Differential Diagnosis for Abdominal Pain in a 50-year-old Female
Single Most Likely Diagnosis
- Irritable Bowel Syndrome (IBS): Given the symptoms of diffuse abdominal pain, mild distention, early satiety, and changes in bowel habits (implied by the presence of abdominal pain and distention), IBS is a plausible diagnosis. The dull and constant nature of the pain with occasional sharp episodes also aligns with IBS, especially in the absence of alarming signs like fever, significant weight loss, or severe abdominal tenderness.
Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): Symptoms like early satiety and diffuse abdominal pain could be related to GERD, especially if there's an association with eating or lying down.
- Functional Dyspepsia: This condition presents with symptoms of upper abdominal discomfort or pain, early satiety, and difficulty swallowing, which could overlap with the patient's presentation.
- Diverticulitis: Although more common in older adults, diverticulitis could present with left lower quadrant tenderness and changes in bowel habits, making it a consideration.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis could present with abdominal pain, changes in bowel habits, and weight loss, although they typically have more pronounced symptoms like diarrhea or blood in stool.
Do Not Miss Diagnoses
- Ovarian Cancer: Given the patient's age and symptoms of abdominal distention, early satiety, and unintentional weight loss, ovarian cancer is a critical diagnosis not to miss. It often presents with non-specific symptoms in early stages.
- Gastric Cancer: Similar to ovarian cancer, gastric cancer can present with non-specific symptoms like early satiety, weight loss, and abdominal discomfort, making it essential to consider.
- Pancreatic Cancer: Abdominal pain, weight loss, and early satiety could be indicative of pancreatic cancer, especially if the pain radiates to the back.
- Mesenteric Ischemia: This is a medical emergency that can present with severe abdominal pain out of proportion to the physical examination findings. Although less likely given the description of dull and constant pain, it's crucial not to miss.
Rare Diagnoses
- Celiac Disease: An autoimmune reaction to gluten, leading to small intestine damage, which could present with abdominal pain, distention, and weight loss.
- Whipple's Disease: A rare bacterial infection that affects the digestive system, presenting with weight loss, diarrhea, and abdominal pain.
- Abdominal Lymphoma: A type of cancer that affects the immune system and can present with abdominal pain, weight loss, and distention due to lymph node enlargement.
- Eosinophilic Gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, leading to abdominal pain, nausea, and vomiting.