Differential Diagnosis
- Single most likely diagnosis
- Gastroparesis: The patient's symptoms of nausea, vomiting after eating, and feeling full quickly are consistent with gastroparesis. The fact that she has had similar symptoms in the past and that her vomiting is usually clear and yellow, suggesting gastric contents, also supports this diagnosis. The normal lab results, including lipase and CBC, make other acute abdominal conditions less likely.
- Other Likely diagnoses
- Functional dyspepsia: The patient's symptoms of nausea, vomiting, and abdominal pain after eating could also be consistent with functional dyspepsia. The lack of other symptoms such as diarrhea or fever makes this diagnosis plausible.
- Irritable bowel syndrome (IBS): Although the patient denies diarrhea, some patients with IBS can present with nausea and vomiting. The abdominal pain and bloating after eating could also be consistent with IBS.
- Peptic ulcer disease: The patient's symptoms of nausea, vomiting, and abdominal pain could be consistent with peptic ulcer disease. However, the lack of other symptoms such as bleeding or significant weight loss makes this diagnosis less likely.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Appendicitis: Although the patient's symptoms are not typical for appendicitis, the presence of LLQ pain and nausea warrants consideration of this diagnosis. Appendicitis can present atypically, especially in young women.
- Intestinal obstruction: The patient's symptoms of nausea, vomiting, and abdominal pain after eating could be consistent with intestinal obstruction. Although this diagnosis is less likely, it is important to consider due to the potential for serious complications.
- Inflammatory bowel disease: The patient's symptoms of nausea, vomiting, and abdominal pain could be consistent with inflammatory bowel disease. Although the lab results are normal, this diagnosis should be considered due to the potential for serious complications.
- Rare diagnoses
- Cyclic vomiting syndrome: This rare condition is characterized by recurrent episodes of nausea and vomiting. Although the patient's symptoms are consistent with this diagnosis, it is relatively rare and should be considered only after other diagnoses have been ruled out.
- Rumination syndrome: This rare condition is characterized by the regurgitation of food after eating, often accompanied by nausea and vomiting. Although the patient's symptoms are consistent with this diagnosis, it is relatively rare and should be considered only after other diagnoses have been ruled out.
- Eosinophilic gastroenteritis: This rare condition is characterized by inflammation of the stomach and intestines, often accompanied by nausea, vomiting, and abdominal pain. Although the patient's symptoms are consistent with this diagnosis, it is relatively rare and should be considered only after other diagnoses have been ruled out.