood supply. It's a surgical emergency that requires immediate attention.
- Hirschsprung's Disease: A congenital condition affecting the large intestine, leading to severe constipation or intestinal obstruction. Early diagnosis is critical for effective management.
- Inguinal Hernia: Can cause abdominal distress and is more common in male infants. If the hernia becomes incarcerated, it can lead to serious complications.
Rare Diagnoses
- Congenital Anomalies of the Gastrointestinal Tract: Conditions such as duodenal atresia, jejunoileal atresia, or meconium ileus can cause abdominal distress in infants. These are usually diagnosed prenatally or shortly after birth.
- Inflammatory Bowel Disease (IBD): Although rare in infants, conditions like Crohn's disease or ulcerative colitis can present with abdominal distress, diarrhea, and weight loss.
- Neuroblastoma: A type of cancer that can cause abdominal distress if the tumor presses on the abdomen or intestines. It's rare but important to consider in the differential diagnosis due to its severity.