Differential Diagnosis for Nausea in the Morning

• Single most likely diagnosis
  • Pregnancy: Morning nausea is a classic symptom of early pregnancy, often due to hormonal changes.
• Other Likely diagnoses
  • Gastroesophageal reflux disease (GERD): Stomach acid reflux can cause nausea, especially in the morning after lying down all night.
  • Motion sickness: For individuals who experience motion sickness, morning nausea can occur, especially if they have been traveling or plan to travel.
  • Hangover: Alcohol consumption the night before can lead to morning nausea.
  • Food poisoning or viral gastroenteritis: Infections can cause nausea, which may be worse in the morning due to an empty stomach.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Meningitis: Although rare, meningitis can present with nausea and vomiting, and it is crucial to diagnose early due to its high mortality rate if left untreated.
  • Brain tumor: Increased intracranial pressure from a brain tumor can cause morning nausea and vomiting.
  • Myocardial infarction (heart attack): In some cases, especially in women, a heart attack can present with nausea and vomiting.
• Rare diagnoses
  • Gastroparesis: A condition where the stomach takes too long to empty its contents, which can cause nausea, especially after eating or in the morning.
  • Cyclical vomiting syndrome: A rare condition characterized by recurring episodes of severe nausea and vomiting.
  • Superior mesenteric artery syndrome: A rare condition where the duodenum is compressed between the abdominal aorta and the superior mesenteric artery, leading to nausea and vomiting.