Differential Diagnosis
- Single most likely diagnosis
- Irritable Bowel Syndrome (IBS) with associated health anxiety: The patient's symptoms of fullness under the left ribs, worsening when sitting, and IBS symptoms are consistent with IBS. The presence of health anxiety may exacerbate her symptoms and concern about her health.
- Other Likely diagnoses
- Gastroesophageal reflux disease (GERD): The patient's symptoms of fullness under the left ribs could be related to GERD, especially if she experiences worsening symptoms when sitting.
- Non-specific lymphadenopathy: The presence of palpable lymph nodes in the elbow and neck could be due to a non-specific cause, such as a viral infection or a reactive lymph node.
- Anxiety disorder: The patient's history of severe health anxiety and current symptoms could be contributing to her overall clinical presentation.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lymphoma: Although less likely, lymphoma is a potentially life-threatening condition that could present with lymphadenopathy and abdominal symptoms.
- Sarcoidosis: This condition can cause lymphadenopathy and abdominal symptoms, and although rare, it is essential to consider due to its potential severity.
- Gastric or pancreatic cancer: Although unlikely in a 31-year-old, these cancers can present with non-specific abdominal symptoms and lymphadenopathy.
- Rare diagnoses
- Celiac disease: This autoimmune disorder can cause abdominal symptoms and lymphadenopathy, although it is less common.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause abdominal symptoms and lymphadenopathy, although they are less likely in this patient.
- Systemic lupus erythematosus (SLE): This autoimmune disorder can cause a wide range of symptoms, including lymphadenopathy and abdominal symptoms, although it is rare.