Differential Diagnosis for 19yo Female with Intermittent, Persistent Vomiting and Bloating after Meals

• Single Most Likely Diagnosis
  • Irritable Bowel Syndrome (IBS): This condition is characterized by recurrent abdominal pain associated with a change in bowel habits, such as diarrhea or constipation, and bloating. The symptoms can be triggered by meals, stress, or other factors, making it a common diagnosis for young adults presenting with these symptoms.
• Other Likely Diagnoses
  • Functional Dyspepsia: This disorder involves persistent or recurrent upper abdominal pain or discomfort that is not exclusively relieved by defecation or associated with the onset of a bowel movement. It can also include symptoms like bloating and nausea, especially after eating.
  • Gastroesophageal Reflux Disease (GERD): Although more commonly associated with heartburn, GERD can also cause nausea and vomiting, especially after meals, due to the reflux of stomach contents into the esophagus.
  • Gastroparesis: A condition where the stomach takes too long to empty its contents, leading to nausea, vomiting, bloating, and discomfort after eating. It can be idiopathic or secondary to other conditions like diabetes.
• Do Not Miss Diagnoses
  • Appendicitis: Although the classic presentation involves acute abdominal pain, nausea, and vomiting, atypical presentations can occur, especially in young women. It's crucial to consider appendicitis due to its potential for severe complications if not promptly treated.
  • Intestinal Obstruction: This is a life-threatening condition that can present with vomiting, abdominal pain, and bloating. Early diagnosis is critical to prevent complications.
  • Ectopic Pregnancy: In women of childbearing age, an ectopic pregnancy must be considered, especially if there's a possibility of pregnancy. It can present with abdominal pain, nausea, and vomiting.
• Rare Diagnoses
  • Celiac Disease: An autoimmune disorder where the ingestion of gluten leads to damage in the small intestine, causing symptoms like bloating, abdominal pain, diarrhea, and sometimes vomiting after eating gluten-containing foods.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can present with a variety of gastrointestinal symptoms, including vomiting and bloating, although they are more commonly associated with diarrhea and weight loss.
  • Mitochondrial Neurogastrointestinal Encephalomyopathy (MNGIE): A rare genetic disorder affecting the mitochondria, leading to gastrointestinal dysmotility, among other symptoms, which can include severe vomiting and bloating.