Dyspepsia Differential Diagnoses

Dyspepsia, also known as indigestion or upset stomach, can be caused by a variety of factors. Here is a differential diagnosis for dyspepsia, categorized for clarity:

• Single Most Likely Diagnosis
  • Gastroesophageal Reflux Disease (GERD): This is often the most common cause of dyspepsia, characterized by stomach acid frequently flowing back into the tube connecting the mouth and stomach (esophagus). Symptoms include heartburn and acid reflux, which can lead to dyspepsia.
• Other Likely Diagnoses
  • Peptic Ulcer Disease: This includes both gastric and duodenal ulcers, which can cause dyspepsia due to the erosion of the lining of the stomach or the first part of the small intestine.
  • Functional Dyspepsia: Also known as non-ulcer dyspepsia or indigestion, this condition is characterized by recurring signs and symptoms of indigestion that have no obvious cause.
  • Helicobacter pylori Infection: This bacterial infection can lead to peptic ulcers and gastritis, both of which can cause dyspepsia.
• Do Not Miss Diagnoses
  • Gastric Cancer: Although rare, gastric cancer can present with dyspepsia and must be considered, especially in older patients or those with risk factors such as a family history.
  • Pancreatic Cancer: Early stages of pancreatic cancer can cause dyspepsia among other symptoms, making it crucial not to miss this diagnosis.
  • Ischemic Heart Disease: Sometimes, dyspepsia can be a symptom of ischemic heart disease, particularly if the pain is related to eating or exertion.
• Rare Diagnoses
  • Zollinger-Ellison Syndrome: A rare disorder characterized by excessive gastric acid production due to a gastrin-producing tumor, leading to severe peptic ulcers and dyspepsia.
  • Eosinophilic Esophagitis: An inflammatory condition of the esophagus that can cause dysphagia (difficulty swallowing) and sometimes dyspepsia, especially in patients with a history of allergies or asthma.
  • Gastroparesis: A condition where the stomach takes too long to empty its contents, which can cause dyspepsia, nausea, vomiting, and feeling full after eating only a small amount of food.

Each of these diagnoses has distinct characteristics and risk factors, and a thorough medical history, physical examination, and sometimes diagnostic tests are necessary to determine the underlying cause of dyspepsia.