Differential Diagnosis for 15-year-old with Abdominal Pains and Vomiting

Single Most Likely Diagnosis

• Functional Dyspepsia: This condition is characterized by recurrent abdominal pain or discomfort in the upper abdomen, often related to eating, which seems to fit the patient's symptoms of abdominal pain after meals followed by vomiting. The pain relief after vomiting could be due to the temporary reduction in abdominal pressure and the removal of irritating substances from the stomach.

Other Likely Diagnoses

• Gastroesophageal Reflux Disease (GERD): Symptoms of GERD can include abdominal pain and vomiting after eating, especially if the food triggers reflux. The pain and vomiting could be a result of stomach acid flowing back into the esophagus.
• Peptic Ulcer Disease: Although less common in teenagers, peptic ulcers can cause abdominal pain related to eating, followed by relief after vomiting, which might reduce stomach acid temporarily.
• Irritable Bowel Syndrome (IBS): While IBS more commonly presents with altered bowel habits, some patients may experience upper abdominal pain and vomiting, especially if they have a predominance of upper GI symptoms.

Do Not Miss Diagnoses

• Appendicitis: Although the symptoms don't perfectly align with the classic presentation of appendicitis (which typically starts with periumbilical pain that migrates to the lower right abdomen), atypical presentations can occur, especially in younger patients. The potential for severe consequences if missed (e.g., perforation) makes it crucial to consider.
• Intestinal Obstruction: This condition can cause severe abdominal pain and vomiting. The pattern of pain and vomiting after eating could be consistent with a partial obstruction, where food intake exacerbates the obstruction.
• Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can present with chronic abdominal pain, vomiting, and other gastrointestinal symptoms. Early diagnosis is crucial for effective management.

Rare Diagnoses

• Gastric Volvulus: A rare condition where the stomach twists abnormally, which can cause severe abdominal pain and vomiting after eating.
• Eosinophilic Gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, which can cause abdominal pain, vomiting, and other gastrointestinal symptoms.
• Celiac Disease: An autoimmune reaction to gluten, leading to small intestine damage, which can cause abdominal pain, vomiting, and other symptoms after eating gluten-containing foods.

Each of these diagnoses should be considered and investigated based on the patient's specific symptoms, medical history, and physical examination findings, with appropriate diagnostic tests ordered as necessary.