Differential Diagnosis

The patient's symptoms of difficulty retaining food, dry heaving, and persistent stomachache suggest a gastrointestinal issue. Here is a differential diagnosis organized into categories:

• Single Most Likely Diagnosis
  • Gastroparesis: This condition is characterized by delayed gastric emptying, which can cause nausea, vomiting, and difficulty eating. The patient's ability to tolerate small portions of food and symptoms of dry heaving after eating support this diagnosis.
• Other Likely Diagnoses
  • Functional dyspepsia: This condition is marked by recurring signs and symptoms of indigestion that have no obvious cause. The patient's persistent stomachache and difficulty eating could be indicative of functional dyspepsia.
  • Gastroesophageal reflux disease (GERD): Although the patient does not report typical symptoms of heartburn, GERD can cause nausea and vomiting, especially after eating.
  • Peptic ulcer disease: The patient's stomachache and difficulty eating could be symptoms of a peptic ulcer, especially if it is located in the stomach or duodenum.
• Do Not Miss Diagnoses
  • Gastric cancer: Although less likely, gastric cancer can cause symptoms similar to those experienced by the patient, including difficulty eating and weight loss. It is essential to rule out this diagnosis due to its severity.
  • Intestinal obstruction: The patient's symptoms of dry heaving and difficulty eating could be indicative of a partial intestinal obstruction, which requires prompt medical attention.
  • Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause gastrointestinal symptoms, including abdominal pain, nausea, and vomiting.
• Rare Diagnoses
  • Celiac disease: This autoimmune disorder can cause gastrointestinal symptoms, including abdominal pain, nausea, and vomiting, after consuming gluten.
  • Eosinophilic gastroenteritis: This rare condition is characterized by eosinophilic infiltration of the gastrointestinal tract, leading to symptoms like abdominal pain, nausea, and vomiting.
  • Superior mesenteric artery syndrome: This rare condition occurs when the duodenum is compressed between the abdominal aorta and the superior mesenteric artery, causing symptoms like nausea, vomiting, and abdominal pain.