Differential Diagnosis for Chronic Vomiting and Diarrhea
Single Most Likely Diagnosis
- Gastroenteritis: This is often the most common cause of chronic vomiting and diarrhea, typically resulting from a viral or bacterial infection. The chronic nature could be due to a prolonged infection or a complication such as a persistent infection or post-infectious irritable bowel syndrome (IBS).
Other Likely Diagnoses
- Irritable Bowel Syndrome (IBS): A common condition characterized by abdominal pain, bloating, and changes in bowel movements, which can include chronic diarrhea and occasional vomiting.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic diarrhea, vomiting, and abdominal pain due to inflammation in the gastrointestinal tract.
- Gastroesophageal Reflux Disease (GERD): While primarily causing heartburn, severe GERD can lead to vomiting, and in some cases, diarrhea, especially if there's an associated condition like gastroparesis.
- Food Intolerances or Allergies: Conditions such as lactose intolerance, gluten intolerance (celiac disease), or food allergies can cause chronic gastrointestinal symptoms including vomiting and diarrhea.
Do Not Miss Diagnoses
- Intestinal Obstruction: Though less common, an obstruction in the intestine can cause severe vomiting and diarrhea, especially if the obstruction is partial. This condition requires immediate medical attention.
- Gastrointestinal Cancer: Though rare, cancers of the stomach, small intestine, or colon can present with chronic vomiting and diarrhea among other symptoms.
- Neuroendocrine Tumors: Certain tumors like gastrinomas or VIPomas can cause severe, chronic diarrhea and vomiting due to excessive hormone production.
- Addison's Disease: A rare endocrine disorder where the adrenal glands do not produce enough cortisol and aldosterone, leading to gastrointestinal symptoms among others.
Rare Diagnoses
- Whipple's Disease: A rare, systemic bacterial infection that can cause chronic diarrhea, vomiting, and malabsorption.
- Eosinophilic Gastroenteritis: A condition characterized by eosinophilic infiltration of the gastrointestinal tract, leading to chronic gastrointestinal symptoms.
- Short Bowel Syndrome: A condition that results from a significant loss of intestinal tissue, leading to malabsorption and chronic diarrhea.
- Congenital Anomalies: Certain congenital conditions of the gastrointestinal tract, though typically diagnosed in infancy, can occasionally present later in life with chronic symptoms.