Differential Diagnosis for Lower Stomach Pain
Given the symptoms of lower stomach pain on the left side and difficulty sleeping, the following differential diagnoses can be considered:
- Single most likely diagnosis:
- Constipation: This is a common condition that can cause lower abdominal pain, particularly on the left side, and can disrupt sleep due to discomfort.
- Other Likely diagnoses:
- Irritable Bowel Syndrome (IBS): Characterized by abdominal pain, bloating, and changes in bowel movements, IBS can cause significant discomfort and sleep disturbances.
- Diverticulitis: Inflammation of the diverticula in the colon can cause left lower quadrant pain, changes in bowel habits, and fever.
- Ovarian Cyst: In women, an ovarian cyst can cause lower abdominal pain, especially if it ruptures or torsions, and can disrupt sleep.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Appendicitis: Although the pain is typically on the right side, in some cases, especially if the appendix is retrocecal, the pain can be more diffuse or on the left side. Missing this diagnosis can lead to perforation and severe complications.
- Ectopic Pregnancy: In women of childbearing age, an ectopic pregnancy can present with lower abdominal pain and must be considered to prevent rupture and severe hemorrhage.
- Intestinal Obstruction: This is a surgical emergency that can cause severe abdominal pain, vomiting, and constipation. Early diagnosis is crucial to prevent complications.
- Rare diagnoses:
- Inflammatory Bowel Disease (Crohn's Disease or Ulcerative Colitis): These conditions can cause chronic abdominal pain, changes in bowel habits, and weight loss, but are less common than other causes of lower stomach pain.
- Endometriosis: This condition, where tissue similar to the lining inside the uterus grows outside of it, can cause chronic pelvic pain, heavy bleeding, and infertility, but the presentation can be variable.
- Colorectal Cancer: Although rare in younger individuals, colorectal cancer can cause abdominal pain, changes in bowel habits, and weight loss, and should be considered in the differential diagnosis, especially in those with risk factors.