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Differential Diagnosis for Epigastric Pain of 1 Week

Single Most Likely Diagnosis

  • Gastroesophageal Reflux Disease (GERD): This is often the most common cause of epigastric pain due to the reflux of stomach acid into the esophagus, leading to inflammation and pain. The symptoms can include heartburn, regurgitation, and epigastric discomfort.

Other Likely Diagnoses

  • Peptic Ulcer Disease: Both gastric and duodenal ulcers can cause epigastric pain, which may be exacerbated by eating or relieved by antacids. The pain is typically a burning or gnawing sensation.
  • Functional Dyspepsia: This condition is characterized by recurring signs and symptoms of indigestion that have no obvious cause. Symptoms can include epigastric pain or discomfort, early satiety, and difficulty swallowing, among others.
  • Gastritis: Inflammation of the stomach lining can cause epigastric pain, nausea, vomiting, and a feeling of fullness. It can be acute or chronic and has various causes, including infection, alcohol, and medications.

Do Not Miss Diagnoses

  • Myocardial Infarction: Although less common, myocardial infarction (heart attack) can present with epigastric pain, especially in women, diabetics, and the elderly. It's crucial to consider this diagnosis due to its high mortality rate if missed.
  • Pancreatitis: Both acute and chronic pancreatitis can cause severe epigastric pain, which may radiate to the back. Other symptoms include nausea, vomiting, and abdominal tenderness.
  • Cholecystitis: Inflammation of the gallbladder can cause right upper quadrant or epigastric pain, especially after eating fatty foods. It's essential to consider this diagnosis due to the potential for complications like perforation.

Rare Diagnoses

  • Gastric Cancer: Although rare, gastric cancer can present with epigastric pain, weight loss, and difficulty swallowing. It's more common in certain populations and those with a family history.
  • Esophageal Spasm: This condition involves abnormal muscle contractions of the esophagus, which can cause chest pain or epigastric discomfort that may mimic cardiac or gastrointestinal issues.
  • Inflammatory Bowel Disease (IBD): While more commonly associated with lower gastrointestinal symptoms, Crohn's disease and ulcerative colitis can occasionally present with upper GI symptoms, including epigastric pain, especially if the stomach or duodenum is involved.

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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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