Differential Diagnosis for Abdominal Cramping with Exertion
- Single Most Likely Diagnosis
- Intestinal angina (chronic mesenteric ischemia): This condition is characterized by abdominal pain that occurs after eating or exertion due to insufficient blood flow to the intestines. It is a likely diagnosis because the symptoms are directly related to increased demand for blood flow during physical activity.
- Other Likely Diagnoses
- Irritable Bowel Syndrome (IBS): IBS can cause abdominal cramping, and while it's not typically associated with exertion, some patients may experience worsening symptoms with physical activity.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause abdominal cramping, and exertion may exacerbate symptoms in some cases.
- Gastroesophageal reflux disease (GERD): Although primarily associated with heartburn, GERD can cause abdominal discomfort that may worsen with exertion.
- Do Not Miss Diagnoses
- Acute mesenteric ischemia: This is a medical emergency where the blood flow to the intestines is suddenly blocked, leading to severe abdominal pain. It's crucial to consider this diagnosis, even if it's less likely, due to its high mortality rate if left untreated.
- Abdominal aortic aneurysm: Rupture of an abdominal aortic aneurysm can cause severe abdominal pain and is a life-threatening condition that requires immediate medical attention.
- Ectopic pregnancy: In women of childbearing age, ectopic pregnancy should be considered as it can cause abdominal pain and is a medical emergency.
- Rare Diagnoses
- Superior mesenteric artery syndrome: A rare condition where the duodenum is compressed between the abdominal aorta and the superior mesenteric artery, causing abdominal pain and nausea.
- Chronic intestinal pseudo-obstruction: A rare condition characterized by impaired intestinal motility, leading to abdominal pain, nausea, and vomiting.
- Abdominal wall pain (rectus sheath hematoma or abdominal wall strain): Although less common, these conditions can cause abdominal pain that may be exacerbated by exertion.