Differential diagnosis of abdominal bloating in comorbid patients and potential management strategy

Abdominal bloating is an urgent medical issue due to a growing number of patients seeking medical aid with such a complaint. This is caused not only by expansion and change of human dietary preferences, but also by iatrogenic causes (common use of antibacterial agents prescribed by some healthcare professionals who do not prevent dysbiotic changes in the intestinal biocenosis). Associated with gastrointestinal and other conditions, bacterial overgrowth syndrome (BOS) is one of bloating causes. BOS incidence increases in proportion to age. Severe often bloating may even worsen the course of an underlying disease and significantly alter the quality of life in a comorbid patient. The paper highlights main causes of bloating, diagnostic search features and potential pharmacotherapy. Moreover, it describes possible diagnostic and therapeutic strategies for management of these patients, as well as the author’s own observation of the clinical case of a patient with a comorbid condition and BOS. Keywords: bloating, flatulence, bacterial overgrowth syndrome, comorbidity, rifaximin. For citation: Pakhomova I.G. Differential diagnosis of abdominal bloating in comorbid patients and potential management strategy. RMJ. 2025;3:35–41. DOI: 10.32364/2225-2282-2025-3-7