Differential Diagnosis for Abdominal Pain or Stomach Ache

What is the Differential Diagnosis for Abdominal Pain?

What is the Meaning of the Term Differential Diagnosis?

The procedure of separation between two or more illnesses which have comparable signs or indications is called as differential diagnosis.

What is the Differential Diagnosis for Abdominal Pain?

Differential Diagnosis for Abdominal Pain

While diagnosing an individual with abdominal pain of acute nature, the doctor usually concentrates on regular conditions that bring about stomach pain or abdominal pain and additionally on more severe conditions. The point of pain or the location of the abdominal pain will usually help in diagnosis. For example, when diagnosing a patient with appendicitis, the location of the pain can give a good hint in the diagnosis of the condition.

Differential Diagnosis for Abdominal Pain or Stomach Ache

An ultimate diagnosis is not generally done at the initial visit of the patient; accordingly, it is basic to start the assessment by dismissing out severe conditions for example vascular illnesses like mesenteric ischemia and aortic dissection and surgical problems such as cholecystitis and appendicitis. The doctors will also examine the wall of the abdomen related conditions like herpes zoster, muscle strain in light of the fact that these are regularly misdiagnosed.

Differential Diagnosis of Abdominal Pain Based on the Location

If the location of the pain is in the Right Upper Quadrant of the abdomen, the potential diagnoses are specified below:

  • If the location of the pain is detected in the biliary region of the upper right quadrant then the potential conditions could be cholelithiasis, cholangitis or cholecystitis.
  • If the pain location is detected in the colonic region of the upper right quadrant then the potential conditions could be diverticulitis or colitis.
  • If the location of the pain is detected in the Hepatic region of the upper right quadrant then the potential conditions could be hepatitis, a mass or abscess.
  • If the location of the pain is detected in the pulmonary region of the upper right quadrant then the potential conditions could be embolus or pneumonia.
  • If the location of the pain is detected in the renal region of the upper right quadrant then the potential conditions could be pyelonephritis or nephrolithiasis.

In case the pain or the affected area is near the Epigastric region of the abdomen, then the conceivable findings are given below:

  • If the pain location is detected in the biliary location of the epigastric region of the abdomen then the potential conditions could be cholangitis, cholecystitis or cholelithiasis.
  • If the location of the pain is detected in the cardiac location of the epigastric region of the abdomen then the potential conditions could be pericarditis or myocardial localized necrosis.
  • If the pain location is detected in the gastric location of the epigastric region of the abdomen then the potential conditions could be peptic ulcer, gastritis or esophagitis.
  • If the pain location is detected in the pancreatic location of the epigastric region of the abdomen then the potential conditions could be a mass or pancreatitis.
  • If the pain location is detected in the vascular location of the epigastric region of the abdomen then the potential conditions could be mesenteric ischemia or aortic dissection.

If the pain area is near the Left upper quadrant of the abdomen, the conceivable findings are given beneath:

  • If the location of the pain is detected in the cardiac region of the upper left quadrant then the potential conditions could be pericarditis, myocardial localized necrosis or angina.
  • If the pain location is detected in the gastric region of the upper left quadrant then the potential conditions could be peptic ulcer or esophagitis or gastritis.
  • If the location of the pain is detected in the pancreatic region of the upper left quadrant then the potential conditions could be pancreatitis or a mass.
  • If the location of the pain is detected in the renal region of the upper left quadrant then the potential conditions could be pyelonephritis or nephrolithiasis.
  • If the location of the pain is detected in the vascular region of the upper left quadrant then the potential conditions could be mesenteric ischemia or aortic dissection.

In case patient feels that the pain is near the Periumbilical area of the abdomen, the conceivable determinations are given below:

If the pain location is detected in the colonic location of the periumbilical region of the abdomen then the potential conditions could be an early appendicitis.

If the pain location is detected in the gastric location of the periumbilical region of the abdomen then the potential conditions could be small bowel mass or blockage, gastritis, peptic ulcer or esophagitis.

If the pain location is detected in the vascular location of the periumbilical region of the abdomen then the potential conditions could be mesenteric ischemia or aortic dissection.

If patient complains about discomfort in the Right lower quadrant of the abdomen, the conceivable findings are given beneath:

  • If the location of the pain is detected in the colonic region of the lower right quadrant then the potential conditions could be colitis, appendicitis, diverticulitis, IBS (Irritable bowel syndrome) or IBD (Inflammatory bowel disease).
  • If the location of the pain is detected in the gynecologic region of the lower right quadrant then the potential conditions could be PID (Pelvic inflammatory disease), ovarian mass, torsion, fibroids or ectopic pregnancy.
  • If the location of the pain is detected in the renal region of the lower right quadrant then the potential conditions could be pyelonephritis or nephrolithiasis.

If pain occurs in the Suprapubic region of the abdomen, the conceivable judgments are given beneath:

  • If the pain location is detected in the colonic location of the suprapubic region of the abdomen then the potential conditions could be IBS (Irritable bowel syndrome), IBD (Inflammatory bowel disease), colitis, appendicitis or diverticulitis.
  • If the pain location is detected in the gynecologic location of the suprapubic region of the abdomen then the potential conditions could be ovarian mass, torsion, PID (Pelvic inflammatory disease), ectopic pregnancy or fibroids.
  • If the pain location is detected in the renal location of the suprapubic region of the abdomen then the potential conditions could be nephrolithiasis, pyelonephritis or cystitis.

If pain occurs in the Left lower quadrant of the abdomen, the conceivable determinations are given beneath:

  • If the location of the pain is detected in the colonic region of the lower left quadrant then the potential conditions could be IBS (Irritable bowel syndrome), IBD (Inflammatory bowel disease), colitis or diverticulitis.
  • If the location of the pain is detected in the gynecologic region of the lower left quadrant then the potential conditions could be ovarian mass, torsion, PID (Pelvic inflammatory disease), ectopic pregnancy or fibroids.
  • If the location of the pain is detected in the renal region of the lower left quadrant then the potential conditions could be pyelonephritis or nephrolithiasis.

In some cases pain occurs to any location then the conceivable findings are given underneath:

  • Abdominal divider. herpes zoster, muscle strain or hernia.
  • Other. peritonitis, narcotic withdrawal, bowel obstruction, sickle cell crisis, mesenteric ischemia, porphyria, heavy metal poisoning or IBD (Inflammatory bowel disease).

Differential Diagnosis for Abdominal Pain Based on History and Physical Examination

In spite of the fact that area of stomach pain or abdominal pain directs the underlying assessment, related signs and indications are prescient of certain reasons for pain in the abdomen and can limit the differential diagnosis.

Medical History Test for Differential Diagnosis for Abdominal Pain

Whenever possible, the medical history has to be acquired from the patient to perform the differential diagnosis. The underlying differential analysis can be dictated by a depiction of the pain's area, radiation, and development (e.g., an infected appendix related torment more often than not shift from the periumbilical range to the lower right quadrant of the stomach). Once the area is distinguished, the doctor has to get general data about onset, span, seriousness, and nature of torment and about compounding and transmitting elements.

Physical Examination for Differential Diagnosis for Abdominal Pain

The physical exam of the patient is also done in the process of differential diagnosis for abdominal pain. The individuals' general characteristic & indispensable signs can contract the differential diagnosis. Individuals with peritonitis are likely to lie still, while individuals accompanying renal colic appear to be not hold still. Presence of fever proposes infection; be that as it may, its nonattendance does not discount it, particularly in patients who are more aged or immune compromised. Tachycardia and orthostatic hypotension recommends hypovolemia. The areas of pain aid the rest of the physical exam. Doctors ought to give careful consideration to the cardiovascular and lung exams in individuals with upper stomach torment since they could recommend pneumonia or heart ischemia.

Differential Diagnosis for Abdominal Pain Based on Imaging Studies

Suggestions for introductory imaging studies for differential diagnosis for abdominal pain depends on the area of stomach pain or abdominal pain. Ultrasonography is prescribed when an individual shows with upper right quadrant pain. Radionuclide imaging is marginally superior to anything ultrasonography for recognizing intense cholecystitis yet is more costly, takes more time to carry out & can't estimate the diagnosis farther to the biliary tract.

Suggested Imaging Studies Based on Location of Abdominal Pain:

  • Location of pain is on Right upper quadrant then the right imaging study will be Ultrasonography.
  • Location of pain is on Left upper quadrant then the right imaging study will be CT scan check.
  • Location of pain is on Right lower quadrant then the right imaging study will be CT with IV intravenous contrast media.
  • Location of torment is on Left lower quadrant then the right imaging study will be CT with oral and IV contrast media.
  • Location of torment is on Right upper quadrant then the right imaging study will be Ultrasonography.
  • Location of torment is on Suprapubic area then the right imaging study will be Ultrasonography.

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Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: August 12, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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