Differential Diagnosis for a 25-year-old with Stomach Pain, Nausea, and Vomiting
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This condition is characterized by stomach acid frequently flowing back into the tube connecting the mouth and stomach (esophagus). Symptoms worsen with eating, especially after consuming trigger foods or drinks, aligning with the patient's presentation.
Other Likely Diagnoses
- Peptic Ulcer Disease: Ulcers in the stomach or duodenum can cause pain that worsens with eating due to the increased acid production. Nausea and vomiting may also be present.
- Gastritis: Inflammation of the stomach lining can lead to pain, nausea, and vomiting, which may be exacerbated by food intake.
- Irritable Bowel Syndrome (IBS): Although IBS primarily affects the large intestine, some patients may experience upper gastrointestinal symptoms like nausea and vomiting, especially if they have a subtype that involves upper GI symptoms.
Do Not Miss Diagnoses
- Appendicitis: Although appendicitis typically presents with pain that initially is diffuse or around the navel and then localizes to the lower right abdomen, atypical presentations can occur, especially in young women. It's crucial to consider this diagnosis due to the potential for severe consequences if missed.
- Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain, nausea, and vomiting. The pain often radiates to the back and can be exacerbated by eating, particularly fatty foods.
- Intestinal Obstruction: A blockage in the intestine can lead to severe abdominal pain, nausea, vomiting, and constipation. This is a medical emergency that requires prompt diagnosis and treatment.
Rare Diagnoses
- Zollinger-Ellison Syndrome: A rare disorder characterized by excessive gastric acid production due to a gastrin-producing tumor, leading to severe peptic ulcers, diarrhea, and abdominal pain.
- Gastric Cancer: Although rare in young individuals, gastric cancer can present with nonspecific symptoms like abdominal pain, nausea, and vomiting, especially in advanced stages.
- Inflammatory Bowel Disease (Crohn's Disease or Ulcerative Colitis): While these conditions primarily affect the lower GI tract, they can have upper GI manifestations and should be considered, especially if other symptoms like diarrhea, weight loss, or blood in stool are present.