Diffuse/poorly characterized | Clinical features | Comments |
Bowel obstruction | Most common symptoms are nausea, vomiting, crampy abdominal pain, and obstipation. Distended, tympanic abdomen with high-pitched or absent bowel sounds. | Multiple etiologies. |
Perforation of the gastrointestinal tract | Severe abdominal pain, particularly following procedures. | Can present acutely or in an indolent manner, particularly in immunosuppressed patients. |
Acute mesenteric ischemia | Acute and severe onset of diffuse and persistent abdominal pain, often described as pain out of proportion to examination. | May occur from either arterial or venous disease. Patients with aortic dissection can have abdominal pain related to mesenteric ischemia. |
Chronic mesenteric ischemia | Abdominal pain after eating ("intestinal angina"), weight loss, nausea, vomiting, and diarrhea. | May occur from either arterial or venous disease. |
Inflammatory bowel disease (ulcerative colitis/Crohn disease) | Associated with bloody diarrhea, urgency, tenesmus, bowel incontinence, weight loss, and fevers. | May have symptoms for years before diagnosis. Associated extraintestinal manifestations (eg, arthritis, uveitis). |
Viral gastroenteritis | Diarrhea accompanied by nausea, vomiting, and abdominal pain. | |
Spontaneous bacterial peritonitis | Fever, abdominal pain, and/or altered mental status. | Most often in cirrhotic patients with advanced liver disease and ascites. |
Dialysis-related peritonitis | Abdominal pain and cloudy peritoneal effluent. Other symptoms and signs include fever, nausea, diarrhea, abdominal tenderness, and rebound tenderness. | Only in peritoneal dialysis patients. |
Colorectal cancer | Variable presentation, including obstruction and perforation. | |
Other malignancy | Vary depending on malignancy. | |
Celiac disease | Abdominal pain in addition to including diarrhea with bulky, foul-smelling, floating stools due to steatorrhea and flatulence. | |
Ketoacidosis | Diffuse abdominal pain and nausea and vomiting. | |
Adrenal insufficiency | Diffuse abdominal pain and nausea and vomiting. | Patients with adrenal crisis may present with shock and hypotension. |
Foodborne illness | Mixture of nausea, vomiting, fever, abdominal pain and diarrhea. | |
Irritable bowel syndrome | Chronic abdominal pain with altered bowel habits. | |
Constipation | Associated with a variety of neurologic and metabolic disorders, obstruction lesions of the gastrointestinal tract, endocrine disorders, psychiatric disorders, and side effect of medications. | |
Diverticulosis | May have symptoms of abdominal pain and constipation. | Often an asymptomatic and incidental finding on colonoscopy or sigmoidoscopy. |
Lactose intolerance | Associated with abdominal pain, bloating, flatulence, and diarrhea. Abdominal pain may be cramping in nature. |
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