Gastrointestinal Conditions that are Frequently Misdiagnosed

In spite of the best efforts of doctors and the latest technologies, certain medical conditions are difficult to diagnose even today. This is usually because many conditions share many of the same symptoms, such as diarrhea, nausea, headache, inflammation, and many more, which often leaves the best of doctors scratching their heads and making educated guesses on the probability of known diseases. It has been observed that as a result, physicians are more likely to diagnose common, but relatively less harmful, diseases first, and then correct their diagnosis to the more severe diseases at a later stage if required. We take a look at some gastrointestinal conditions that are frequently misdiagnosed.

Why Is It Difficult To Diagnose Gastrointestinal Conditions?

Diarrhea, abdominal pain, bloating, and gas are some of the common symptoms that are similar in many gastrointestinal (GI) conditions. It is possible to experience more than one digestive condition that has overlapping symptoms. Due to the similarity of symptoms across many GI illnesses, diagnosing GI disorders is a very complicated and challenging process. It may take a large number of diagnostic tests to eliminate certain conditions and find evidence of other diseases.

This is why even though you are hoping to get a quick diagnosis, it is still worth waiting for your doctor to finish running the diagnostic tests to arrive at the correct diagnosis. Bear in mind that even though the symptoms may be similar, all GI disorders are different, and a wrong diagnosis can lead to incorrect or delayed treatment for your actual condition. Without getting the proper treatment, there are many GI conditions that can have life-threatening complications.

You can quicken the process and narrow down the diagnosis by correctly telling your physician about all your symptoms, family medical history, as well as a detailed personal medical history. Make sure that you do not leave out anything, including minor things like a lack of appetite and weight loss, as these could be important clues to help reach a final diagnosis.

After arriving at a precise diagnosis, your doctor will then lay out the treatment options so that you can begin to feel better at the earliest. If you feel like some things in your diagnosis could have been overlooked, then it is a good idea to get a second opinion.

Gastrointestinal Conditions that are Frequently Misdiagnosed

Discussed below are some of the most commonly misdiagnosed gastrointestinal conditions.

Inflammatory Bowel Disease (IBD)

There are two major types of inflammatory bowel diseasesulcerative colitis and Crohn’s disease. (1) IBD affects more than a million people in the United States, along with several million people around the world. (2)

The common symptoms of IBD include:

While ulcerative colitis affects the inner layer of the rectum and the large intestine, Crohn’s disease affects the entire GI tract – right from the mouth down to the anus, and it also involves all the layers of the intestinal wall. Ulcerative colitis affects more men than women, and Crohn’s affects more women than men.

Some of the similarities between ulcerative colitis and Crohn’s disease include:

  • Abdominal pain or abdominal discomfort
  • Bloody stools
  • Rectal bleeding
  • Abdominal cramping
  • Constipation
  • Fevers
  • Weight loss
  • Loss of appetite
  • Abnormal menstrual cycles in women

These symptoms get further aggravated by diet and stress.

Diagnosing for both Crohn’s disease and ulcerative colitis proves to be very challenging because of the similar symptoms between both the conditions. Furthermore, these symptoms also overlap with symptoms of other GI disorders.

However, it is crucial to get the diagnosis right in order to select the correct treatment and avoiding serious complications from these disorders if they are left untreated.

Irritable Bowel Syndrome (IBS)

IBS is a commonly occurring GI disorder that affects the large intestine. IBS affects approximately 10 to 15 percent of the entire population worldwide. (3) When you have

IBS, your body tends to be highly sensitive to gas present in the digestive system, and your large intestine also contracts very often. (4)

Some of the common symptoms of IBS include:

  • Nausea and vomiting
  • Gas and bloating
  • Abdominal pain
  • Abdominal cramping
  • Abdominal discomfort
  • Alternating constipation, diarrhea, and other changes in bowel movements
  • Bloating
  • Mucus in stool
  • You will typically find that the abdominal symptoms get relieved or partially relieved after you have a bowel movement.
  • IBS is more likely to affect women than men, and it generally begins in adults in their early 20s and 30s.

IBS is primarily diagnosed (5) based on your symptoms, and your doctor will order several tests to rule out other GI disorders as well as IBS, especially if you experience the following:

  • If you have a family history of IBD or colorectal cancer
  • If there are abnormal laboratory test results or some physical findings
  • If you have symptoms such as fever, weight loss, bloody stools

The symptoms of IBS generally get triggered by food, stress, and hormones (in women).

Diverticulitis

Diverticulosis is a GI condition that affects the lower part of the large intestine. In this disorder, there are tiny pockets that form in the weak spots of the lower large intestines. Diverticulosis is a rare condition before the age of 30, but it becomes quite common after the age of 60. There are generally no symptoms visible, so it is common that many people do not even realize that they have diverticulosis.

A complication of diverticulosis is known as diverticulosis, which happens when the bacteria get trapped in these tiny pockets, thus leading to swelling and infection.

Diverticulitis is the inflammation or infection of these pockets that form in the intestines, these pockets being termed as diverticula. (6)

Symptoms of diverticulitis include:

  • Cramping limited to the left side of your abdomen that tends to go away or gets relieved after having a bowel movement or passing gas
  • Bright red blood present in your stool
  • Severe abdominal pain
  • Fever
  • Chills
  • Tenderness in the lower abdomen
  • Obstruction of the colon

These symptoms are quite similar to the symptoms of IBS, and if left untreated without a correct diagnosis, then diverticulitis can lead to the tearing of the intestinal wall. This will cause the waste products to leak out into the abdominal cavity, causing a painful infection of the abdominal cavity, intestinal blockages, and abscesses.

Ischemic Colitis

Ischemic colitis is a GI condition that occurs when the blood flowing to a part of the large intestine gets reduced. This is usually because of narrowed and blocked blood vessels, and this reduced blood flow means that there is not enough oxygen being supplied to the cells of the GI system. (7)

Since ischemic colitis deprives your digestive system of oxygen and nutrients, you are likely to experience the following symptoms:

  • Abdominal cramping/pain or tenderness
  • Nausea
  • Vomiting
  • Rectal bleeding or bright red or maroon blood in the stool
  • Passage of blood even without stool
  • Diarrhea
  • Stomach pain especially after meals
  • An urgent need to pass stool

As you can see, the symptoms of ischemic colitis are similar to the symptoms of IBD. The only difference is that the abdominal pain is limited to the left side. Ischemic colitis can affect a person at any age, but it is more common after the age of 60.

The treatment of ischemic colitis revolves around proper hydration as many times it tends to resolve on its own. In some cases, though, it can cause damage to your colon, which required corrective surgery to fix. (8)

Exocrine Pancreatic insufficiency (EPI)

Exocrine pancreatic insufficiency (EPI) is a GI condition that affects the manner in which you digest your good. In people with EPI, the pancreas fail to manufacture a sufficient amount of the enzymes that the body requires for the breakdown and absorption of nutrients from food.

EPI shares its symptoms with a number of GI disorders. These shared symptoms include:

  • Abdominal discomfort/pain/tenderness
  • Bloating
  • Always feeling full
  • Diarrhea
  • Gas

You are considered to be at a greater risk of developing EPI if you have the following:

It is also possible for a person to develop EPI as well as another GI condition, including:

It is very important to get the diagnosis for EPI right. This is because EPI interferes with the ability of the body to absorb essential nutrients from food. A delayed diagnosis and, therefore, a delayed treatment will result in poor appetite and weight loss.

If left untreated, EPI can lead to malnutrition. Some of the symptoms of malnutrition include:

  • Low mood
  • Muscle weakness
  • Fatigue

Weakened immune system leading to frequent infections or illness

There is no one diagnostic test for diagnosing EPU. Diagnosis for EPI typically revolves around a series of tests including a pancreatic function test. (9)

Conclusion: Other GI Conditions

If you have an undiagnosed GI condition, you should discuss your specific symptoms and medical history in detail with your doctor to help them diagnose the problem correctly and determine the next steps in treatment. There are some other GI conditions as well that have overlapping symptoms and are frequently misdiagnosed similar to the condition discussed above. These may include:

  • Celiac disease
  • Colon polyps
  • Food allergies and sensitivities
  • Endocrine disorders such as carcinoid tumors or Addison’s disease
  • Gastroparesis
  • Pancreatitis
  • Gastroesophageal reflux disease (GERD)
  • Parasitic infection
  • Ulcers
  • Pancreatitis
  • Stomach and colorectal cancers
  • Viral infection
  • Bacterial infection

If you experience any of the GI symptoms as the ones listed here, then making an appointment with your doctor at the earliest is recommended. Make sure to go over all your symptoms and to let your doctor know about the duration you have been having them. Be ready to discuss your medical history, your family’s medical history, and any allergies or food sensitivities you might be having. The details of your allergies and your symptoms can prove to be crucial information for your doctor to help them diagnose your condition correctly and begin your treatment at the earliest.

References:

  1. Lennard-Jones, J.E., 1989. Classification of inflammatory bowel disease. Scandinavian Journal of Gastroenterology, 24(sup170), pp.2-6.
  2. Tontini, G.E., Vecchi, M., Pastorelli, L., Neurath, M.F. and Neumann, H., 2015. Differential diagnosis in inflammatory bowel disease colitis: state of the art and future perspectives. World journal of gastroenterology: WJG, 21(1), p.21.
  3. Däbritz, J., Musci, J. and Foell, D., 2014. Diagnostic utility of faecal biomarkers in patients with irritable bowel syndrome. World journal of gastroenterology: WJG, 20(2), p.363.
  4. Whitehead, W.E., Engel, B.T. and Schuster, M.M., 1980. Irritable bowel syndrome. Digestive diseases and sciences, 25(6), pp.404-413.
  5. van Zanten, S.V., 2003. Diagnosing irritable bowel syndrome. Reviews in gastroenterological disorders, 3, p.S12.
  6. Jacobs, D.O., 2007. Diverticulitis. New England Journal of Medicine, 357(20), pp.2057-2066.
  7. Gandhi, S.K., Hanson, M.M., Vernava, A.M., Kaminski, D.L. and Longo, W.E., 1996. Ischemic colitis. Diseases of the colon & rectum, 39(1), pp.88-100.
  8. Washington, C. and Carmichael, J.C., 2012. Management of ischemic colitis. Clinics in colon and rectal surgery, 25(04), pp.228-235.
  9. Domínguez‐Muñoz, J.E., 2011. Pancreatic exocrine insufficiency: diagnosis and treatment. Journal of gastroenterology and hepatology, 26, pp.12-16.

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