Differential Diagnosis for a 52-year-old Female Vomiting Every Morning
- Single most likely diagnosis:
- Pregnancy: Although the patient is 52, it's essential to consider pregnancy as a cause of morning vomiting, especially if she is still menstruating or has not undergone menopause.
- Gastroesophageal reflux disease (GERD): Morning vomiting can be a symptom of GERD, which is common in adults and can be exacerbated by lying down at night.
- Other Likely diagnoses:
- Gastroparesis: This condition, characterized by delayed stomach emptying, can cause morning vomiting, especially after eating the night before.
- Peptic ulcer disease: Ulcers in the stomach or duodenum can cause morning vomiting, especially if they are bleeding or perforated.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause morning vomiting, especially if the disease is active.
- Food intolerance or sensitivity: Lactose intolerance, gluten sensitivity, or other food intolerances can cause morning vomiting if the patient consumes the offending food the night before.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
- Brain tumor: Although rare, a brain tumor can cause morning vomiting due to increased intracranial pressure.
- Meningitis or encephalitis: Infections like meningitis or encephalitis can cause vomiting, especially in the morning, and require prompt medical attention.
- Intestinal obstruction: A bowel obstruction can cause severe vomiting, including morning vomiting, and is a medical emergency.
- Myocardial infarction: In some cases, a heart attack can cause vomiting, including morning vomiting, especially in women.
- Rare diagnoses:
- Cyclic vomiting syndrome: A rare condition characterized by recurrent episodes of severe vomiting, often with no apparent cause.
- Superior mesenteric artery syndrome: A rare condition where the duodenum is compressed by the superior mesenteric artery, causing vomiting and other symptoms.
- Eosinophilic esophagitis: A rare condition characterized by inflammation of the esophagus, which can cause vomiting and other symptoms.