Differential Diagnosis for Heartburn in a 13-year-old
Single most likely diagnosis
- Gastroesophageal reflux disease (GERD): This is the most likely diagnosis given the frequency and duration of heartburn symptoms. GERD is common in adolescents and can be exacerbated by factors such as diet, obesity, and anxiety.
Other Likely diagnoses
- Functional dyspepsia: This condition is characterized by recurring upper abdominal pain or discomfort, and can sometimes present with heartburn-like symptoms. It is often associated with anxiety and stress.
- Irritable bowel syndrome (IBS): Although IBS typically presents with abdominal pain and altered bowel habits, some patients may experience heartburn as a symptom.
- Eating disorders (e.g., bulimia nervosa): Adolescents with eating disorders may experience heartburn due to frequent self-induced vomiting or other disordered eating behaviors.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause heartburn, as well as other gastrointestinal symptoms. Although less common in adolescents, IBD can have serious complications if left untreated.
- Eosinophilic esophagitis: This condition is characterized by an allergic inflammatory response in the esophagus, which can cause heartburn, dysphagia, and food impaction. It is essential to consider this diagnosis to avoid missing a potentially severe condition.
- Peptic ulcer disease: Although less common in adolescents, peptic ulcers can cause heartburn and other gastrointestinal symptoms. If left untreated, peptic ulcers can lead to serious complications like bleeding or perforation.
Rare diagnoses
- Zollinger-Ellison syndrome: This rare condition is characterized by excessive gastric acid production due to a gastrin-producing tumor. It can cause severe heartburn, among other symptoms.
- Esophageal motility disorders (e.g., achalasia): These conditions are characterized by abnormal esophageal contractions, which can cause heartburn, dysphagia, and regurgitation. They are relatively rare in adolescents.