Differential Diagnosis for 16-year-old Female with Epigastric Abdominal Pain
- Single most likely diagnosis:
- Gastroesophageal reflux disease (GERD): This is a common condition in adolescents, characterized by stomach acid flowing back into the esophagus, causing epigastric pain and discomfort.
- Other Likely diagnoses:
- Peptic ulcer disease: This condition can cause epigastric pain, especially if the ulcer is located in the stomach or duodenum.
- Functional dyspepsia: This is a common condition in adolescents, characterized by recurring epigastric pain or discomfort, often related to eating.
- Irritable bowel syndrome (IBS): Although IBS typically presents with abdominal pain in the lower quadrants, some patients may experience epigastric pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Acute appendicitis: Although appendicitis typically presents with right lower quadrant pain, some cases may have atypical presentations, including epigastric pain.
- Pancreatitis: This condition can cause severe epigastric pain, and it's essential to consider it in the differential diagnosis, especially if the patient has a history of gallstones or other risk factors.
- Gastric cancer: Although rare in adolescents, gastric cancer can present with epigastric pain and should be considered in the differential diagnosis, especially if the patient has a family history or other risk factors.
- Rare diagnoses:
- Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis): These conditions can cause epigastric pain, although they are less common in adolescents.
- Eosinophilic esophagitis: This condition is characterized by inflammation of the esophagus, often caused by an allergic reaction, and can present with epigastric pain and difficulty swallowing.
- Gastric volvulus: This is a rare condition where the stomach twists abnormally, causing epigastric pain and vomiting.