Differential Diagnosis for Abdominal Pain that Comes in Waves

• Single Most Likely Diagnosis
  • Intestinal obstruction: This condition is characterized by the blockage of the intestine, which can cause abdominal pain that comes in waves due to the peristalsis of the intestine trying to overcome the obstruction.
• Other Likely Diagnoses
  • Kidney stones: The movement of a kidney stone through the ureter can cause severe, wave-like pain as the stone irritates the ureteral lining.
  • Gallbladder disease (cholecystitis or cholelithiasis): Inflammation of the gallbladder or the presence of gallstones can cause intermittent, wave-like pain, especially after eating fatty foods.
  • Gastroesophageal reflux disease (GERD): Although more commonly associated with heartburn, severe GERD can cause intermittent abdominal pain.
• Do Not Miss Diagnoses
  • Appendicitis: While the pain of appendicitis often starts as diffuse and then localizes, it can sometimes present with wave-like pain, especially if the appendix is located in an unusual position.
  • Ectopic pregnancy: This is a life-threatening condition where a pregnancy develops outside the uterus, often causing severe, wave-like abdominal pain.
  • Ruptured abdominal aortic aneurysm: A sudden, severe wave-like pain in the abdomen can be a sign of a ruptured aneurysm, which is a medical emergency.
• Rare Diagnoses
  • Porphyria: A group of disorders that can cause acute, intermittent abdominal pain, among other symptoms.
  • Lead poisoning: Can cause severe, intermittent abdominal pain, although this is relatively rare.
  • Diabetic ketoacidosis: While more commonly associated with hyperglycemic symptoms, diabetic ketoacidosis can cause abdominal pain, which might be perceived as wave-like in some cases.