Differential Diagnosis for Bloating as the Only Symptom

• Single Most Likely Diagnosis
  • Irritable Bowel Syndrome (IBS): This is the most common cause of bloating, characterized by recurrent abdominal pain associated with a change in bowel habits, such as diarrhea or constipation, but bloating can be a predominant symptom.
• Other Likely Diagnoses
  • Functional Dyspepsia: A condition where there is persistent or recurrent upper abdominal pain or discomfort that is not explained by other medical conditions, and bloating can be a significant symptom.
  • Small Intestine Bacterial Overgrowth (SIBO): An excessive growth of bacteria in the small intestine, leading to bloating, gas, and abdominal discomfort.
  • Lactose Intolerance or Other Food Intolerances: Difficulty digesting certain foods can lead to bloating, gas, and discomfort.
• Do Not Miss Diagnoses
  • Ovarian Cancer: Although rare, ovarian cancer can present with bloating as an early symptom, making it crucial not to miss this diagnosis, especially in postmenopausal women.
  • Celiac Disease: An autoimmune disorder where the ingestion of gluten leads to damage in the small intestine, causing bloating among other symptoms.
  • Intestinal Obstruction: A blockage that prevents the normal flow of the products of digestion, which can cause severe bloating and is a medical emergency.
• Rare Diagnoses
  • Gastroparesis: A condition where the stomach takes too long to empty its contents, leading to bloating, nausea, and vomiting.
  • Abdominal Adhesions: Bands of fibrous tissue that can form between abdominal organs or between an organ and the wall of the abdomen, potentially causing bloating and discomfort.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause bloating, though they are typically accompanied by other symptoms such as diarrhea, weight loss, and blood in the stool.