Differential Diagnosis for Severe Abdominal Pain
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This condition is characterized by stomach acid frequently flowing back into the tube connecting the mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of the esophagus, causing discomfort. The symptoms worsen with eating or drinking, which increases stomach pressure and can cause more acid to reflux into the esophagus.
Other Likely Diagnoses
- Functional Dyspepsia: A term for recurring signs and symptoms of indigestion that have no obvious cause. Symptoms can include pain or discomfort in the upper abdomen, early satiety, and difficulty swallowing. Eating can exacerbate symptoms.
- Irritable Bowel Syndrome (IBS): Although IBS typically presents with altered bowel habits (diarrhea or constipation), some patients may experience abdominal pain that worsens with eating due to increased bowel motility and sensitivity.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause abdominal pain that worsens with eating due to inflammation and irritation of the bowel lining.
Do Not Miss Diagnoses
- Esophageal Perforation: Although rare, an esophageal perforation can present with severe pain that worsens with swallowing. It's a medical emergency requiring prompt intervention.
- Acute Coronary Syndrome: In some cases, myocardial infarction (heart attack) can present with epigastric discomfort or pain that may worsen with eating due to increased demand on the heart. It's crucial to consider cardiac causes, especially in patients with risk factors.
- Mesenteric Ischemia: This condition involves insufficient blood flow to the intestines and can cause severe abdominal pain that may worsen with eating. It's a medical emergency.
Rare Diagnoses
- Eosinophilic Esophagitis: A chronic immune system disease in which a type of white blood cell, the eosinophil, builds up in the esophagus in response to an allergen or irritant. It can cause difficulty swallowing, food impaction, and abdominal pain that worsens with eating certain foods.
- Celiac Disease: An autoimmune disorder where the ingestion of gluten leads to damage in the small intestine. It can cause abdominal pain, diarrhea, and malabsorption, and symptoms can worsen with the consumption of gluten-containing foods.
- Gastric Volvulus: A rare condition where the stomach twists abnormally, which can cause severe abdominal pain, especially after eating. It requires urgent medical attention.