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Differential Diagnosis

  • Single most likely diagnosis:
    • Irritable Bowel Syndrome (IBS) - The patient's symptoms of abdominal pain, changes in bowel habits (diarrhea, loose stools), gas, and urgency are classic for IBS. The onset after a stressful event (birthday party with excessive alcohol and food) and the improvement when the patient returned to their hometown also support this diagnosis. The patient's reaction to high FODMAP foods further aligns with IBS.
  • Other Likely diagnoses:
    • Post-Infectious Irritable Bowel Syndrome (PI-IBS) - Although the stool tests did not show any infection, PI-IBS can occur after a gastrointestinal infection, and the patient's symptoms started after a bout of diarrhea. However, the lack of evidence of an infection makes this less likely than classic IBS.
    • Stress-induced gastrointestinal symptoms - The patient's history of symptoms during stressful periods (10&12 board exams) and the improvement when stress was reduced (at hometown) suggests that stress could be exacerbating or triggering the symptoms.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Inflammatory Bowel Disease (IBD) - Conditions like Crohn's disease or ulcerative colitis can present with similar symptoms to IBS but are more serious and require different management. The absence of blood in the stool, significant weight loss, or other systemic symptoms makes this less likely, but it should always be considered.
    • Celiac Disease - An autoimmune reaction to gluten that can cause diarrhea, abdominal pain, and gas. Testing for celiac disease is important, especially if symptoms persist or worsen over time.
  • Rare diagnoses:
    • Small Intestine Bacterial Overgrowth (SIBO) - Can cause bloating, gas, diarrhea, and abdominal pain. It's less common but should be considered if symptoms persist despite management for IBS.
    • Fructose or lactose malabsorption - These conditions can cause similar symptoms to IBS, especially after consuming specific types of food. However, the patient's reaction to a variety of foods, including high FODMAP foods, makes these less likely as the sole diagnosis.

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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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