Differential Diagnosis for Severe Indigestion
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This is the most likely diagnosis due to the chronic nature of the symptoms, particularly the worsening of indigestion after eating. GERD is a common condition where stomach acid frequently flows back into the tube connecting the mouth and stomach (esophagus), causing symptoms like indigestion.
Other Likely Diagnoses
- Peptic Ulcer Disease: This condition, which includes gastric and duodenal ulcers, can cause chronic indigestion, especially after eating. The pain can be related to food intake, either being relieved or exacerbated by eating.
- Functional Dyspepsia: Also known as non-ulcer dyspepsia or indigestion, this is a term for recurring signs and symptoms of indigestion that have no obvious cause. Symptoms can vary but often include pain or discomfort in the upper abdomen, early satiety, and difficulty swallowing.
- Irritable Bowel Syndrome (IBS): Although primarily known for altering bowel habits, IBS can also cause upper gastrointestinal symptoms, including indigestion and discomfort.
Do Not Miss Diagnoses
- Coronary Artery Disease: It's crucial not to miss cardiac causes of chest discomfort, as they can be life-threatening. Although the description points towards gastrointestinal issues, atypical presentations of coronary artery disease, especially in women, can sometimes mimic indigestion.
- Gastric Cancer: Although rare, gastric cancer can present with chronic indigestion and upper gastrointestinal symptoms. It's essential to consider this, especially in high-risk populations or those with alarming symptoms like weight loss or difficulty swallowing.
- Esophageal Cancer: Similar to gastric cancer, esophageal cancer can cause chronic symptoms of indigestion, difficulty swallowing, and weight loss. Early detection is critical for treatment outcomes.
Rare Diagnoses
- Zollinger-Ellison Syndrome: A rare disorder characterized by excessive gastric acid production due to a gastrin-secreting tumor, leading to severe peptic ulcer disease and chronic indigestion.
- Eosinophilic Esophagitis: An inflammatory condition of the esophagus that can cause difficulty swallowing, food impaction, and chronic indigestion, often related to food allergies or sensitivities.
- Celiac Disease: An autoimmune disorder where the ingestion of gluten leads to damage in the small intestine, causing various gastrointestinal symptoms, including indigestion and abdominal discomfort.