Differential Diagnosis for Severe Stomach Pain
The patient presents with severe stomach pain, which can be caused by various conditions. Here's a differential diagnosis, categorized for clarity:
- Single Most Likely Diagnosis
- Gastroenteritis: This is a common condition characterized by inflammation of the stomach and intestines, often caused by viral or bacterial infections. The symptoms include stomach pain, nausea, vomiting, and diarrhea, which align with the patient's complaint of severe stomach pain.
- Other Likely Diagnoses
- Irritable Bowel Syndrome (IBS): A chronic condition that affects the large intestine, causing a variety of symptoms including abdominal pain, changes in bowel movements, and bloating.
- Gastritis: Inflammation of the stomach lining, which can cause pain, nausea, and vomiting.
- Constipation: Although less likely to cause severe pain, constipation can lead to significant abdominal discomfort.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic inflammation and severe abdominal pain.
- Do Not Miss Diagnoses
- Appendicitis: Although the pain typically starts near the navel and then moves to the lower right abdomen, it's crucial to consider appendicitis due to its potential for severe complications if not promptly treated.
- Peptic Ulcer Disease: Stomach or duodenal ulcers can cause severe pain and may lead to perforation or bleeding if not addressed.
- Pancreatitis: Inflammation of the pancreas, which can cause severe abdominal pain, nausea, and vomiting.
- Ectopic Pregnancy: In women of childbearing age, an ectopic pregnancy can cause severe abdominal pain and is a medical emergency.
- Intestinal Obstruction: A blockage in the intestine that can cause severe pain, vomiting, and constipation.
- Rare Diagnoses
- Intussusception: A condition where a part of the intestine slides into an adjacent part, potentially causing bowel obstruction.
- Volvulus: A twisting of a portion of the intestine, which can cut off blood flow and lead to tissue death.
- Abdominal Aortic Aneurysm: Although more common in older adults with risk factors, a ruptured aneurysm can cause severe abdominal pain and is immediately life-threatening.
- Porphyria: A group of disorders that can cause severe abdominal pain, among other symptoms, due to a buildup of natural chemicals that produce porphyrin in the body.
Each of these diagnoses has a different set of risk factors, symptoms, and diagnostic approaches. A thorough medical history, physical examination, and potentially diagnostic tests such as imaging studies or endoscopy will be necessary to determine the cause of the patient's severe stomach pain.