Differential Diagnosis for Nausea and Vomiting after Drinking Alcohol
Single Most Likely Diagnosis
- Alcohol Intolerance or Sensitivity: This is the most common reason for nausea and vomiting after alcohol consumption. It occurs when the body is unable to properly break down alcohol due to a deficiency in the enzyme alcohol dehydrogenase or aldehyde dehydrogenase, leading to the accumulation of toxic byproducts.
Other Likely Diagnoses
- Hangover: A hangover is a common condition that occurs after heavy alcohol consumption, characterized by nausea, vomiting, headache, and fatigue. It is caused by dehydration, electrolyte imbalance, and the toxic effects of alcohol and its metabolites.
- Gastroesophageal Reflux Disease (GERD): Alcohol can relax the lower esophageal sphincter, allowing stomach acid to flow back into the esophagus and cause nausea and vomiting.
- Irritable Bowel Syndrome (IBS): Some people with IBS may experience nausea and vomiting after consuming alcohol, possibly due to the irritant effects of alcohol on the bowel.
Do Not Miss Diagnoses
- Alcohol-Induced Pancreatitis: Although less common, pancreatitis is a serious condition that can be triggered by heavy alcohol consumption. Nausea and vomiting are common symptoms, and missing this diagnosis can lead to severe complications.
- Methanol or Ethylene Glycol Poisoning: In cases where the alcohol consumed is contaminated with methanol or ethylene glycol (e.g., moonshine), nausea and vomiting can be symptoms of poisoning. These conditions require immediate medical attention to prevent serious complications, including blindness and death.
- Gastritis or Gastric Ulcer: Excessive alcohol consumption can cause stomach inflammation (gastritis) or ulcers, leading to nausea and vomiting. While not usually life-threatening, these conditions can cause significant morbidity if not treated.
Rare Diagnoses
- Addison's Disease: Rarely, nausea and vomiting after alcohol consumption could be a sign of Addison's disease, a condition where the adrenal glands do not produce enough cortisol and aldosterone. Alcohol can exacerbate the symptoms of this condition.
- Porphyria: This is a group of rare genetic disorders that can cause a range of symptoms, including nausea and vomiting, after alcohol consumption. Alcohol can trigger acute attacks in people with certain types of porphyria.