Differential Diagnosis for Abdominal Pain

The patient presents with abdominal pain that worsens after eating, inability to tolerate oral intake, nausea, vomiting, and bloatedness. Here's a categorized differential diagnosis:

• Single Most Likely Diagnosis
  • Gastroenteritis: This condition is characterized by inflammation of the gastrointestinal tract, often due to viral or bacterial infections. Symptoms such as abdominal pain, nausea, vomiting, and bloatedness are common, especially after eating, which can irritate the stomach further.
• Other Likely Diagnoses
  • Peptic Ulcer Disease: Ulcers in the stomach or duodenum can cause abdominal pain that worsens after eating, especially if the food is spicy, fatty, or acidic. Nausea and vomiting can also occur.
  • Gastritis: Inflammation of the stomach lining can lead to symptoms similar to gastroenteritis, including pain after eating and difficulty tolerating food.
  • Irritable Bowel Syndrome (IBS): Although IBS is more chronic, an acute exacerbation could present with these symptoms, especially if the patient has a history of the condition.
• Do Not Miss Diagnoses
  • Appendicitis: While the pain of appendicitis typically starts near the navel and then moves to the lower right abdomen, it can sometimes present atypically, especially in children or the elderly. Vomiting and nausea are common, and the condition requires urgent surgical attention.
  • Intestinal Obstruction: This is a life-threatening condition where the intestine is partially or completely blocked, which can cause severe abdominal pain, vomiting, and constipation. The inability to tolerate oral intake is a key symptom.
  • Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain that radiates to the back, worsens after eating, and is accompanied by nausea and vomiting.
• Rare Diagnoses
  • Mesenteric Ischemia: A condition where the blood flow to the intestines is blocked, leading to tissue death. It presents with severe abdominal pain out of proportion to the physical examination, and can be accompanied by nausea, vomiting, and bloatedness.
  • Inflammatory Bowel Disease (IBD) Flare: Conditions like Crohn's disease or ulcerative colitis can have acute exacerbations that present with these symptoms, although they are typically seen in patients with a known history of IBD.

Each of these diagnoses has a distinct set of symptoms and risk factors, and a thorough history, physical examination, and diagnostic tests are necessary to determine the underlying cause of the patient's symptoms.