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Differential Diagnosis for a 72-year-old Female with Nausea, Vomiting, and Diarrhea

Single Most Likely Diagnosis

  • Gastroenteritis: This is the most common cause of nausea, vomiting, and diarrhea in adults, often due to viral or bacterial infections. The patient's age and symptoms align with this diagnosis, making it the most likely.

Other Likely Diagnoses

  • Medication-induced gastrointestinal symptoms: Given the patient's age, she may be on multiple medications, some of which could cause gastrointestinal side effects.
  • Food poisoning: Consuming contaminated food can lead to symptoms of nausea, vomiting, and diarrhea, and this is a common issue in the community.
  • Urinary Tract Infection (UTI): While more commonly associated with dysuria and frequency, UTIs can present with nonspecific symptoms like nausea and vomiting, especially in the elderly.
  • Diverticulitis: Inflammation of the diverticula in the colon can cause nausea, vomiting, and changes in bowel habits, including diarrhea.

Do Not Miss Diagnoses

  • Appendicitis: Although less common in the elderly, appendicitis can present atypically with nausea, vomiting, and diarrhea, rather than the classic right lower quadrant pain.
  • Mesenteric Ischemia: A condition where blood flow to the intestines is blocked, leading to ischemia. It's a surgical emergency that can present with nonspecific abdominal symptoms, including nausea, vomiting, and diarrhea.
  • Bowel Obstruction: A mechanical or functional obstruction of the intestine can cause severe nausea, vomiting, and diarrhea or constipation. It requires prompt diagnosis and treatment.
  • Inflammatory Bowel Disease (IBD) flare: While IBD (Crohn's disease or ulcerative colitis) is more common in younger populations, it can occur at any age, and a flare can present with gastrointestinal symptoms.

Rare Diagnoses

  • Neuroendocrine tumors: Certain tumors, like carcinoid syndrome, can cause diarrhea and flushing, among other symptoms.
  • Thyroid storm: Hyperthyroidism can lead to gastrointestinal symptoms, including nausea, vomiting, and diarrhea, although this is less common.
  • Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic symptoms, including nausea, vomiting, and diarrhea, due to catecholamine surges.
  • Vasculitis: Inflammation of the blood vessels can affect various organs, including the gastrointestinal tract, leading to nonspecific symptoms like nausea, vomiting, and diarrhea.

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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.

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