Differential Diagnosis for Chronic Nausea and Vomiting
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This is a common condition where stomach acid frequently flows back into the tube connecting the mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of the esophagus, causing discomfort. Chronic nausea and vomiting are typical symptoms, making GERD a likely diagnosis.
Other Likely Diagnoses
- Gastroparesis: A condition where the stomach takes too long to empty its contents. This delay can cause nausea, vomiting, and feeling full after eating only a small amount of food, making it a plausible cause for chronic nausea and vomiting.
- Functional Dyspepsia: Also known as non-ulcer stomach pain or indigestion, this condition is characterized by recurring signs and symptoms of indigestion that have no obvious cause. Symptoms can include chronic nausea and vomiting.
- Irritable Bowel Syndrome (IBS): While primarily known for causing abdominal pain and changes in bowel movements, some individuals with IBS may experience nausea and vomiting, especially if their condition is not well-managed.
Do Not Miss Diagnoses
- Appendicitis: Although appendicitis typically presents with acute abdominal pain, nausea, and vomiting, in some cases, the symptoms can be more chronic, especially if the appendix is not completely blocked. Missing this diagnosis can lead to severe complications, including perforation.
- Intestinal Obstruction: A blockage that prevents the normal flow of the products of digestion (including food, fluid, and gas) in the intestines can cause severe nausea and vomiting. This condition requires immediate medical attention.
- Pancreatitis: Inflammation of the pancreas can cause chronic nausea and vomiting, among other symptoms. Both acute and chronic pancreatitis can have severe consequences if not properly managed.
- Brain Tumors: Certain brain tumors, especially those affecting the brainstem or cerebellum, can cause chronic nausea and vomiting due to increased intracranial pressure or direct effects on the vomiting centers in the brain.
Rare Diagnoses
- Cyclic Vomiting Syndrome: A rare disorder characterized by recurring episodes of severe nausea and vomiting. These episodes can be similar to those experienced during migraine headaches and may be related to migraine activity in some individuals.
- Eosinophilic Gastroenteritis: A rare condition where eosinophils (a type of white blood cell) accumulate in the gastrointestinal tract, leading to inflammation and symptoms that can include chronic nausea and vomiting.
- Superior Mesenteric Artery Syndrome: A rare condition where the duodenum (the first part of the small intestine) is compressed between the abdominal aorta and the superior mesenteric artery, leading to chronic nausea, vomiting, and abdominal pain.