Differential Diagnosis

The patient presents with gastrointestinal issues and neck and arm pain. Here's a breakdown of the differential diagnosis:

• Single most likely diagnosis:

  • Gastroesophageal reflux disease (GERD) for the gastrointestinal symptoms, given the heartburn, chest pain relieved by burping, and gas and bloating after meals, especially with raw vegetables and dairy. For the neck and arm pain, Cervical Radiculopathy or a Musculoskeletal Issue seems likely, considering the pain in the left neck muscle, tingling or numbness down the left arm, and the description of pain as a straight line.

• Other Likely diagnoses:

  • Irritable Bowel Syndrome (IBS) could also explain the gastrointestinal symptoms, especially given the regular bowel movements and the relation of symptoms to specific food groups.
  • Functional Dyspepsia might be considered for the post-meal bloating and discomfort.
  • For the neck and arm pain, Thoracic Outlet Syndrome could be a possibility, given the nature of the pain and numbness, although the absence of pulsing in arteries makes vascular causes less likely.

• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):

  • Myocardial Infarction (MI) or Acute Coronary Syndrome: Although the chest pain does not fully rise to the throat and is relieved by burping, which is atypical for MI, cardiac causes must always be considered, especially in patients with risk factors.
  • Esophageal rupture or perforation could present with severe chest pain and must be ruled out, especially if there's a history of severe vomiting or other predisposing factors.
  • For the neck and arm pain, Cervical Spine Fracture or Dislocation, and less commonly, Spinal Cord Infarction, are critical diagnoses not to miss, especially if there's a history of trauma.

• Rare diagnoses:

  • Eosinophilic Esophagitis could be considered for the gastrointestinal symptoms, especially if there's an atopic history, given the difficulty in swallowing and food impaction, though not directly mentioned here.
  • Gastric Volvulus or Diaphragmatic Hernia could cause similar gastrointestinal symptoms but are less common.
  • For the neck and arm pain, Pancoast Tumor (a type of lung cancer) could be a rare cause, presenting with shoulder and arm pain due to invasion of the brachial plexus, though this would typically be accompanied by other symptoms like weight loss and cough.