Differential Diagnosis for Vomiting in a 10-year-old Child
Single Most Likely Diagnosis
- Gastroesophageal reflux disease (GERD): This condition is common in children and can cause chronic vomiting due to the reflux of stomach acid into the esophagus. The symptoms can persist for more than a month, fitting the timeline provided.
Other Likely Diagnoses
- Gastroenteritis: Although typically an acute condition, some cases of gastroenteritis can have a prolonged course, especially if caused by certain pathogens or if there are complications.
- Food intolerance or allergy: Conditions such as lactose intolerance or a food allergy could lead to chronic vomiting after consuming specific foods.
- Functional gastrointestinal disorders: Disorders like cyclic vomiting syndrome or functional dyspepsia can cause recurrent or chronic vomiting without an identifiable cause.
Do Not Miss Diagnoses
- Appendicitis: Although appendicitis typically presents acutely, atypical presentations can occur, especially in younger children. Chronic or intermittent vomiting could be a symptom in some cases.
- Type 1 Diabetes: Uncontrolled diabetes can lead to diabetic ketoacidosis, which may present with vomiting among other symptoms.
- Ingestion or poisoning: Chronic exposure to toxins or substances that cause vomiting is a critical consideration to avoid missing a potentially life-threatening condition.
- Brain tumors or increased intracranial pressure: These conditions can cause vomiting, often worse in the morning, due to increased pressure within the skull.
Rare Diagnoses
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic vomiting among other gastrointestinal symptoms, although they are less common in children.
- Gastroparesis: A condition characterized by delayed stomach emptying, which can cause chronic vomiting, especially after meals.
- Mitochondrial disorders: Certain mitochondrial diseases can affect the gastrointestinal system and cause chronic vomiting among a myriad of other symptoms.