Table of Contents
Common Questions
Chat with CodyMD
Cody's Chat with Patient
Cody's AI Summary
Top 3 AI Diagnosis List
Review by Dr Albert DiPiero
Dr. DiPiero Video Guide to this Case Study
Resource Center
Testimonials
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Case Study
Meet your host
Albert DiPiero, MD MPH FACP
I am a co-founder and the Chief Medical Officer at CodyMD and your host for this edition of Cody Grand Rounds. I have been a practicing physician and faculty member at medical schools for over 26 years.
About The AI Doctor Case Study
CodyMD is a partnership between Human Doctors and AI Doctors. Cody is an AI Doctor who helps thousands of people every day. At each Cody Grand Rounds, I select a real case and review it with Cody, the AI Doctor.
Each case is based on a real patient but has been modified to maintain privacy and to emphasize certain teaching points.
Common Questions
What causes left lower abdominal pain?
What organ is on the lower left side of the abdomen?
When should I seek medical attention for abdominal pain?
When should I be worried about loss of appetite?
What disease makes you lose appetite?
Chat with CodyMD
Click the button below to initiate a conversation with CodyMD, your AI Doctor.
Cody's Chat with Patient
Below is a conversation transcript between the patient and our AI Doctor CodyMd.
Cody, the AI Doctor
How may I help you today?
Patient
I have pain in by left lower belly.
Cody, the AI Doctor
So you want to focus on your left lower quadrant pain today, is that correct?
Patient
Yes, that's right.
Cody, the AI Doctor
Good to meet you! My goal is to provide you with an accurate assessment and plan. Let's start with your current symptoms. How long have you been experiencing the left lower quadrant pain?
Patient
It's been about five days now.
Cody, the AI Doctor
I see. How did the pain start? Did it come on suddenly or gradually?
Patient
It started gradually and has been getting worse over the days.
Cody, the AI Doctor
On a scale from 1 to 10, with 1 being no pain and 10 being the worst pain imaginable, how would you rate your pain?
Patient
I would say it's about a 6 or 7.
Cody, the AI Doctor
Are you experiencing any other symptoms along with the pain, such as nausea?
Patient
Yes, I have some mild nausea, and I've also lost my appetite.
Cody, the AI Doctor
Have you noticed any changes in your bowel movements?
Patient
Yes, I still have bowel movements, but they come with crampy lower quadrant pain.
Cody, the AI Doctor
Is there any blood in your stool?
Patient
No, no blood in the stool.
Cody, the AI Doctor
Have you had any urinary symptoms, such as pain when urinating, increased frequency, or urgency?
Patient
No, none at all.
Cody, the AI Doctor
What about flank pain? Any discomfort in areas like your back or sides?
Patient
No, no flank pain.
Cody, the AI Doctor
Do you have any other medical conditions?
Patient
No, just overweight. My BMI is 29.
Cody, the AI Doctor
Understood. Is there any family history of gastrointestinal conditions or cancers?
Patient
No, none that I know of.
Cody, the AI Doctor
Now let’s discuss your overall health. Do you drink alcohol or use any illicit drugs?
Patient
I drink alcohol occasionally, but no illicit drugs.
Cody, the AI Doctor
Thanks for sharing that information. How has your appetite been recently?
Patient
I’ve pretty much lost my appetite over these past few days.
Cody, the AI Doctor
Okay, I am starting to get a better picture. Do you have any recent travel history or did you eat any unusual foods recently?
Patient
No recent travels or unusual foods, just my regular diet.
Cody's AI Summary
- You are a 45-year-old man with left lower abdominal pain for about five days.
- The pain started gradually and has worsened over time. You rate the pain as moderately severe (6-7 out of 10).
- You also have mild nausea and have lost your appetite.
- You continue to have bowel movements, but they come with crampy lower quadrant pain, and there's no blood in your stool.
- Your BMI is 29, indicating that you are overweight. You have no other medical conditions and no family history of gastrointestinal conditions or cancers.
- You have not had any recent travel or dietary changes.
Top 3 AI Diagnosis List
Based on the information and conversations with Cody, we have prepared a top 3 AI Diagnosis List.
1. Diverticulitis (55 % probability)
Inflammation or infection of small pouches (diverticula) that can form in your intestines. It typically presents with left lower quadrant abdominal pain, changes in bowel habits, nausea, and decreased appetite.
2. Infectious Colitis (25 % probability)
Inflammation of the colon due to an infection, which can cause crampy lower abdominal pain, changes in bowel habits, and sometimes nausea. Without a history of recent travel or diarrhea, this is less likely but still a consideration.
3. Ischemic Colitis (15% probability)
Reduced blood flow to the colon, which can cause abdominal pain, usually on the left side, along with changes in bowel habits, and even bloody bowel movements. It's less common but a potential diagnosis, especially in middle-aged or older adults.
Review by Dr Albert DiPiero
Dr. Albert DiPiero
In reviewing the patient’s history and symptoms, a 45-year-old male with left lower quadrant pain, mild nausea, and appetite loss raises several diagnostic considerations. Given the gradual onset and worsening nature of the pain over five days, along with the associated gastrointestinal symptoms, the top AI diagnoses of diverticulitis, infectious colitis, and ischemic colitis are appropriate. These are important and potentially serious diagnoses that must be evaluated thoroughly.
1. Diverticulitis (75 % probability)
Diverticulitis is a primary consideration given the left lower quadrant pain and nausea and loss of appetite and possible fever. The patient’s age and overweight status are risk factors.
2. Infectious Colitis (15 % probability)
Though generally more common with a history of recent travel or dietary changes, infectious colitis remains a potential diagnosis. However, the lack of diarrhea makes this less probable.
3. Ischemic Colitis (10% probability)
Ischemic colitis is less common but should still be considered, particularly if there is a history of cardiovascular issues or other risk factors for poor blood circulation, which were not indicated in this case. The absence of blood in stool does not rule out this condition, as it often presents without these symptoms initially.
Next Steps for Evaluation
Examination: a thorough abdominal examination is highly recommended to determine the severity of condition.
Laboratory Tests: Complete blood count, CRP, and stool studies to check for infection or inflammation.
Imaging: A CT scan of the abdomen and pelvis to evaluate for diverticulitis or other structural abnormalities.
Potential Treatment Modalities
Treatment: Start antibiotics if severe diverticulitis is diagnosed, along with dietary modifications and hydration. Further evaluation by a gastroenterologist may be warranted based on initial findings.
Diet: During an acute attack of diverticulitis, you may need to start with a clear liquid diet (Broth, clear juices, gelatin, and popsicles). This helps to rest the colon. As symptoms improve, you can transition to a low-fiber diet. Examples: White bread, white rice, eggs, fish, poultry. Once fully recovered, gradually reintroduce fiber into your diet, which helps to prevent future attacks. Examples: Fruits, vegetables, whole grains, and legumes. Avoid trigger foods such as seeds, nuts, popcorn, and spicy foods as they can irritate the colon.
Dr. DiPiero Video Guide to this Case Study
Resource Center
Testimonials
Genuinely saved my life. I went to an Instacare for severe abdominal pain and was told to take Tums for the next two weeks. I left feeling rushed out and unheard. I wrote out my symptoms to CodyMD and was told there’s a 75% chance I have acute appendicitis. I took myself to the hospital and had emergency surgery the same morning.
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After trying out multiple similar websites, I am so happy I found CodyMD. The user friendly score is 100%! I was amazed at how fast my questions were answered with my info taken into consideration, not one generic answer. This site is truly brilliant and will benefit soo many people as far as time and money.
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Just loved getting the peace of mind that I’m not the only one that has had these issues and it’s not as bad as I thought.
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