Differential Diagnosis for Lower Back Pain with Bowel Movement
- Single most likely diagnosis
- Musculoskeletal strain: This is the most common cause of lower back pain and can be exacerbated by bowel movements, especially if they are strained or difficult.
- Other Likely diagnoses
- Constipation: Hard stools can cause straining during bowel movements, leading to increased pressure on the lower back and resulting pain.
- Hemorrhoids: Pain from hemorrhoids can be referred to the lower back, especially during bowel movements.
- Anal fissure: A tear in the lining of the anus can cause sharp pain during and after bowel movements, potentially radiating to the lower back.
- Proctalgia fugax: A condition characterized by sudden, severe pain in the anus and rectum, which can also be felt in the lower back.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cauda equina syndrome: A serious condition where the nerves in the spinal canal are compressed, causing pain, numbness, and weakness in the legs, as well as bowel and bladder dysfunction.
- Abdominal aortic aneurysm: A rupture of the aorta can cause severe back pain and abdominal pain, and is a medical emergency.
- Spinal infection (e.g., osteomyelitis, discitis): Infections of the spine can cause severe back pain, fever, and other systemic symptoms.
- Cancer (e.g., colorectal, spinal): Although rare, cancer can cause lower back pain and changes in bowel habits.
- Rare diagnoses
- Intestinal obstruction: A blockage of the intestine can cause severe abdominal pain, constipation, and back pain.
- Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis): Chronic inflammation of the bowel can cause abdominal pain, changes in bowel habits, and back pain.
- Spinal stenosis: Narrowing of the spinal canal can cause back pain, numbness, and weakness in the legs, especially with walking or standing.