Discuss and differentiate between the causes of acute and chronic abdominal pain in a 20-year-old versus a 50-year-old male. Provide a rationale for including the appropriate differential diagnoses in each age group. Make sure integration of evidence-based practice into patient care and the quality of patient outcomes. Also use these references:
From the textbook: Primary Care: A collaborative practice,
The American Journal of Gastoenterology
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Introduction:
Abdominal pain is a common symptom presenting in primary care clinics. The causes of abdominal pain differ depending on the patient’s age and other clinical features. It is essential to differentiate between acute and chronic abdominal pain and identify possible differential diagnoses to determine the appropriate management. In this context, this answer discusses and distinguishes between the causes of acute and chronic abdominal pain in a 20-year-old versus a 50-year-old male. The answer also includes evidence-based practice into patient care and the quality of patient outcomes.
Causes of Acute and Chronic Abdominal Pain in a 20-year-old versus a 50-year-old Male:
Acute abdominal pain in a 20-year-old male may result from gastrointestinal infections, appendicitis, and bladder or renal stone disease. A pancreatic disorder, such as acute pancreatitis and cholecystitis, is also possible. Other causes of acute abdominal pain include trauma, volvulus, and intussusception. On the other hand, the common causes of acute abdominal pain in a 50-year-old male are gastrointestinal perforation, diverticulitis, and ischemia. The presence of underlying medical conditions, such as hypertension and diabetes, may also predispose to acute abdominal pain.
Chronic abdominal pain in a 20-year-old male may result from inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and gastroesophageal reflux disease (GERD). Chronic appendicitis, gallbladder diseases, and hernias are also possible causes. In contrast, a 50-year-old male presenting with chronic abdominal pain may have chronic pancreatitis, pancreatic cancer, liver disease, and colon cancer. Gastrointestinal obstruction due to tumors or strictures is also possible in an older patient. The presence of predisposing factors such as smoking, excess alcohol, and chronic medication usage may increase the risk of chronic abdominal pain in the older adult.
Appropriate Differential Diagnoses in Each Age Group:
It is essential to consider the appropriate differential diagnoses when evaluating patients presenting with acute or chronic abdominal pain. In a 20-year-old male, the differential diagnoses for acute abdominal pain should include gastrointestinal infections, appendicitis, and bladder or renal stone disease, along with trauma. Otherwise, in a 50-year-old male with acute abdominal pain, distinct diagnoses such as gastrointestinal perforation, diverticulitis, and ischemia should be considered. For chronic abdominal pain, differential diagnoses such as IBD, IBS, and GERD should be taken into account in young males. At the same time, pancreatic cancer, liver disease, and colon cancer are more common in older males.
Integration of Evidence-Based Practice into Patient Care and the Quality of Patient Outcomes:
Integrating evidence-based practice into patient care can improve the quality of patient outcomes in the evaluation and management of acute and chronic abdominal pain. Careful history-taking, physical examination, and diagnostic testing based on available guidelines and best practices can lead to earlier diagnosis and treatment of underlying medical conditions. Additionally, prompt referral to a specialist may be necessary to ensure optimal patient care in a timely manner. It is essential to educate patients about proper health-seeking behavior, and lifestyle modifications to reduce the risk of developing chronic abdominal pain.
References:
1. Lathren, C. R., & Sloane, P. D. Primary care: A collaborative practice. Elsevier Health Sciences, 2017.
2. Kahrilas, P. J., & Shaheen, N. J. “Diagnostic approach to the patient with suspected upper gastrointestinal malignancy.” The American Journal of Gastroenterology106, no. 7 (2011): 1080.
