What is the diagnosis for a patient presenting with acute abdominal pain, constipation, and diarrhea, who experienced symptom improvement with Actilax (Senna) and has a history of similar gastroenteritis episode, after consuming undercooked potatoes and carrots?

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Differential Diagnosis

The patient presents with abdominal pain, constipation, and diarrhea, which could be indicative of several conditions. Here's a breakdown of the differential diagnosis:

  • Single most likely diagnosis
    • Irritable Bowel Syndrome (IBS): The patient's symptoms of abdominal pain, constipation, and diarrhea, as well as the improvement with Actilax (a laxative), suggest IBS. The sharp, twisting pain and feeling of incomplete evacuation are also consistent with IBS.
  • Other Likely diagnoses
    • Gastroenteritis: The patient's history of a similar episode in September 2024 and the recent consumption of undercooked potatoes and carrots could suggest a gastrointestinal infection.
    • Inflammatory Bowel Disease (IBD): The patient's symptoms of abdominal pain, diarrhea, and weight loss (not explicitly mentioned but possible) could be indicative of IBD, such as Crohn's disease or ulcerative colitis.
  • Do Not Miss
    • Appendicitis: Although the patient's symptoms do not typically suggest appendicitis (e.g., no vomiting, no fever), it is essential to consider this diagnosis due to its potential severity and need for prompt surgical intervention.
    • Intestinal obstruction: The patient's symptoms of abdominal pain, constipation, and diarrhea could be indicative of an intestinal obstruction, which requires immediate medical attention.
    • Diverticulitis: The patient's symptoms of abdominal pain, diarrhea, and chills could suggest diverticulitis, which can be a serious condition if left untreated.
  • Rare diagnoses
    • Intussusception: A rare condition where a part of the intestine telescopes into another, causing abdominal pain, constipation, and diarrhea.
    • Mesenteric ischemia: A rare condition where the blood flow to the intestine is compromised, causing abdominal pain, diarrhea, and potentially life-threatening complications.
    • Colorectal cancer: Although rare in younger patients, colorectal cancer can cause abdominal pain, constipation, and diarrhea, and should be considered in the differential diagnosis, especially if the patient has a family history or other risk factors.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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