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Last updated: October 24, 2025View editorial policy

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Differential Diagnosis for Lower Abdominal Pain

Single Most Likely Diagnosis

  • Constipation: A common cause of lower abdominal pain, often accompanied by changes in bowel habits, but not necessarily nausea, vomiting, or diarrhea.
  • Musculoskeletal strain: Lower back or abdominal muscle strain can cause significant pain and is a frequent occurrence.

Other Likely Diagnoses

  • Urinary Tract Infection (UTI): While UTIs often present with dysuria and frequency, some patients may experience lower abdominal pain without these symptoms.
  • Ovarian cysts: These can cause intermittent or constant lower abdominal pain and are relatively common in women of reproductive age.
  • Inguinal hernia: Especially in men, an inguinal hernia can cause lower abdominal pain, particularly with coughing, lifting, or straining.

Do Not Miss Diagnoses

  • Appendicitis: Although classically presenting with nausea, vomiting, and diarrhea, some cases may not have these symptoms, making it crucial not to miss this diagnosis due to its potential for severe complications.
  • Ectopic pregnancy: A life-threatening condition in women of childbearing age, presenting with lower abdominal pain, which may or may not be accompanied by other symptoms like vaginal bleeding.
  • Diverticulitis: Inflammation of the diverticula in the colon can cause severe lower abdominal pain and may not always present with the typical changes in bowel habits.
  • Kidney stones: While often associated with severe flank pain, kidney stones can sometimes cause lower abdominal pain, especially if they are moving down the ureter.

Rare Diagnoses

  • Endometriosis: A condition where tissue similar to the lining inside the uterus grows outside of it, leading to pain, often cyclic, and other symptoms.
  • Inflammatory bowel disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic lower abdominal pain, among other symptoms.
  • Ovarian torsion: A rare but emergency condition where the ovary twists around its ligaments, cutting off blood supply, and causing severe pain.
  • Ruptured abdominal aortic aneurysm: Although more common in older individuals with risk factors, this is a life-threatening condition that requires immediate medical attention.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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