Differential Diagnosis for Intractable Nausea and Vomiting

Single Most Likely Diagnosis

• Gastroenteritis: This is often the most common cause of intractable nausea and vomiting, typically resulting from a viral or bacterial infection. The symptoms can be severe and include diarrhea, abdominal cramps, and fever, in addition to nausea and vomiting.

Other Likely Diagnoses

• Pregnancy: Morning sickness is a common symptom of early pregnancy, which can sometimes be severe and lead to intractable nausea and vomiting.
• Gastroesophageal Reflux Disease (GERD): GERD can cause nausea and vomiting, especially after eating, due to the reflux of stomach contents into the esophagus.
• Food Poisoning: Consuming contaminated food can lead to severe nausea and vomiting, often accompanied by diarrhea and abdominal pain.
• Medication Side Effects: Certain medications, such as chemotherapy drugs, antibiotics, and anesthetics, can cause intractable nausea and vomiting as a side effect.

Do Not Miss Diagnoses

• Appendicitis: Although less common, appendicitis can present with nausea and vomiting, and it is crucial to diagnose promptly to avoid rupture and peritonitis.
• Intestinal Obstruction: This is a life-threatening condition that can cause severe nausea and vomiting, requiring immediate medical attention.
• Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain, nausea, and vomiting, and it is essential to diagnose and treat promptly.
• Brain Tumors: Certain brain tumors, especially those in the posterior fossa, can cause increased intracranial pressure leading to nausea and vomiting.

Rare Diagnoses

• Cyclic Vomiting Syndrome: A rare condition characterized by recurrent episodes of severe nausea and vomiting, often without an identifiable cause.
• Gastroparesis: A condition where the stomach muscles are weakened, leading to delayed gastric emptying and causing nausea, vomiting, and bloating.
• ** Superior Mesenteric Artery Syndrome**: A rare condition where the duodenum is compressed between the abdominal aorta and the superior mesenteric artery, leading to nausea, vomiting, and abdominal pain.
• Increased Intracranial Pressure (ICP): Conditions such as idiopathic intracranial hypertension or space-occupying lesions can cause nausea and vomiting, often accompanied by headache and visual disturbances.