Differential Diagnosis for Maria's Chronic Abdominal Pain
Single Most Likely Diagnosis
- Irritable Bowel Syndrome (IBS): This diagnosis is likely due to Maria's symptoms of intermittent abdominal pain, bloating, gas buildup, and altered bowel habits (constipation and occasional diarrhea). Her pain worsening with eating and improvement with bowel movements also supports this diagnosis.
Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD) exacerbation: Given Maria's history of GERD, her symptoms of abdominal pain, especially after eating, could be related to GERD exacerbation, possibly due to her diet (sodas, spicy food, coffee).
- Constipation: Maria's reported constipation, straining during bowel movements, and irregular bowel habits could contribute to her abdominal pain.
- Endometrial polyp: Although less directly related to her gastrointestinal symptoms, the possible endometrial polyp found on her transvaginal ultrasound could be contributing to her abdominal pain, especially considering her upcoming gynecology appointment.
Do Not Miss Diagnoses
- Pancreatitis: Although less likely, pancreatitis could cause intermittent abdominal pain radiating to the mid-back, worsened by eating. It's crucial to consider this diagnosis due to its potential severity.
- Gallbladder disease: Given Maria's symptoms of right upper quadrant pain and worsening pain after eating, gallbladder disease (e.g., cholecystitis or gallstones) should be considered.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis could present with chronic abdominal pain, changes in bowel habits, and other symptoms Maria is experiencing.
Rare Diagnoses
- Celiac disease: An autoimmune reaction to gluten could cause abdominal pain, bloating, and changes in bowel habits, although this would be less common.
- Small intestine bacterial overgrowth (SIBO): This condition, characterized by an overgrowth of bacteria in the small intestine, could lead to symptoms similar to IBS, including bloating, gas, and abdominal pain.
- Abdominal wall pain: Sometimes, abdominal pain can be referred from the abdominal wall itself, due to conditions like abdominal wall hernias or myofascial pain syndrome, although these would be less likely given Maria's other symptoms.