Differential Diagnosis for Nausea and Vomiting after Meals

• Single most likely diagnosis:
  • Gastroesophageal reflux disease (GERD) - This condition is characterized by the backflow of stomach acid into the esophagus, often triggered by eating, which can cause nausea and vomiting after meals.
• Other Likely diagnoses:
  • Gastroparesis - A condition where the stomach takes too long to empty its contents, leading to nausea, vomiting, and feeling full after eating only a small amount of food.
  • Peptic ulcer disease - Ulcers in the stomach or duodenum can cause pain and discomfort after eating, leading to nausea and vomiting.
  • Food poisoning or viral gastroenteritis - Infections from contaminated food or viruses can cause acute onset of nausea and vomiting after meals.
  • Irritable bowel syndrome (IBS) - Although primarily associated with abdominal pain and altered bowel habits, some patients with IBS may experience nausea and vomiting, especially after eating.
• Do Not Miss diagnoses:
  • Appendicitis - Although abdominal pain is the primary symptom, nausea and vomiting can occur, especially if the appendix is located near the stomach or intestines.
  • Intestinal obstruction - A blockage in the intestines can cause severe nausea and vomiting, especially after eating, and is a medical emergency.
  • Pancreatitis - Inflammation of the pancreas can cause severe abdominal pain, nausea, and vomiting, which may worsen after eating.
  • Cholecystitis - Inflammation of the gallbladder can cause right upper quadrant pain, nausea, and vomiting, especially after fatty meals.
• Rare diagnoses:
  • Gastric cancer - Although rare, gastric cancer can cause nausea, vomiting, and weight loss, especially in older adults or those with a family history.
  • Zollinger-Ellison syndrome - A rare disorder characterized by excessive gastric acid production, leading to severe peptic ulcers, diarrhea, and nausea.
  • Eosinophilic gastroenteritis - A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, leading to nausea, vomiting, and abdominal pain.