Vomiting Soon After Eating

CLINICAL DIAGNOSTIC MANUAL

Vomiting that occurs shortly after eating can be the result of a variety of conditions affecting the gastrointestinal tract or adjacent organs. Common causes include inflammation of the stomach or intestines, obstructions in the transit of gastric or intestinal content, and alterations in gastrointestinal motility. Identifying the cause of these vomits requires careful evaluation of symptoms, clinical history, and the performance of complementary tests. Possible causes include gastritis, peptic ulcer, gastric outlet obstruction, tumours of the small intestine, and functional disorders such as gastroparesis.

Pathology	Symptoms and Clinical Signs	Suspicion Diagnosis	Confirmation Diagnosis
Gastritis or peptic ulcer	Epigastric pain, burning, nausea, vomiting after eating.	Epigastric pain after meals, relief with vomiting or antacids.	Upper gastrointestinal endoscopy showing erosions or ulcers in the gastric or duodenal mucosa.
Obstruction of gastric content outlet	Postprandial vomiting, abdominal distension, weight loss, early satiety, dehydration.	Frequent vomiting after meals, weight loss. History of gastric carcinoma or previous pyloric stenosis.	Abdominal CT showing obstruction or upper gastrointestinal endoscopy revealing stenosis or tumour.
Small intestine tumour	Intermittent abdominal pain, nausea, vomiting, weight loss, signs of partial or total intestinal obstruction.	Symptoms of intestinal obstruction with intermittent pain. History of unexplained weight loss.	Abdominal CT or magnetic resonance enterography showing the tumour or obstruction.
Gastroparesis caused by diabetes	Nausea, postprandial vomiting, fullness, feeling of a full stomach.	Postprandial vomiting and fullness in patients with a history of diabetes.	Gastric emptying scintigraphy showing delayed gastric emptying.
Acute cholecystitis	Pain in the upper right quadrant, fever, nausea, vomiting, pain radiated to the shoulder or back.	Pain in the upper right quadrant and positive Murphy’s sign, accompanied by vomiting and fever.	Abdominal ultrasound showing thickening of the gallbladder wall or presence of stones.
Acute pancreatitis	Severe abdominal pain radiated to the back, nausea, vomiting, fever, abdominal distension.	Severe abdominal pain and vomiting in patients with a history of alcoholism or biliary disease.	Elevated blood amylase and lipase levels, along with abdominal CT showing pancreatic inflammation or necrosis.