Differential Diagnosis for Abdominal Pain
Single Most Likely Diagnosis
- Gastroenteritis: This is often the most common cause of abdominal pain, especially if the pain is accompanied by symptoms like diarrhea, vomiting, and fever. The justification for this diagnosis is the high prevalence of gastrointestinal infections in the general population.
Other Likely Diagnoses
- Irritable Bowel Syndrome (IBS): A common condition characterized by chronic abdominal pain, bloating, and alteration of bowel habits. It's a likely diagnosis in patients with long-standing symptoms without alarming signs like weight loss or blood in stool.
- Urinary Tract Infection (UTI): Can cause abdominal pain, especially in the lower abdomen, and is often accompanied by dysuria, frequency, and urgency. This diagnosis is likely in patients with these additional symptoms.
- Constipation: Can cause significant abdominal pain and discomfort, often accompanied by bloating and difficulty passing stools. This is a common issue in the general population, especially in those with low fiber diets or inadequate fluid intake.
- Inflammatory Bowel Disease (IBD): Includes conditions like Crohn's disease and ulcerative colitis, which can cause chronic abdominal pain, diarrhea, weight loss, and sometimes blood in stool. This diagnosis is considered in patients with persistent symptoms and signs of malabsorption.
Do Not Miss Diagnoses
- Appendicitis: Although not the most common cause, appendicitis is a medical emergency that requires prompt surgical intervention. It typically presents with severe, localized pain in the lower right abdomen, fever, and loss of appetite.
- Ectopic Pregnancy: A life-threatening condition in women of childbearing age, presenting with severe abdominal pain, vaginal bleeding, and sometimes symptoms of early pregnancy. It's crucial to consider this diagnosis in any female patient with abdominal pain and a positive pregnancy test.
- Ruptured Aortic Aneurysm: Presents with severe, tearing abdominal pain that may radiate to the back, and is a medical emergency requiring immediate intervention. This diagnosis is critical in older patients with risk factors for aortic aneurysm, such as hypertension and smoking.
- Intestinal Obstruction: Can cause severe abdominal pain, vomiting, and constipation. It's a serious condition that may require surgical intervention and should be considered in patients with a history of abdominal surgery or other risk factors.
Rare Diagnoses
- Pancreatitis: Inflammation of the pancreas, which can cause severe abdominal pain radiating to the back, nausea, and vomiting. It's less common but should be considered in patients with risk factors like gallstones or excessive alcohol use.
- Diverticulitis: Inflammation of the diverticula in the colon, which can cause abdominal pain, usually on the lower left side, fever, and changes in bowel habits. This condition is more common in older adults and those with a low-fiber diet.
- Mesenteric Ischemia: A rare but serious condition where there's inadequate blood flow to the intestines, causing severe abdominal pain out of proportion to the physical examination findings. It's more common in older patients with cardiovascular disease.
- Endometriosis: Can cause chronic pelvic pain in women, especially during menstruation, and is often accompanied by infertility and dyspareunia. This diagnosis is considered in women of reproductive age with cyclic abdominal pain.