Differential Diagnosis for Abdominal Pain and Vomiting Relieved by Eating

Single Most Likely Diagnosis

• Duodenal Ulcer: The pain being relieved after eating is a classic symptom of duodenal ulcers. Food buffers the acid in the stomach, providing temporary relief from the ulcer pain.

Other Likely Diagnoses

• Gastric Ulcer: Although less common than duodenal ulcers for symptoms to be relieved by eating, some gastric ulcers can present with similar symptoms, especially if the ulcer is located in a position where food can provide a buffering effect.
• Gastroesophageal Reflux Disease (GERD): While GERD typically worsens with eating, especially after consuming trigger foods, some patients may experience relief from symptoms after eating due to the buffering effect of food on stomach acid.
• Functional Dyspepsia: This condition involves recurring signs and symptoms of indigestion that have no obvious cause. Symptoms can sometimes be alleviated by eating, though this is less consistent than with peptic ulcers.

Do Not Miss Diagnoses

• Gastric Cancer: Although rare, gastric cancer can present with similar symptoms, including relief from eating due to the mechanical buffering of the tumor by food. Missing this diagnosis could be fatal.
• Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease can sometimes present with abdominal pain that may seem to improve with eating due to the anti-inflammatory effects of certain nutrients or the temporary distraction from pain.
• Mesenteric Ischemia: This condition involves poor blood flow to the intestine and can cause abdominal pain after eating due to increased demand for blood flow. However, in some cases, the pain might seem to improve temporarily after eating due to other factors, making it a critical diagnosis not to miss.

Rare Diagnoses

• Zollinger-Ellison Syndrome: A rare disorder characterized by excessive gastric acid production due to a gastrin-producing tumor. Symptoms can include abdominal pain and vomiting, which might be temporarily relieved by eating due to the buffering effect of food.
• Eosinophilic Gastroenteritis: A rare condition involving eosinophilic infiltration of the gastrointestinal tract, which can cause abdominal pain, vomiting, and other symptoms. The relationship between eating and symptom relief can vary.