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DDxPro
Possible Diagnoses
Gastroparesis
Gastroparesis
Nausea
Upper abdominal pain
Easy satiety
Pain with sleeping
Mild bloating
Gastric residual in four hours
Vomiting
Exacerbate after eating
Bloating
Postprandial fullness
Weight loss
Epigastric pain
Postprandial nausea
Abdominal discomfort
Burning sensation
Crampy sensation
Epigastric distention
Epigastric tenderness
Gastric retention
Localized pain
Gastric outlet obstruction
Gastric outlet obstruction
Epigastric pain
Vomiting
Increase of postprandial abdominal pain
Succussion splash
Nausea
Weight loss
Early satiety
Bloating
Malnutrition
Hypochloremic metabolic alkalosis
Hypokalemic hypochloremic metabolic alkalosis
Recurrent vomiting
Presence of chronic dehydration
Dilated stomach
Epigastric tympanitic mass
Left upper quadrant tympanitic mass
Palpable abdominal mass
Gastroenteritis
Mucosal eosinophilic gastroenteritis
Diarrhea
Early satiety
Nausea
Vomiting
Abdominal bleeding
Acute onset of gastrointestinal bleeding
Black stool
Bleeding episodes
Blood in the vomitus
Colitis
Gi bleeding
Hemorrhagic complications
Melena
Occult blood
Stool guaiac-positive
Tarry stool
Bloody diarrhea
Discomfort or pain in upper belly
Discomfort or pain near the ribs
Upset stomach
Dyspepsia
Dyspepsia
Burning
Early satiety
Epigastric pain
No evidence of structural disease to explain the symptoms
Postprandial fullness
Symptom onset at least six months
Discomfort or pain in upper belly
Ribs area pain
Upper belly disomfort
Upper belly pain
Upset stomach
Fullness
Last three months
Meal related
Bloating
Abdominal discomfort
Centered in the upper abdomen
Epigastric pain syndrome
Persistent abdominal pain
Postprandial distress syndrome
Peptic ulcer
Acute peptic ulcer
Awakes from sleep
Relief with anti secretory agents
Abdominal pain
Intense pain
More localized pain
Recurs when stomach is empty
Sudden onset
When stomach is empty
Burning pain
Upper abdomen discomfort
At night
Epigastric pain
Hunger-like pain
Sudden severe abdominal pain
Relieved by eating
Relief with antiacid
Awakes the patient from sleep
Hematochezia
Vomiting
Diffused
Peptic ulcer
Centered in epigastrium
Epigastric pain
Awakes the patient from sleep
Relief with anti secretory agents
Recurs when stomach is empty
Burning pain
Upper abdomen discomfort
At night
Relieved by eating
Relief with antiacid
Gnawing pain
Worsens with eating
Dyspepsia
Patient show site of pain with one finger
Vomiting after eating
Radiate to back
Meal related
Recurrent abdominal pain
Weight loss
Anorexia
Duodenal ulcer
Awakes from sleep
Relief with anti secretory agents
Recurs several hours after a meal
Recurs when stomach is empty
When stomach is empty
Burning pain
Upper abdomen discomfort
At night
Epigastric pain
Hunger-like pain
Relieved by eating
Relief with antiacid
Awakes the patient from sleep
Vomiting after eating
Radiate to back
Meal related
Epigastric tenderness
Nausea relieved by eating
Severe abdominal pain
Discomfort or pain in upper belly
Gastric ulcer
Awakes from sleep
Relief with anti secretory agents
Recurs when stomach is empty
When stomach is empty
Burning pain
Upper abdomen discomfort
At night
Epigastric pain
Hunger-like pain
Relieved by eating
Relief with antiacid
Awakes the patient from sleep
Discomfort or pain in upper belly
Discomfort or pain near the ribs
Upset stomach
three months
Diarrhea
Burning
Symptom onset at least six months
Abdominal pain
Systemic lupus erythematosus
Systemic lupus erythematosus
Arthralgia
Myalgia
Fatigue
Fever
Arthritis
Arthritis in hands
Arthritis in knees
Arthritis in wrists
Intermittent arthritis
Migratory arthritis
Nonerosive arthritis
Polyarticular arthritis
Symmetrical arthritis
Tenderness in joints
Tenderness in tendons
Anorexia
Malaise
Weight loss
Photosensitivity
Malar rash
Ulcerative colitis
Ulcerative colitis
Rectal bleeding
Chronic diarrhea
Frequent discharge of mucus
Frequent diarrhea
Gross bleeding
Diarrhea
Physical signs of proctitis
Frequent bloody diarrhea
Feeling of incomplete evacuation
Abdominal tenderness
Bloody stools
Malnutrition
Weight loss
Constipation
Abdominal pain
Fever
Bloody diarrhea
Cramping abdominal pain
Pallor
Erythema nodosum
Brucellosis
Brucellosis
Lethargy
Sweating
Weight loss
Arthralgia
Chills
Fever
Acute febrile illness
Night sweats
Joint swelling
Joint tenderness
Arthlargia
Arthlargia of hips
Arthlargia of knees
Arthlargia of spine
Malaise
Joint bursitis
Intermittent back pain
Pallor
Conjuctival contact with infected brucella material
Inhalation of infected aerosols
Alcoholic liver disease
Alcoholic liver disease
Anorexia
Fatigue
Fever
Jaundice
Nausea
Right upper quadrant abdominal discomfort
Vomiting
Weight loss
Digital clubbing
Palmar erythema
Ascites
Splenomegaly
Asterixis
Confusion
Dupuytren contractures
Gynecomastia
Hematemesis
Leg swelling
Weight gain
Gastrointestinal bleeding
Involuntary Weight Loss
Recent institution of diuretic
Observe Repeat weight at 1–2 mo
Stable weight
Usual follow-up
Documented further IWL
Complete history, mental status, examination, diet and appetite, routine cancer screening tests
Preexisting chronic illness known to cause IWL
Reevaluate and optimize therapy
Review prescription and over-the-counter medications for anorectic side effects
Eliminate or modify offending medications
History or examination findings suggestive of illnesses known to cause IWL
Focus evaluation directed by abnormal findings
No history or examination findings suggestive of cause
CBC, SMA 12 Urinalysis Thyroid-stimulating hormone level Chest x-ray Stool guaiacs
Normal findings(CBC,SMA...)
More detailed psychosocial history: Screen for depression, anxiety, eating disorders...
Probable psychosocial cause detected
Treat Appropriate(psychosocial cause)
No abnormalities detected(psychosocial cause)
Unexplained IWL
Follow at close intervals (high risk)
Abnormal findings(CBC,SMA...)
Follow-up abnormal values
No recent institution of diuretic
Complete history, mental status, examination, diet and appetite, routine cancer screening tests
Preexisting chronic illness known to cause IWL
Reevaluate and optimize therapy
Review prescription and over-the-counter medications for anorectic side effects
Eliminate or modify offending medications
History or examination findings suggestive of illnesses known to cause IWL
Focus evaluation directed by abnormal findings
No history or examination findings suggestive of cause
CBC, SMA 12 Urinalysis Thyroid-stimulating hormone level Chest x-ray Stool guaiacs
Normal findings(CBC,SMA...)
More detailed psychosocial history: Screen for depression, anxiety, eating disorders...
Probable psychosocial cause detected
Treat Appropriate(psychosocial cause)
No abnormalities detected(psychosocial cause)
Unexplained IWL
Follow at close intervals (high risk)
Abnormal findings(CBC,SMA...)
Follow-up abnormal values
Nausea and Vomiting
History, PE, Laboratory evaluation
Assess for mechanical obstruction, peritonitis, dehydration, or bleeding
YES (mechanical obstruction, peritonitis, dehydration, or bleeding)
Replace fluids, Consider hospitalization
NO (mechanical obstruction, peritonitis, dehydration, or bleeding)
Regurgitation of undigested food? rumination, esophageal stricture, Zenker’s diverticulitis
Assess for pharmacologic or toxic causes
YES (pharmacologic or toxic causes)
Discontinue offending agent Treat toxicity
NO (pharmacologic or toxic causes)
Constant or recurrent, intermittent
Consider: Migraines, Seizure disorder, Cyclic vomiting, CNS lesions
Duration < 1 wk
Consider: Food poisoning, Gastroenteritis
Fluid and electrolyte replacement, observation, antiemetics
Duration > 7 days
Predominantly AM vomiting
Consider: Pregnancy, Uremia, Alcohol use, Increased intracranial pressure
Focal defects, Brainstem Posterior fossa, Abdominal migraine
Etiology still uncertain
Consider: Electrogastrography, MRI of brain
Vomiting > 1 hr after meal
Gastric emptying study
Prolonged emptying
Consider: Gastroparesis, Trial prokinetic agents, Gastric outlet obstructions
EGD
Normal emptying
Consider: Conversion reaction, Depression
Psychological evaluation
Vertigo
Consider: Labyrinthine disorder
Etiology still uncertain
Consider: Electrogastrography, MRI of brain
Vomiting immediately after meals
Consider: Gastroesophageal reflux disease, Bulimia
Etiology still uncertain
Consider: Electrogastrography, MRI of brain
Chronic orthostatic hypotension, hyponatremia
Consider: Adrenal insufficiency
Etiology still uncertain
Consider: Electrogastrography, MRI of brain
Weight loss
Consider: Malignancy, Gastroparesis, Gastric outlet obstruction
EGD
Etiology still uncertain
Consider: Electrogastrography, MRI of brain
Anorexia
History Physical examination, Laboratory tests
Non-medical cause
Social factors
Psychological disorders
Depression Dementia Alcoholism Drug abuse Psychosis Anxiety Bereavement
Age-related conditions
Decreased olfactory sense Hypogeusia Visual disorders Hearing disorders Dental disorders
Eating disorders
Medical disease
Medications
Sedatives & psychotropics Digoxin Laxatives Appetite suppressants Thiazide diuretics...
CNS disease
Endocrine disorders
Thyroid disease, Adrenal insufficiency, Diabetes, Hyperparathyroidism, Hypercalcemia
GI disorders
Malabsorption syndromes, Peptic ulcer, Biliary disease, Hepatitis, GERD...
Diagnostic tests: Stool for blood, fat, parasites Upper GI with small bowel follow-through...
Other medical diseases
Chronic infection Malignancy Cardiopulmonary disease Cerebrovascular disease Abdominal ischemia