Differential Diagnosis for Spontaneous Vomiting
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This condition is characterized by the backflow of stomach acid into the esophagus, which can cause vomiting after eating. The timing of vomiting 3 hours after food intake aligns with the typical presentation of GERD, as it allows enough time for the stomach to empty and for acid to reflux into the esophagus.
Other Likely Diagnoses
- Gastroparesis: A condition where the stomach takes too long to empty its contents, leading to vomiting. The delay in vomiting after eating fits this diagnosis, as gastroparesis often results in delayed gastric emptying.
- Food Poisoning: Although the question does not specify recent travel or consumption of high-risk foods, food poisoning remains a common cause of vomiting after eating and should be considered.
- Peptic Ulcer Disease: Ulcers in the stomach or duodenum can cause vomiting, especially if they are bleeding or if the ulcer is located in an area that obstructs the flow of food.
Do Not Miss Diagnoses
- Appendicitis: Although less common, appendicitis can present with vomiting, especially if the appendix is located near the stomach or small intestine, causing irritation and subsequent vomiting.
- Pancreatitis: Inflammation of the pancreas can cause severe vomiting, and while it may not be the first consideration, missing this diagnosis could have serious consequences.
- Intestinal Ischemia: Reduced blood flow to the intestines can cause vomiting among other symptoms. This is a critical diagnosis not to miss due to its high mortality rate if left untreated.
Rare Diagnoses
- Cyclic Vomiting Syndrome: A rare condition characterized by recurrent episodes of severe vomiting with no apparent cause, which could fit the presentation if other causes are ruled out.
- Rumination Syndrome: A condition where food is regurgitated and then chewed and swallowed again, which could be considered if the vomiting is shortly after eating and the content is recognizable food.
- Eosinophilic Esophagitis: An allergic condition causing inflammation of the esophagus, which could lead to vomiting, especially if there's a history of allergies or atopic diseases.