Differential Diagnosis for Abdominal Pain and Fullness
Single Most Likely Diagnosis
- Gastritis: The patient's symptoms of abdominal pain and fullness that occur only after meals suggest a condition related to the stomach. Gastritis, which is inflammation of the stomach lining, is a common cause of postprandial (after meal) pain and discomfort.
Other Likely Diagnoses
- Peptic Ulcer Disease: Similar to gastritis, peptic ulcers can cause pain that worsens after eating due to the increased acid production in the stomach.
- Gastroesophageal Reflux Disease (GERD): Although GERD typically presents with heartburn, some patients may experience abdominal fullness and pain after meals, especially if the reflux leads to stomach inflammation.
- Functional Dyspepsia: This condition is characterized by recurring signs and symptoms of indigestion that have no obvious cause. Symptoms can include pain or discomfort in the upper abdomen that may be exacerbated by eating.
Do Not Miss Diagnoses
- Appendicitis: Although the pain of appendicitis typically starts near the navel and then moves to the lower right abdomen, it's crucial not to miss this diagnosis due to its potential for severe complications if not treated promptly. The fact that the pain occurs after meals could be coincidental.
- Pancreatitis: Acute pancreatitis can cause severe abdominal pain that may radiate to the back and can be exacerbated by eating, especially fatty foods. Missing this diagnosis could lead to serious complications.
- Intestinal Obstruction: This is a condition where the intestine is partially or completely blocked, which can cause severe abdominal pain, vomiting, and constipation. The pain might seem to worsen after meals if the obstruction leads to increased pressure and discomfort during eating.
Rare Diagnoses
- Gastric Cancer: Although rare, especially in younger populations, gastric cancer can present with postprandial pain and a feeling of fullness due to the tumor's effect on the stomach's ability to expand and accommodate food.
- Zollinger-Ellison Syndrome: A rare disorder characterized by excessive gastric acid secretion due to a gastrin-producing tumor, leading to severe peptic ulcers and diarrhea. The symptoms could include abdominal pain after eating due to the high acid production.
- Eosinophilic Gastroenteritis: A rare condition where eosinophils (a type of white blood cell) infiltrate the gastrointestinal tract, leading to inflammation and symptoms that can include abdominal pain, nausea, and vomiting, potentially worsening after meals.