Differential Diagnosis for Patient Restricting Calories and Self-Inducing Vomit
- Single most likely diagnosis:
- Bulimia Nervosa: This is the most likely diagnosis given the patient's behavior of restricting calories and self-inducing vomit, which are characteristic symptoms of bulimia nervosa, an eating disorder marked by binge eating followed by purging or other compensatory behaviors.
- Other Likely diagnoses:
- Anorexia Nervosa, Purging Type: While anorexia nervosa is primarily characterized by restrictive eating, the purging type involves self-induced vomiting or laxative use, which aligns with the patient's behavior.
- Other Specified Feeding or Eating Disorder (OSFED): This diagnosis applies to individuals who do not meet the full criteria for other eating disorders like bulimia nervosa or anorexia nervosa but still exhibit significant eating disorder symptoms, such as atypical anorexia nervosa or bulimia nervosa of low frequency and/or limited duration.
- Do Not Miss diagnoses:
- Gastrointestinal Disorders (e.g., Gastroparesis, Gastroesophageal Reflux Disease): These conditions can cause nausea and vomiting, which might be mistaken for self-induced vomiting. Missing these diagnoses could lead to untreated underlying conditions causing significant morbidity.
- Diabetes Mellitus: Uncontrolled diabetes can lead to ketoacidosis, which may cause vomiting. Missing this diagnosis could be life-threatening due to the risk of diabetic ketoacidosis.
- Pregnancy: Morning sickness during pregnancy can cause vomiting. Although less likely to be associated with calorie restriction, it's crucial not to miss pregnancy due to the potential for significant health implications for both mother and fetus if not properly managed.
- Rare diagnoses:
- Rumination Syndrome: A condition where food is regurgitated into the mouth without nausea or retching, often re-chewed, and then swallowed again. It's less common and might be considered if other eating disorders have been ruled out.
- Cholecystitis or Other Biliary Disorders: Inflammation of the gallbladder or other biliary disorders can cause vomiting. While less directly related to calorie restriction and self-induced vomiting, these conditions are important to consider due to their potential for severe complications if untreated.