Differential Diagnosis for Abdomen Pain after Meal

Single most likely diagnosis

• Gastroesophageal Reflux Disease (GERD): This condition is characterized by stomach acid frequently flowing back into the tube connecting the mouth and stomach (esophagus). Symptoms often worsen after eating, making it a common cause of postprandial abdominal pain.

Other Likely diagnoses

• Peptic Ulcer Disease: Ulcers in the stomach or duodenum can cause pain that worsens after meals due to increased acid production.
• Irritable Bowel Syndrome (IBS): Although the pain pattern can vary, some individuals with IBS experience worsening symptoms after eating, possibly due to food intolerance or sensitivity.
• Gallstones: Gallstones can cause biliary colic, which may be triggered by fatty meals, leading to right upper quadrant abdominal pain.
• Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause abdominal pain that may be exacerbated by eating.

Do Not Miss (ddxs that may not be likely, but would be deadly if missed)

• Acute Mesenteric Ischemia: A sudden onset of abdominal pain after meals could be indicative of mesenteric ischemia, a condition where blood flow to the intestines is blocked, leading to tissue death. It's a medical emergency.
• Pancreatitis: Acute pancreatitis can cause severe abdominal pain that may radiate to the back and worsen after eating, especially fatty foods.
• Appendicitis: While appendicitis typically presents with pain that initially is diffuse or around the navel and then localizes to the right lower quadrant, it can occasionally be triggered by meals and must be considered in the differential diagnosis to avoid missing this surgical emergency.

Rare diagnoses

• Eosinophilic Gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, which can cause abdominal pain, nausea, and vomiting after eating.
• Celiac Disease: An autoimmune disorder where the ingestion of gluten leads to damage in the small intestine, causing abdominal pain, diarrhea, and malabsorption.
• Intestinal Obstruction: Although more commonly associated with vomiting and absolute constipation, early signs can include abdominal pain after meals due to the partial obstruction of the intestine.