Differential Diagnosis for Colicky Pain
- Single most likely diagnosis:
- Intestinal obstruction: This is a common cause of colicky pain, especially if the pain is severe and intermittent, often accompanied by vomiting and abdominal distension. The colicky nature of the pain is due to the peristalsis against the obstruction.
- Other Likely diagnoses:
- Kidney stones (renal colic): Characterized by severe, episodic pain that radiates from the flank to the groin, often accompanied by nausea, vomiting, and sometimes blood in the urine.
- Biliary colic: Caused by gallstones, this condition presents with intermittent, severe right upper quadrant pain, especially after fatty meals, and may radiate to the right shoulder.
- Ureteral colic: Similar to renal colic but occurs when a stone is moving down the ureter, causing severe pain that can shift in location as the stone moves.
- Intussusception: A condition where a part of the intestine slides into an adjacent part, leading to bowel obstruction and potentially severe, colicky abdominal pain, more common in children.
- Do Not Miss diagnoses:
- Appendicitis: While not typically colicky, appendicitis can present with severe, intermittent pain that becomes constant, and missing this diagnosis can lead to perforation and severe complications.
- Ectopic pregnancy: A life-threatening condition in women of childbearing age, presenting with severe, lower abdominal pain that may be colicky, accompanied by vaginal bleeding and missed periods.
- Volvulus: A condition where the intestine twists around itself, cutting off blood supply, leading to severe abdominal pain, vomiting, and potential for necrosis if not promptly treated.
- Rare diagnoses:
- Lead poisoning: Can cause severe, colicky abdominal pain, often accompanied by constipation, and is a rare but important consideration, especially in children or individuals exposed to lead.
- Porphyria: A group of disorders that can cause acute intermittent porphyria, characterized by severe, colicky abdominal pain, neurological symptoms, and sometimes psychiatric disturbances.
- Hereditary angioedema: A rare genetic disorder that can cause recurrent episodes of severe abdominal pain due to edema of the intestinal wall, often accompanied by cutaneous and laryngeal edema.