Differential Diagnosis for Recurrent GI Issues
The patient's symptoms of recurrent GI issues, discomfort, diarrhea, constipation, and painful cramps can be attributed to various conditions. Here's a categorized differential diagnosis:
Single most likely diagnosis
- Irritable Bowel Syndrome (IBS): This is the most likely diagnosis given the patient's symptoms of abdominal pain, diarrhea, and constipation, which are characteristic of IBS. The condition is chronic and often recurrent, fitting the patient's presentation.
Other Likely diagnoses
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause similar symptoms, including diarrhea, constipation, and abdominal pain.
- Gastroesophageal Reflux Disease (GERD): Although primarily associated with heartburn, GERD can also cause abdominal discomfort and pain.
- Small Intestine Bacterial Overgrowth (SIBO): This condition can lead to bloating, abdominal pain, diarrhea, and constipation due to an overgrowth of bacteria in the small intestine.
- Food Intolerances: Lactose intolerance, gluten intolerance (celiac disease or non-celiac gluten sensitivity), and fructose malabsorption can cause similar gastrointestinal symptoms.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Colon Cancer: Although less common in younger individuals, colon cancer can present with changes in bowel habits, abdominal pain, and weight loss.
- Ischemic Bowel Disease: Reduced blood flow to the intestines can cause severe abdominal pain, diarrhea, and constipation, and is a medical emergency.
- Infectious Causes: Certain infections like Clostridioides difficile (C. diff) or gastrointestinal infections from bacteria, viruses, or parasites can cause severe diarrhea and abdominal pain.
Rare diagnoses
- Celiac Disease: An autoimmune disorder caused by a reaction to gluten, leading to small intestine damage and malabsorption.
- Whipple's Disease: A rare, systemic bacterial infection that can cause malabsorption, weight loss, and abdominal pain.
- Eosinophilic Gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, leading to abdominal pain, diarrhea, and vomiting.
- Intestinal Obstruction: A blockage in the intestine that can cause severe abdominal pain, vomiting, and changes in bowel habits.