You seem to care, and love him, but after 3 years anyone would be exhausted.
Two things strike me about your post.
1 - you focus on the why, not what. The impact of his needs will be the same no matter if he has autism, ADHD, or is NT. I understand your desire to pinpoint why.. but it's of less importance, if you step back, than figuring out solutions. If he's diagnosed with something, there may be more solutions available (specialist therapy, drugs, adaptations that can be put in place for education settings etc)... But his behaviour is his behaviour no matter what is causing it. You may feel more optimistic if you focus on what, not why. You seem very down but lots of parents struggle with issues during raising children, no one has it fully figured out. So, re frame it. Less "what is causing this" and more "ok, so he needs to get off a bottle and start on using a cup"... What do other parents of autistic kids do? They look for a sippy cup that has a different plastic (maybe the ones you've tried are too hard, or soft, or maybe he'd prefer a straw one, etc etc). Or maybe it's an association problem, the sippy cup you're using is something he's learned comes with crying and pressure.. so make it massive deal to get him to choose his own "special big boy, no one else is allowed to use it" cup... You'll know if that's a bad idea, if maybe it'll overwhelm him. If it does, put everyone in the family on the same cup.. yes, you and any partner drink for a few days from the new family cups... To reduce pressure on him.
Which brings me onto my second point.. what support do you have? You don't mention a partner, a friend, a mum's group, health visitor. Who's assisting you? Is there anyone to provide you with a sounding board before the referral comes in? Autism support groups online may also help.