Differential Diagnosis for 74 yo Male with Anorexia, Nausea, and Vomiting
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): The symptoms of anorexia, nausea, and vomiting after food intake, particularly vomiting of saliva, can be indicative of GERD, especially in the context of a normal CBC and unremarkable urinalysis. The ultrasound finding of benign prostatic hyperplasia (BPH) is common in older males and may not directly relate to the gastrointestinal symptoms but is noted.
Other Likely Diagnoses
- Peptic Ulcer Disease: This condition can cause similar symptoms, especially if the ulcers are located in the stomach or duodenum. The vomiting after food intake could be related to irritation of the ulcer by food.
- Gastritis: Inflammation of the stomach lining can lead to nausea, vomiting, and anorexia. It could be caused by various factors, including infection (e.g., H. pylori), medications (e.g., NSAIDs), or other irritants.
- Functional Dyspepsia: This is a condition characterized by recurring signs and symptoms of indigestion that have no obvious cause. Symptoms can include nausea, vomiting, and anorexia, especially after eating.
Do Not Miss Diagnoses
- Gastric Cancer: Although less likely, gastric cancer can present with nonspecific symptoms such as anorexia, nausea, and vomiting. Given the patient's age, it's crucial not to miss this diagnosis, as early detection significantly improves prognosis.
- Pyloric Obstruction: This condition, which can be due to various causes including peptic ulcers, tumors, or other masses, can lead to vomiting after eating. It's a critical diagnosis to consider because it may require urgent intervention.
- Medication-Induced Nausea and Vomiting: Certain medications can cause significant gastrointestinal side effects. Reviewing the patient's medication list is essential to identify any potential culprits.
Rare Diagnoses
- Zollinger-Ellison Syndrome: A rare disorder characterized by excessive gastric acid production due to a gastrin-secreting tumor, leading to severe peptic ulcers and diarrhea or vomiting.
- Eosinophilic Gastroenteritis: A rare condition where eosinophils infiltrate the gastrointestinal tract, potentially causing nausea, vomiting, and abdominal pain.
- Gastroparesis: A condition where the stomach takes too long to empty its contents, which can lead to nausea, vomiting, and anorexia. It can be due to diabetes, post-surgical complications, or other rare conditions.