Differential Diagnosis for a 35-year-old Female with Daily Burping for 1 Year, H. Pylori Negative
- Single most likely diagnosis:
- Functional dyspepsia: This condition is characterized by recurring symptoms of upper abdominal discomfort or pain that are not explained by other medical conditions. Given the chronic nature of the symptoms and the absence of H. pylori infection, functional dyspepsia is a plausible explanation for her symptoms.
- Other Likely diagnoses:
- Gastroesophageal reflux disease (GERD): Although typically associated with heartburn, GERD can also cause burping. The chronic nature of her symptoms could suggest GERD, especially if she experiences other symptoms like regurgitation.
- Irritable bowel syndrome (IBS): While primarily known for causing abdominal pain and changes in bowel movements, some individuals with IBS may experience upper gastrointestinal symptoms, including burping.
- Aerophagia: This condition involves swallowing air, which can lead to belching. It can be associated with eating habits, gum chewing, or drinking carbonated beverages.
- Do Not Miss diagnoses:
- Gastric cancer: Although rare, especially in a 35-year-old, gastric cancer can present with nonspecific symptoms like burping. Given the potential severity, it's crucial to consider, especially if other risk factors are present.
- Peptic ulcer disease: Despite being H. pylori negative, peptic ulcers can still occur due to NSAID use or other less common causes. They can cause a variety of symptoms, including burping.
- Rare diagnoses:
- Eosinophilic esophagitis: An inflammatory condition of the esophagus that can cause difficulty swallowing, food impaction, and possibly burping, though it's less commonly associated with this symptom.
- Rumination syndrome: A condition where food is regurgitated into the mouth, which can then be swallowed again or spat out. It might cause burping but is relatively rare and more often seen in individuals with certain psychological conditions or after certain types of surgery.
- Gastroparesis: A condition where the stomach takes too long to empty its contents. While more commonly associated with nausea, vomiting, and feeling full after eating only a small amount of food, it could potentially cause burping in some cases.