Differential Diagnosis for a 9-year-old Female with Stomach Cramping, Low Appetite, and Intermittent Fever
- Single most likely diagnosis:
- Functional abdominal pain or Irritable Bowel Syndrome (IBS). This diagnosis is likely due to the presence of stomach cramping, changes in bowel habits (constipation relieved by senna and peppermint tea), and the absence of alarming symptoms such as vomiting, diarrhea, or significant weight loss. The intermittent fever could be a non-specific symptom or related to a viral infection.
- Other Likely diagnoses:
- Viral gastroenteritis without diarrhea (atypical presentation). Some viral infections can cause fever and abdominal pain without the typical symptoms of diarrhea or vomiting.
- Constipation with overflow. Although the patient experiences relief with senna and peppermint tea, the constipation could be contributing to the abdominal pain and low appetite.
- Inflammatory bowel disease (IBD) - Crohn's disease or ulcerative colitis. These conditions can present with abdominal pain, changes in appetite, and intermittent fever, although they typically also involve diarrhea or blood in the stool.
- Do Not Miss diagnoses:
- Appendicitis. Although the patient does not have the classic symptoms of vomiting or diarrhea, appendicitis can present atypically, especially in children, and is a surgical emergency.
- Intussusception. This condition involves the telescoping of one portion of the intestine into another and can cause intermittent abdominal pain, fever, and changes in bowel habits. It is a medical emergency.
- Ovarian torsion or other gynecological emergencies. These conditions are rare but can cause severe abdominal pain and should be considered, especially if the pain is localized to one side.
- Rare diagnoses:
- Chronic intestinal pseudo-obstruction. A rare condition characterized by impaired intestinal motility leading to abdominal pain, nausea, vomiting, and changes in bowel habits.
- Eosinophilic gastroenteritis. A rare inflammatory condition of the gastrointestinal tract that can cause abdominal pain, nausea, and changes in bowel habits.
- Abdominal lymphoma or other malignancies. Although extremely rare in children, these conditions can cause non-specific symptoms such as abdominal pain, fever, and changes in appetite.