Differential Diagnosis for Abdominal Pain and Fullness
The patient presents with 5 days of abdominal pain and fullness, with symptoms worsening after meals. Here's a categorized differential diagnosis:
- Single Most Likely Diagnosis
- Gastritis or Peptic Ulcer Disease: The symptoms of abdominal pain and nausea after meals are classic for gastritis or peptic ulcer disease. The timing of the symptoms in relation to meals suggests an issue with the stomach or duodenum.
- Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): Although GERD typically presents with heartburn and regurgitation, some patients may experience abdominal pain and nausea after eating, especially if they have a large or heavy meal.
- 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, bloating, and nausea after eating.
- Cholecystitis or Cholelithiasis: Inflammation of the gallbladder or gallstones can cause abdominal pain, especially after fatty meals, which can trigger gallbladder contraction.
- Do Not Miss Diagnoses
- Appendicitis: Although the pain typically starts near the navel and then moves to the lower right abdomen, atypical presentations can occur, and missing appendicitis can lead to severe consequences.
- Pancreatitis: Acute pancreatitis can present with abdominal pain that worsens after eating, especially fatty foods. It's a serious condition that requires prompt diagnosis and treatment.
- Intestinal Obstruction: This is a life-threatening condition that can cause abdominal pain, nausea, and vomiting. Although it typically presents with more severe symptoms, early or partial obstruction might have a more subtle presentation.
- Rare Diagnoses
- Zollinger-Ellison Syndrome: A rare disorder characterized by excessive gastric acid production due to a gastrin-producing tumor, leading to severe peptic ulcer disease and diarrhea.
- Abdominal Migraine: A condition that presents with recurrent episodes of abdominal pain, often accompanied by other symptoms like nausea, vomiting, and headache, similar to migraine headaches.
- Eosinophilic Gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, leading to abdominal pain, nausea, and vomiting, often related to food allergies or sensitivities.
Each of these diagnoses should be considered based on the patient's specific presentation, medical history, and additional diagnostic findings.