Differential Diagnosis for Vomiting after Meals with Abdominal Pain

Single Most Likely Diagnosis

• Gastroesophageal Reflux Disease (GERD): This condition is characterized by the backflow of stomach acid into the esophagus, leading to symptoms like vomiting after meals and abdominal pain. The proximity of symptoms to meal times and the nature of the pain (often described as burning) support this diagnosis.

Other Likely Diagnoses

• Peptic Ulcer Disease: Ulcers in the stomach or duodenum can cause abdominal pain and vomiting, especially after eating. The pain is typically localized to the upper abdomen and can be exacerbated by food.
• Gastritis: Inflammation of the stomach lining can lead to vomiting and abdominal pain after meals. Gastritis can be acute or chronic and has various causes, including infection, medication, and alcohol use.
• Functional Dyspepsia: This condition involves recurring signs and symptoms of indigestion that have no obvious cause. Symptoms can include vomiting and abdominal pain after eating.

Do Not Miss Diagnoses

• Appendicitis: Although appendicitis typically presents with pain that migrates to the lower right abdomen, it can occasionally cause upper abdominal pain and vomiting, especially in the early stages. Missing this diagnosis can lead to severe consequences, including perforation.
• Intestinal Obstruction: This is a blockage that prevents the normal flow of the products of digestion, including food, fluid, and gas. Symptoms can include vomiting and abdominal pain, and it requires immediate medical attention.
• Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain and vomiting. The pain is often constant and can radiate to the back.

Rare Diagnoses

• Zollinger-Ellison Syndrome: A rare disorder characterized by excessive gastric acid secretion due to a gastrin-producing tumor, leading to severe peptic ulcers, diarrhea, and abdominal pain.
• Eosinophilic Gastroenteritis: A rare condition where eosinophils infiltrate the gastrointestinal tract, causing inflammation and leading to symptoms like vomiting and abdominal pain after eating.
• Gastric Cancer: Although rare, especially in younger populations, gastric cancer can present with nonspecific symptoms like vomiting after meals and abdominal pain. It's more common in certain geographic areas and with specific risk factors.