Differential Diagnosis for Patient with Stomach Pain and Upper Abdominal Pain
The patient presents with stomach pain, upper abdominal pain, bloating, nausea, and a history of diverticulitis and stomach ulcer. Here is a differential diagnosis organized into categories:
- Single Most Likely Diagnosis
- Peptic Ulcer Disease (PUD): The patient's history of a stomach ulcer and current symptoms of upper abdominal pain, nausea, and inability to eat suggest a possible recurrence or exacerbation of PUD. The pain described as feeling like it's "on fire" is also consistent with ulcer disease.
- Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): The patient's symptoms of upper abdominal pain, bloating, and nausea could be related to GERD, especially if the pain is worsened by eating or lying down.
- Gastritis: Inflammation of the stomach lining could cause the patient's symptoms, including pain, nausea, and bloating.
- Functional Dyspepsia: This condition is characterized by recurring upper abdominal pain or discomfort, bloating, and early satiety, which aligns with the patient's symptoms.
- Do Not Miss Diagnoses
- Appendicitis: Although the patient's pain is primarily in the upper abdomen, appendicitis can sometimes present with upper abdominal pain that later localizes to the right lower quadrant. Missing this diagnosis could lead to serious complications.
- Pancreatitis: The patient's severe upper abdominal pain, nausea, and vomiting could be indicative of pancreatitis, which requires prompt medical attention.
- Cholecystitis: Inflammation of the gallbladder could cause the patient's symptoms, including upper abdominal pain, nausea, and vomiting.
- Rare Diagnoses
- Zollinger-Ellison Syndrome: A rare condition characterized by excessive gastric acid production, which could cause severe upper abdominal pain, diarrhea, and weight loss.
- Gastric Cancer: Although rare, gastric cancer could present with upper abdominal pain, weight loss, and difficulty eating, especially in patients with a history of stomach ulcers or other risk factors.
- Eosinophilic Gastroenteritis: A rare condition characterized by inflammation of the stomach and small intestine, which could cause abdominal pain, nausea, and vomiting.