Differential Diagnosis for On and Off Fullness Under Left Ribs
Single Most Likely Diagnosis
- Irritable Bowel Syndrome (IBS): This condition is characterized by recurring abdominal pain or discomfort, often associated with changes in bowel movements. The symptoms can worsen with certain positions, such as sitting, and can cause feelings of fullness or bloating, particularly under the ribs.
Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): GERD can cause a feeling of fullness or discomfort under the ribs, especially after eating or when lying down, but symptoms can also worsen when sitting due to increased abdominal pressure.
- Functional Dyspepsia: This condition involves recurring signs and symptoms of indigestion that have no obvious cause. Symptoms can include fullness, bloating, and discomfort in the upper abdomen, which might radiate under the ribs.
- Constipation: Constipation can lead to feelings of fullness, bloating, and discomfort, particularly if the constipation is severe and leads to significant abdominal distension.
Do Not Miss Diagnoses
- Splenic Infarction or Rupture: Although less common, conditions affecting the spleen, such as infarction or rupture, can present with sudden onset of severe pain under the left ribs. These conditions are medical emergencies.
- Pancreatitis: Pancreatitis can cause severe abdominal pain that radiates to the back and can be worsened by sitting up or eating. It's a serious condition that requires immediate medical attention.
- Pulmonary Embolism: While more commonly associated with respiratory symptoms, a pulmonary embolism can occasionally present with chest or abdominal pain, especially if the embolism affects the lower parts of the lungs.
Rare Diagnoses
- Gastric Volvulus: A rare condition where the stomach twists abnormally, which can cause severe abdominal pain, nausea, and vomiting. The pain can be localized under the ribs.
- Splenic Cysts or Tumors: Abnormal growths on the spleen can cause a feeling of fullness or discomfort under the left ribs, depending on their size and location.
- Diaphragmatic Hernia: A rare condition where part of the stomach or intestine bulges up into the chest through an opening in the diaphragm, which can cause abdominal discomfort or pain under the ribs.