Endocrine, nutritional, and metabolic diseases (E00-E90).
- Fructose intolerance (fruit sugar intolerance).
- Lactose intolerance (lactose intolerance).
- Porphyria or acute intermittent porphyria (AIP); genetic disease with autosomal dominant inheritance; patients with this disease have a 50 percent reduction in the activity of the enzyme porphobilinogen deaminase (PBG-D), which is sufficient for porphyrin synthesis. Triggers of a porphyria attack, which can last a few days but also months, are infections, drugs or alcohol. The clinical picture of these attacks presents as acute abdomen or neurological deficits, which can take a lethal course. The leading symptoms of acute porphyria are intermittent neurologic and psychiatric disturbances. Autonomic neuropathy is often in the foreground, causing abdominal colic (acute abdomen), nausea (nausea), vomiting or constipation (constipation), as well as tachycardia (heartbeat too fast: > 100 beats per minute) and labile hypertension (high blood pressure).
- Sorbitol tolerance – intolerance of the sugar substitute sorbitol.
- Wheat allergy – time to onset of symptoms: hours to days; determination of wheat IgE; skin test.
- Wheat sensitivity (synonym: nonceliac gluten sensitivity, NCGS) – time to onset of symptoms: variable, hours to days; symptoms may be intestinal (“affecting the intestine”) and extraintestinal (“outside the intestine “); gliadin antibodies: negative; IgE antibodies positive; skin test: no. Cause of wheat sensitivity are amylase trypsin inhibitors (ATIs), which are found in wheat, barley and rye; a gluten-free diet leads at the same time to an avoidance of ATIs and thus in about 90% of cases to a disappearance of symptoms.
Cardiovascular system (I00-I99).
- Right heart failure – restriction of the pumping function of the right heart.
Infectious and parasitic diseases (A00-B99).
- Typhoid fever
Liver, gallbladder and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).
- Ascites (abdominal dropsy)
- Biliary colic in cholecystolithiasis (gallstones).
- Bile acid loss syndrome (disease in which there is a functionally relevant deficiency of bile acids; leading symptoms: chologenic diarrhea (bile acid-related diarrhea), steatorrhea (fatty stools); secondary diseases; maldigestion (insufficient splitting of food components), possibly also cholesterol gallstones and oxalate kidney stones).
- Liver cirrhosis – irreversible damage to the liver, leading to a gradual connective tissue remodeling of the liver with restriction of liver function.
- Pancreatic insufficiency – impaired functioning of the pancreas.
Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).
- Appendicitis (appendicitis).
- Bacterial overgrowth (Small Intestinal Bacterial Overgrowth, SIBO) [dysbiosis].
- Bacterial overgrowth of the small intestine (dysbiosis).
- Chronic constipation (constipation)
- Intestinal stenosis – narrowing of the intestine
- Diseases of the colon such as colitis (inflammation of the intestine).
- Functional dyspepsia (irritable stomach)
- Gastroparesis – motility disorder (movement disorder) of the stomach with initial flaccid paralysis, later hypotonic muscle tone; gastric disease in which food is digested more slowly than normal.
- Ileus (intestinal obstruction)
- Gastric outlet stenosis (MAS; narrowing of the muscle at the stomach outlet) – more often caused by antral carcinoma (tumor, which is located in the stomach outlet area) than by ulcer disease (stomach ulcer)
- Peritonitis (inflammation of the peritoneum).
- Irritable bowel syndrome (IBS)
- Celiac disease (gluten allergy; gluten-induced enteropathy).
Neoplasms – tumor diseases (C00-D48)
- Colon carcinoma (colorectal cancer)
Psyche – Nervous System (F00-F99; G00-G99).
- Aerophagy – swallowing air.
- Mental stress
Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).
- Acute abdomen – emergency with severe abdominal pain and abdominal wall guarding.
- Heartburn (pyrosis)
- Uremia (occurrence of urinary substances in the blood above normal values).
Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).
- Renal colic in nephrolithiasis (kidney stones) or other kidney diseases.
Injuries, poisonings, and other consequences of external causes (S00-T98).
- Adhesions (adhesions) after surgery.
Medication
- Anion exchange resins (colestipol, colestyramine).
- Antiadiposita (orlistat)
- Antibiotics
- Rifaximin
- Antidiabetics
- Alpha-glucosidase inhibitors (acarbose, miglitol).
- Biguanides (metformin)
- Calcium (in case of overdose)
- HMG-CoA reductase inhibitors (3-hydroxy-3-methylglutaryl coenzymeA reductase inhibitors; statins) – atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin.
- Laxatives
- Phytotherapeutics – nettle root (Urtica dioica).
- Proton pump inhibitors (proton pump inhibitors, PPI; frequency: common).
- See also under “Gastrointestinal discomfort caused by medications.”
Other differential diagnoses
- Nutrition
- Incorrect eating and drinking habits such as hasty eating and drinking carbonated beverages.
- Consumption of vegetables and legumes (due tocontained sugar molecules rhamnose and stachyose, which can not be utilized in the small intestine and are only transferred in the colon by the bacterial flora), which have a flatulent effect. Rhamnose and stachyose are also found in higher concentrations in other foods: Chicken eggs, cabbage, crispbread, sauerkraut, celery, watermelon and onions.
- At the beginning of a high-fiber diet (but stops after two to three weeks).
- Jerusalem artichoke, which contains inulin, can also increase gas production.
- Micronutrient deficiency (vital substances) – see prevention with micronutrients.
