Differential Diagnosis for Stomach Pain after Gastroscopy

Single Most Likely Diagnosis

• Gastroscopy-induced gastric irritation or mucosal trauma: This is the most likely cause of stomach pain after a gastroscopy, as the procedure involves the insertion of an endoscope into the stomach, which can cause irritation or minor trauma to the gastric mucosa.

Other Likely Diagnoses

• Gastroesophageal reflux disease (GERD) exacerbation: The procedure may temporarily disrupt the normal functioning of the lower esophageal sphincter, leading to increased reflux and stomach pain.
• Bloating and discomfort due to air insufflation: During gastroscopy, air is insufflated into the stomach to provide a clear view, which can lead to bloating and discomfort after the procedure.
• Procedure-related anxiety or stress: Anxiety or stress related to the procedure can manifest as stomach pain or discomfort.

Do Not Miss Diagnoses

• Perforation of the stomach or esophagus: Although rare, perforation is a serious complication of gastroscopy that requires immediate medical attention. Symptoms can include severe abdominal pain, fever, and signs of peritonitis.
• Bleeding: Bleeding can occur due to biopsy or the procedure itself, and while it's usually minor, it can be severe and life-threatening in some cases.
• Infection: Introduction of bacteria during the procedure can lead to infection, which is more likely in patients with certain underlying conditions.

Rare Diagnoses

• Mallory-Weiss syndrome: This condition involves tears in the mucous membrane or lining of the lower end of the esophagus, where it connects to the stomach, which can be caused by the gastroscopy procedure.
• Pneumoperitoneum: Air in the abdominal cavity, which can occur if there is a perforation during the procedure, is a rare but serious complication.
• Allergic reaction to the sedation or disinfectants used: While rare, an allergic reaction to any of the substances used during the gastroscopy can cause a range of symptoms, including stomach pain.