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A 26-year-old man with abdominal pain
26 years old | Male
Vignette:
Simon, a young man aged 26, is the son of Nancy (see Case 32). You have not seen Simon since he was 18, when his parents were divorcing and he was experiencing recurrent headaches. On reviewing his medical record before calling him in, you see that he was seen in accident and emergency with abdominal pain at the weekend and that he had been told to see his GP as soon as possible. He comes in with a young woman whom he introduces as his fiancée, Tina, and they both tell how he had terrific pains and bloating all over his abdomen associated with belching and wind, and that she had rushed him up to the hospital. Simon tells you he had no vomiting or fever and feels back to normal today. He felt better once he opened his bowels properly. His bowels go through phases of being very erratic – sometimes he does not open them for several days and on other days he has diarrhoea several times before going to work. He has never had any blood in the stools, but sometimes they are mucusy. His general health is good and he has not lost any weight. He admitted that recently he has not been eating regularly because he and Tina have been very preoccupied with their wedding plans. He has had several bouts of similar abdominal pains over the last few years and they are very worried that there is something seriously wrong.
Summary:
abdominal pain | terrific pain | bloating | belching | altered bowel habit | diarrhea | constipation | mucusy stool | Worried
Dx:
IBS
Ref:
ccu general practice case 16 page 75
Rank |
Disease |
Weight |
|---|---|---|
| 1 | Giardiasis | 462.0 |
| 2 | Irritable Bowel Syndrome | 433.0 |
| 3 | Sigmoid volvulus | 378.0 |
| 4 | Intestinal Pseudo Obstruction | 351.0 |
| 5 | Ovarian Cancer | 291.0 |
| 6 | Acute intermittent porphyria | 265.0 |
| 7 | Hereditary Angioedema | 265.0 |
| 8 | Ulcerative Colitis | 264.0 |
| 9 | Lactose intolerance | 255.0 |
| 10 | Mesenteric ischemia | 254.0 |
| 11 | Crohn Disease | 251.0 |
| 12 | Intestinal Entamoeba histolytica amebiasis | 249.0 |
| 13 | Acute Appendicitis | 248.0 |
| 14 | Intussusception | 237.0 |
| 15 | Acute peptic ulcer | 236.0 |
| 16 | Duodenal Ulcer | 233.0 |
| 17 | Gastric Ulcer | 233.0 |
| 18 | Zollinger-Ellison Syndrome | 231.0 |
| 19 | Acute perforated appendicitis | 231.0 |
| 20 | Hemolytic uremic syndrome | 228.0 |
| 21 | Food poisoning | 221.0 |
| 22 | Bacterial gastroenteritis | 219.0 |
| 23 | Anal Fissure | 219.0 |
| 24 | Diverticulitis | 218.0 |
| 25 | mucosal Eosinophilic gastroenteritis | 212.0 |
| 26 | Intestinal Obstruction | 207.0 |
| 27 | Non-cholera Vibrio infections | 189.0 |
| 28 | Ruptured ectopic pregnancy | 185.0 |
| 29 | pancreatic cancer | 183.0 |
| 30 | Colorectal cancer | 183.0 |
| 31 | Peritoneal dialysis associated peritonitis | 179.0 |
| 32 | Primary sclerosing cholangitis | 177.0 |
| 33 | Eosinophilic gastroenteritis | 177.0 |
| 34 | Muscle Layer Eosinophilic gastroenteritis | 177.0 |
| 35 | subserosal eosinophilic gastroenteritis | 177.0 |
| 36 | Gastroparesis | 173.0 |
| 37 | Listerial gastroenteritis | 172.0 |
| 38 | Premenstrual syndrome | 170.0 |
| 39 | Intra-abdominal abscess | 165.0 |
| 40 | Peptic Ulcer | 164.0 |
| 41 | Acute viral meningitis | 163.0 |
| 42 | Thrombotic thrombocytopenic purpura | 162.0 |
| 43 | Brucellosis | 162.0 |
| 44 | Choledochal Cyst | 160.0 |
| 45 | Endometriosis | 159.0 |
| 46 | Salmonella infection | 159.0 |
| 47 | Tuberculous Peritonitis | 157.0 |
| 48 | Adrenal crisis | 156.0 |
| 49 | Gastrointestinal Hemorrhage | 156.0 |
| 50 | Lower gastrointestinal hemorrhage | 156.0 |
| 51 | Upper gastrointestinal hemorrhage | 156.0 |
| 52 | Rumination Syndrome | 155.0 |
| 53 | Amebic Liver Abscess | 153.0 |
| 54 | Diabetic Amyotrophy | 153.0 |
| 55 | Celiac Disease | 152.0 |
| 56 | Ruptured Tuboovarian abscess | 152.0 |
| 57 | Campylobacter infection | 150.0 |
| 58 | Gastric Volvulus | 148.0 |
| 59 | Dyspepsia | 144.0 |
| 60 | Addison Disease | 144.0 |
| 61 | Kawasaki disease | 144.0 |
| 62 | Chronic pelvic pain in women | 144.0 |
| 63 | Viral Gastroenteritis | 144.0 |
| 64 | Henoch-Schonlein purpura | 142.0 |
| 65 | Pheochromocytoma | 142.0 |
| 66 | Travelers diarrhea | 142.0 |
| 67 | Type 2 Diabetes mellitus | 140.0 |
| 68 | Cholera | 140.0 |
| 69 | Foodborne E coli infection | 140.0 |
| 70 | Anthrax | 140.0 |
| 71 | Psoas Abscess | 139.0 |
| 72 | Graves Disease | 139.0 |
| 73 | Primary biliary cirrhosis | 138.0 |
| 74 | Type 1 Diabetes mellitus | 137.0 |
| 75 | Gastroenteritis | 136.0 |
| 76 | Chronic Pancreatitis | 135.0 |
| 77 | Bacterial pharyngitis | 133.0 |
| 78 | Systemic sclerosis | 131.0 |
| 79 | Hepatocellular carcinoma | 130.0 |
| 80 | Ileus | 128.0 |
| 81 | Autoimmune hepatitis | 128.0 |
| 82 | Intestinal malrotation | 128.0 |
| 83 | Painless thyroiditis | 128.0 |
| 84 | Acute Cholecystitis | 127.0 |
| 85 | Emphysematous cholecystitis | 127.0 |
| 86 | Shigellosis | 126.0 |
| 87 | Liver Cirrhosis | 125.0 |
| 88 | Liver disease | 125.0 |
| 89 | Abdominal compartment syndrome | 125.0 |
| 90 | Biliary cirrhosis | 125.0 |
| 91 | Tuboovarian abscess | 125.0 |
| 92 | Toxic Megacolon | 124.0 |
| 93 | Churg-Strauss Syndrome | 123.0 |
| 94 | Meckel diverticulum | 122.0 |
| 95 | Autosomal Dominant Polycystic Kidney Disease | 121.0 |
| 96 | Anaphylaxis | 120.0 |
| 97 | Spontaneous bacterial peritonitis | 119.0 |
| 98 | Parkinson disease | 119.0 |
| 99 | Hypothyroidism | 119.0 |
| 100 | Diabetes Mellitus | 119.0 |
| 101 | Leiomyomas | 115.0 |
| 102 | Peutz-Jeghers Syndrome | 114.0 |
| 103 | Secondary Peritonitis | 113.0 |
| 104 | Typhoid infection | 113.0 |
| 105 | Alcoholic hepatitis | 112.0 |
| 106 | Sarcoidosis | 112.0 |
| 107 | Acute pyelonephritis in adults | 112.0 |
| 108 | Familial adenomatous polyposis syndrome | 111.0 |
| 109 | Abetalipoproteinemia | 110.0 |
| 110 | Klebsiella pneumoniae liver abscess | 109.0 |
| 111 | Short bowel syndrome | 109.0 |
| 112 | Amyloidosis | 109.0 |
| 113 | Analgesic nephropathy | 108.0 |
| 114 | Intraperitoneal bleeding | 106.0 |
| 115 | Malaria | 105.0 |
| 116 | Urinary Tract Obstruction | 104.0 |
| 117 | Foreign body ingestion | 104.0 |
| 118 | Inflammatory Bowel Diseases | 102.0 |
| 119 | Choledocholithiasis | 100.0 |
| 120 | Pyogenic Liver Abscess | 99.0 |
| 121 | Ovarian Hyperstimulation Syndrome | 98.0 |
| 122 | Familial Mediterranean fever | 97.0 |
| 123 | Systemic lupus erythematosus | 96.0 |
| 124 | Osteoporosis | 96.0 |
| 125 | Gallstones | 95.0 |
| 126 | Gastric Outlet Obstruction | 95.0 |
| 127 | Renal Cell Carcinoma | 95.0 |
| 128 | Hyperparathyroidism | 95.0 |
| 129 | Hyperthyroidism | 94.0 |
| 130 | Extraintestinal Entamoeba histolytica amebiasis | 91.0 |
| 131 | Autoimmune Pancreatitis | 90.0 |
| 132 | Amebiasis | 90.0 |
| 133 | Migraine headache in adults | 89.0 |
| 134 | Acalculous Cholecystitis | 87.0 |
| 135 | chronic acalculous cholecystitis | 87.0 |
| 136 | Inguinal hernia | 87.0 |
| 137 | Annular pancreas | 86.0 |
| 138 | Ectopic Pregnancy | 86.0 |
| 139 | Chronic Myeloid Leukemia | 86.0 |
| 140 | Multiple Sclerosis | 86.0 |
| 141 | Ascites | 84.0 |
| 142 | Biliary cyst | 83.0 |
| 143 | Hypercalcemia | 83.0 |
| 144 | Goiter | 83.0 |
| 145 | Diffuse nontoxic goiter | 83.0 |
| 146 | Toxic multinodular goiter | 83.0 |
| 147 | Obstructive cervical goiters | 83.0 |
| 148 | Cervical goiter | 83.0 |
| 149 | Acute Cholangitis | 81.0 |
| 150 | Kidney stones | 81.0 |
| 151 | Gallbladder cancer | 80.0 |
| 152 | Alcoholic Liver Disease | 80.0 |
| 153 | Gastroesophageal reflux disease | 79.0 |
| 154 | Rocky Mountain spotted fever | 78.0 |
| 155 | Umbilical hernia | 78.0 |
| 156 | Multiple endocrine neoplasia 2B | 77.0 |
| 157 | Multiple endocrine neoplasia 2A | 76.0 |
| 158 | Ruptured ovarian cyst | 75.0 |
| 159 | Exocrine pancreatic insufficiency | 74.0 |
| 160 | Migraine | 74.0 |
| 161 | Fibromyalgia | 73.0 |
| 162 | Alcoholic Liver Cirrhosis | 72.0 |
| 163 | Hypogammaglobulinemia | 72.0 |
| 164 | Hepatic Encephalopathy | 71.0 |
| 165 | Cholangiocarcinoma | 70.0 |
| 166 | Acute disseminated encephalomyelitis | 70.0 |
| 167 | Hereditary hemochromatosis | 69.0 |
| 168 | Graves ophthalmopathy | 69.0 |
| 169 | Esophagitis | 68.0 |
| 170 | Acute Clonorchiasis | 68.0 |
| 171 | Pelvic inflammatory disease | 68.0 |
| 172 | Acute pelvic inflammatory disease | 68.0 |
| 173 | Acute Lymphoblastic leukemia in children | 68.0 |
| 174 | Achalasia | 68.0 |
| 175 | Adrenocortical carcinoma | 66.0 |
| 176 | Glomerulonephritis | 66.0 |
| 177 | Acute Renal vein thrombosis | 65.0 |
| 178 | Non-ST-elevation myocardial infarction | 65.0 |
| 179 | Chronic Clonorchiasis | 64.0 |
| 180 | Diabetic Ketoacidosis | 64.0 |
| 181 | Gastritis | 63.0 |
| 182 | Renal and perinephric abscess | 63.0 |
| 183 | Panic disorder in adults | 63.0 |
| 184 | Alcoholic Fatty Liver | 63.0 |
| 185 | Diabetic Neuropathy | 63.0 |
| 186 | Central hypothyroidism | 63.0 |
| 187 | Budd Chiari Syndrome | 62.0 |
| 188 | Polyarteritis nodosa | 62.0 |
| 189 | Acetaminophen overdose | 62.0 |
| 190 | Heparin-induced thrombocytopenia | 62.0 |
| 191 | Acute bacterial meningitis in children | 62.0 |
| 192 | Pyelonephritis | 61.0 |
| 193 | Acute pericarditis | 61.0 |
| 194 | Endometrial cancer | 61.0 |
| 195 | Clostridium difficile infection | 61.0 |
| 196 | Stevens-Johnson syndrome | 61.0 |
| 197 | Common cutaneous drug reactions | 60.0 |
| 198 | Gastric cancer | 59.0 |
| 199 | Wilson disease | 58.0 |
| 200 | Acute otitis media | 58.0 |
| 201 | Medullary thyroid cancer | 57.0 |
| 202 | Ovarian Torsion | 57.0 |
| 203 | Hiatus hernia | 56.0 |
| 204 | Aortic Dissection | 56.0 |
| 205 | Guillain-Barre syndrome | 56.0 |
| 206 | Malt lymphoma | 53.0 |
| 207 | Acute Pancreatitis | 51.0 |
| 208 | Chronic heart failure | 51.0 |
| 209 | Chronic Lymphocytic Leukemia | 51.0 |
| 210 | Acute fatty liver of pregnancy | 50.0 |
| 211 | Breast Cancer | 50.0 |
| 212 | STI HIV Pharyngitis | 50.0 |
| 213 | Pancreatic Pseudocyst | 48.0 |
| 214 | Hypertriglyceridemia | 48.0 |
| 215 | Non-small cell lung cancer | 48.0 |
| 216 | Aseptic meningitis | 48.0 |
| 217 | Primary Myelofibrosis | 47.0 |
| 218 | Hyperosmolar Hyperglycemic state | 47.0 |
| 219 | Acute peritonitis | 46.0 |
| 220 | biliary colic | 46.0 |
| 221 | Chronic bacterial prostatitis | 46.0 |
| 222 | Acute bacterial meningitis in neonates | 46.0 |
| 223 | Infectious mononucleosis | 44.0 |
| 224 | Anemia of chronic disease | 44.0 |
| 225 | Autosomal Recessive Polycystic Kidney Disease | 43.0 |
| 226 | Acromegaly | 43.0 |
| 227 | Discogenic low back pain | 43.0 |
| 228 | COVID19 | 42.0 |
| 229 | Acute Liver Failure | 42.0 |
| 230 | Epiploic appendagitis | 41.0 |
| 231 | Cystic Fibrosis | 41.0 |
| 232 | Hyperprolactinemia | 41.0 |
| 233 | Hepatorenal Syndrome | 40.0 |
| 234 | Bladder Cancer | 40.0 |
| 235 | Urinary tract infection | 40.0 |
| 236 | Acute Cystitis(Men) | 40.0 |
| 237 | Cystitis | 40.0 |
| 238 | Pneumonia | 40.0 |
| 239 | Gallstone pancreatitis | 39.0 |
| 240 | Acute Myeloid Leukemia in adults | 38.0 |
| 241 | Middle East respiratory syndrome | 38.0 |
| 242 | Prostatitis | 36.0 |
| 243 | Chronic prostatitis | 36.0 |
| 244 | Globus Sensation | 36.0 |
| 245 | Endometritis | 34.0 |
| 246 | Chronic Kidney Diseases | 34.0 |
| 247 | Ovarian and fallopian tube torsion | 34.0 |
| 248 | Adrenal Suppression | 34.0 |
| 249 | Acute Lymphocytic Leukemia in Adults | 34.0 |
| 250 | Multiple Myeloma | 34.0 |
| 251 | Acute heart failure | 34.0 |
| 252 | Motion Sickness | 34.0 |
| 253 | Obstructive Sleep Apnea | 33.0 |
| 254 | Ankylosing spondylitis | 33.0 |
| 255 | Asthma | 33.0 |
| 256 | Dubin-Johnson syndrome | 32.0 |
| 257 | Psoriasis | 32.0 |
| 258 | Bullous pemphigoid | 31.0 |
| 259 | Gilbert syndrome | 31.0 |
| 260 | Disseminated intravascular coagulation | 31.0 |
| 261 | Eclampsia | 30.0 |
| 262 | Osteomyelitis | 30.0 |
| 263 | Chronic Hepatitis | 29.0 |
| 264 | Alzheimer disease | 29.0 |
| 265 | Granulomatosis with polyangiitis | 29.0 |
| 266 | Insect bites and stings | 27.0 |
| 267 | Peritonitis | 26.0 |
| 268 | Enterovesical fistula | 26.0 |
| 269 | Influenza | 26.0 |
| 270 | biliary SOD | 25.0 |
| 271 | Tinnitus | 25.0 |
| 272 | Atypical pneumonia | 25.0 |
| 273 | Acute cervical spine trauma | 25.0 |
| 274 | Non-alcoholic Fatty Liver Disease | 24.0 |
| 275 | Anaplastic thyroid cancer | 24.0 |
| 276 | Sphincter of Oddi Dysfunction | 24.0 |
| 277 | pancreatic SOD | 24.0 |
| 278 | Atopic dermatitis | 24.0 |
| 279 | COPD Exacerbation | 24.0 |
| 280 | Acute Cystitis(Women) | 23.0 |
| 281 | Osteoarthritis | 23.0 |
| 282 | Renal vein thrombosis | 23.0 |
| 283 | Chronic Renal vein thrombosis | 23.0 |
| 284 | Von willebrand disease | 23.0 |
| 285 | Aortic coarctation | 22.0 |
| 286 | Chronic fatigue syndrome | 21.0 |
| 287 | Cholecystitis | 21.0 |
| 288 | Chronic Cholecystitis | 21.0 |
| 289 | Hyperaldosteronism | 21.0 |
| 290 | Blepharitis | 21.0 |
| 291 | Mirizzi Syndrome | 20.0 |
| 292 | Preeclampsia | 20.0 |
| 293 | Vaginitis | 20.0 |
| 294 | Urethritis | 20.0 |
| 295 | Phimosis | 20.0 |
| 296 | Paraphimosis | 20.0 |
| 297 | Chronic liver disease | 20.0 |
| 298 | Portal hypertension | 20.0 |
| 299 | Chronic Mitral regurgitation | 20.0 |
| 300 | Epidemic keratoconjunctivitis | 20.0 |
| 301 | Optic neuritis | 20.0 |
| 302 | Neuropapillitis | 20.0 |
| 303 | Splenic Infarction | 19.0 |
| 304 | Gout | 19.0 |
| 305 | Ischemic stroke | 19.0 |
| 306 | Gallbladder Dyskinesia | 19.0 |
| 307 | Tinea versicolor | 19.0 |
| 308 | Lung Cancer | 18.0 |
| 309 | Rotor syndrome | 18.0 |
| 310 | Premature labor | 18.0 |
| 311 | Menopause | 18.0 |
| 312 | Chronic pyelonephritis | 18.0 |
| 313 | Carpal Tunnel Syndrome | 18.0 |
| 314 | Acute Hepatitis | 17.0 |
| 315 | Testicular cancer | 17.0 |
| 316 | Mitral Stenosis | 17.0 |
| 317 | Splenic abscess | 16.0 |
| 318 | Splenic Rupture | 16.0 |
| 319 | Simple kidney cyst | 15.0 |
| 320 | Amphetamine use disorder | 15.0 |
| 321 | Milk-alkali syndrome | 15.0 |
| 322 | Acute Milk-alkali syndrome | 15.0 |
| 323 | Chronic Milk-alkali syndrome | 15.0 |
| 324 | Clonorchiasis | 14.0 |
| 325 | Unstable angina | 14.0 |
| 326 | Intrahepatic cholestasis of pregnancy | 14.0 |
| 327 | Systemic vasculitis | 14.0 |
| 328 | Limited cutaneous systemic sclerosis | 14.0 |
| 329 | Secondary hyperparathyroidism | 14.0 |
| 330 | Extrahepatic Cholestasis | 13.0 |
| 331 | Intrahepatic Cholestasis | 13.0 |
| 332 | Rheumatoid Arthritis | 12.0 |
| 333 | Stable angina | 12.0 |
| 334 | Psychogenic polydipsia | 12.0 |
| 335 | Allergic rhinitis | 12.0 |
| 336 | Drowning | 11.0 |
| 337 | Toxic thyroid adenoma | 11.0 |
| 338 | Mallory-Weiss syndrome | 11.0 |
| 339 | Cushing syndrome | 10.0 |
| 340 | Bed bugs | 10.0 |
| 341 | Herpes zoster | 10.0 |
| 342 | Gestational diabetes mellitus | 10.0 |
| 343 | Renal Artery Stenosis | 9.0 |
| 344 | Hemorrhagic stroke | 9.0 |
| 345 | Acute Bacterial Prostatitis | 8.0 |
| 346 | Common cold(children) | 8.0 |
| 347 | Thyroid lymphoma | 8.0 |
| 348 | Paraneoplastic Syndromes | 8.0 |
| 349 | Cryptorchidism | 8.0 |
| 350 | Primary ciliary dyskinesia | 7.0 |
| 351 | Kartagener syndrome | 7.0 |
| 352 | Common cold(adults) | 7.0 |
| 353 | Diabetic Kidney Disease | 7.0 |
| 354 | Psoriatic arthritis | 7.0 |
| 355 | Epididymo-orchitis | 6.0 |
| 356 | Liver Abscess | 6.0 |
| 357 | Ramsay Hunt syndrome | 6.0 |
| 358 | Meniere disease | 6.0 |
| 359 | ST-elevation myocardial infarction | 6.0 |
| 360 | Benign Prostatic Hyperplasia | 4.0 |
| 361 | Acute Rhinosinusitis | 4.0 |
| 362 | Acute viral rhinosinusitis | 4.0 |
| 363 | Acute bacterial rhinosinusitis | 4.0 |
| 364 | Chlamydia pneumoniae infection | 3.0 |
| 365 | Alopecia areata | 2.0 |
| 366 | Acute Bronchitis | 2.0 |
| 367 | endocarditis | 1.0 |
| 368 | Hemorrhoids | 0.0 |
| 369 | Immune thrombocytopenia | 0.0 |
| 370 | Recurrent aphthous stomatitis | 0.0 |
| 371 | Acute epididymitis | 0.0 |
| 372 | Hodgkin lymphoma | 0.0 |
| 373 | Myasthenia Gravis | 0.0 |
| 374 | Congenital Myasthenic Syndromes | 0.0 |
| 375 | Neonatal Myasthenia Gravis | 0.0 |
| 376 | Transverse myelitis | 0.0 |
| 377 | Bell palsy | 0.0 |
| 378 | Myoclonus | 0.0 |