Differential Diagnosis for Constant Epigastric Pain and Burping
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This condition is characterized by the backflow of stomach acid into the esophagus, leading to symptoms such as epigastric pain and burping. The constant nature of the pain and the association with burping make GERD a highly plausible diagnosis.
Other Likely Diagnoses
- Peptic Ulcer Disease: Both gastric and duodenal ulcers can cause epigastric pain and may be associated with burping, especially if the ulcer is located near the pylorus, affecting gastric emptying.
- Functional Dyspepsia: This condition involves recurring signs and symptoms of indigestion that have no obvious cause. Symptoms can include epigastric pain and burping, among others.
- Gastritis: Inflammation of the stomach lining can cause epigastric pain and may lead to burping due to increased gas production or swallowing air as a response to discomfort.
Do Not Miss Diagnoses
- Myocardial Infarction: Although less common, myocardial infarction (heart attack) can present with epigastric pain, especially in women, diabetics, and the elderly. The pain may be accompanied by other symptoms such as shortness of breath, nausea, or radiating pain.
- Pancreatitis: Acute pancreatitis can cause severe, persistent epigastric pain that may radiate to the back and can be associated with nausea, vomiting, and abdominal tenderness.
- Esophageal Rupture or Perforation: A severe and potentially life-threatening condition that requires immediate medical attention. Symptoms can include severe chest pain, epigastric pain, and difficulty swallowing.
Rare Diagnoses
- Gastric Cancer: Although rare, especially in younger populations, gastric cancer can present with nonspecific symptoms such as epigastric pain, weight loss, and difficulty swallowing.
- Zollinger-Ellison Syndrome: A rare disorder characterized by excessive gastric acid production due to a gastrin-producing tumor, leading to severe peptic ulcers and diarrhea.
- Eosinophilic Esophagitis: A chronic immune system disease in which a type of white blood cell, the eosinophil, builds up in the esophagus in response to an allergen or irritant, leading to difficulty swallowing and food impaction.