Differential Diagnosis
- Single most likely diagnosis
- Irritable Bowel Syndrome (IBS): The patient's symptoms of increased acid reflux, indigestion, and abdominal pain, particularly the dull and sharp pain in the left lower quadrant, are consistent with IBS. The fact that she is vegan and takes B12, and has normal bowel movements, also supports this diagnosis.
- Other Likely diagnoses
- Diverticulitis: The patient's left lower quadrant pain could be indicative of diverticulitis, especially if she has a history of diverticula. However, the absence of changes in bowel movements and the description of the pain as dull and sharp make this diagnosis less likely.
- Ovarian Cyst: The patient's symptoms of left lower quadrant pain, which she describes as similar to ovulation pain, could be indicative of an ovarian cyst. The fact that she is ovulating and the pain has not resolved supports this diagnosis.
- Inflammatory Bowel Disease (IBD): The patient's symptoms of increased acid reflux, indigestion, and abdominal pain could be indicative of IBD, such as Crohn's disease or ulcerative colitis. However, the absence of changes in bowel movements and the fact that she is vegan make this diagnosis less likely.
- Do Not Miss
- Ectopic Pregnancy: Although the patient reports ovulating, an ectopic pregnancy must be ruled out, especially if she has missed a period or has a history of pelvic inflammatory disease.
- Ovarian Torsion: The patient's symptoms of severe, sharp pain in the left lower quadrant could be indicative of ovarian torsion, which is a medical emergency.
- Appendicitis: Although the patient's pain is in the left lower quadrant, appendicitis must be considered, especially if she has a history of appendicitis or has symptoms such as fever, nausea, and vomiting.
- Rare diagnoses
- Endometriosis: The patient's symptoms of left lower quadrant pain, which she describes as similar to ovulation pain, could be indicative of endometriosis. However, this diagnosis is less likely given the absence of other symptoms such as heavy menstrual bleeding or dyspareunia.
- Intestinal Obstruction: The patient's symptoms of abdominal pain and normal bowel movements could be indicative of an intestinal obstruction, although this is a rare diagnosis.