What are the differential diagnoses for epigastric pain accompanied by diarrhea?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: February 28, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Epigastric Pain with Diarrhea

Single Most Likely Diagnosis

  • Gastroesophageal Reflux Disease (GERD): This condition is characterized by stomach acid frequently flowing back into the tube connecting the mouth and stomach (esophagus). The symptoms can include epigastric pain and, less commonly, diarrhea, especially if the reflux leads to gastritis or if there's an associated irritable bowel syndrome (IBS).

Other Likely Diagnoses

  • Peptic Ulcer Disease: This includes both gastric and duodenal ulcers, which can cause epigastric pain. Diarrhea can be associated with peptic ulcer disease, especially if the ulcers lead to an infection or if there's a complication like a perforation.
  • Irritable Bowel Syndrome (IBS): While IBS primarily causes abdominal pain and changes in bowel movements (diarrhea or constipation), some patients may experience upper gastrointestinal symptoms, including epigastric discomfort.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause both abdominal pain and diarrhea. Epigastric pain might be less common but can occur, especially if the disease affects the upper GI tract.

Do Not Miss Diagnoses

  • Acute Pancreatitis: This is a serious condition that requires immediate medical attention. It can cause severe epigastric pain and, in some cases, diarrhea. The pain often radiates to the back and worsens after eating.
  • Gastric Cancer: Although less common, gastric cancer can present with epigastric pain and changes in bowel habits, including diarrhea. It's crucial to consider this diagnosis, especially in older adults or those with risk factors.
  • Mesenteric Ischemia: This condition involves insufficient blood flow to the intestines and can cause severe abdominal pain, including epigastric pain, and diarrhea. It's a medical emergency.

Rare Diagnoses

  • Zollinger-Ellison Syndrome: A rare disorder characterized by excessive gastric acid production due to a gastrin-producing tumor, leading to peptic ulcers, diarrhea, and abdominal pain.
  • Eosinophilic Gastroenteritis: A rare condition where eosinophils infiltrate the gastrointestinal tract, causing inflammation and symptoms like abdominal pain, diarrhea, and sometimes epigastric pain.
  • Whipple's Disease: A rare, systemic bacterial infection that can cause malabsorption, weight loss, diarrhea, and abdominal pain, including epigastric pain, although it's less common.

Related Questions

What is the diagnosis for a patient with elevated iron saturation, low Total Iron-Binding Capacity (TIBC), low ferritin, normal hemoglobin, and a differential diagnosis of Mixed Connective Tissue Disease (MCTD) versus Dermatomyositis?
What is Hemophagocytic Lymphohistiocytosis (HLH)?
What is the best course of action for a patient with a 15-year history of untreated autoimmune disease, now diagnosed, who continues to exhibit evidence of inflammation and active disease flare despite treatment with multiple immunosuppressants?
What is the treatment for Giardiasis (Giardia infection)?
What is the composition of a migraine cocktail, typically consisting of medications such as (Non-Steroidal Anti-Inflammatory Drugs) NSAIDs, (Triptans), and (Anti-Emetics)?
What is the next step for a patient on Cellcept (Mycophenolate Mofetil), Rituximab, high-dose Intravenous Immunoglobulin (IVIG), Prednisone, and Plaquenil (Hydroxychloroquine) with persistent active inflammation, neutrophilia, and hypocomplementemia?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question