Differential Diagnosis for Chronic Bloating
Single Most Likely Diagnosis
- Irritable Bowel Syndrome (IBS): This is the most common cause of chronic bloating, characterized by recurrent abdominal pain, bloating, and changes in bowel habits without any mechanical, inflammatory, or biochemical abnormalities.
Other Likely Diagnoses
- Functional Dyspepsia: A condition characterized by upper abdominal symptoms such as bloating, discomfort, and early satiety, without evidence of organic disease.
- Small Intestine Bacterial Overgrowth (SIBO): An excessive growth of bacteria in the small intestine, leading to bloating, gas, and abdominal discomfort.
- Lactose Intolerance: The inability to digest lactose due to a deficiency of lactase enzyme, resulting in bloating, gas, and diarrhea after consuming lactose-containing products.
- Fructose Malabsorption: Difficulty absorbing fructose, leading to bloating, gas, and abdominal pain after consuming fructose-rich foods.
Do Not Miss Diagnoses
- Celiac Disease: An autoimmune disorder where the ingestion of gluten leads to damage in the small intestine, causing bloating, diarrhea, and malabsorption. If missed, it can lead to severe malnutrition and other complications.
- Gastric Cancer: Although rare, gastric cancer can present with chronic bloating and should be considered, especially in high-risk populations or those with alarm symptoms like weight loss or bleeding.
- Ovarian Cancer: Can cause bloating due to ascites or intestinal obstruction, making it a critical diagnosis not to miss, particularly in postmenopausal women.
Rare Diagnoses
- Gastroparesis: A condition where the stomach takes too long to empty its contents, leading to bloating, nausea, and vomiting.
- Intestinal Obstruction: A blockage that prevents the normal flow of the products of digestion, which can cause severe bloating, abdominal pain, and constipation.
- Cystic Fibrosis: A genetic disorder that can lead to malabsorption and bloating due to pancreatic insufficiency.
- Eosinophilic Gastroenteritis: A rare condition characterized by the infiltration of eosinophils into the gastrointestinal wall, leading to bloating, abdominal pain, and diarrhea.