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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.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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