Gas and Bloating—Controlling Emissions Thomas G. Cotter, MD, Mark Gurney, MB BCh, Conor G. Loftus, MD  Mayo Clinic Proceedings  Volume 91, Issue 8, Pages 1105-1113 (August 2016) DOI: 10.1016/j.mayocp.2016.04.017 Copyright © 2016 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 1 A simplified approach to the evaluation of the patient with gas-related symptoms. aIndicated in the presence of alarm features: Age > 50 years, upper GI malignancy in a first-degree relative, weight loss, GI bleeding, or iron deficiency anemia, dysphagia, odynophagia, persistent vomiting, abnormal imaging suggesting organic disease (American Society for Gastrointestinal Endoscopy). bConsider EGD (+/− gastric biopsies) and/or gastric emptying test to rule-out an organic etiology, in certain patients. EGD = esophagogastroduodenoscopy; HbA1c = glycosylated hemoglobin; IBS = irritable bowel syndrome; IBS-C = irritable bowel syndrome–constipation; SBO = small bowel obstruction; SIBO = small intestine bacterial overgrowth; TSH = thyroid-stimulating hormone. Mayo Clinic Proceedings 2016 91, 1105-1113DOI: (10.1016/j.mayocp.2016.04.017) Copyright © 2016 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 2 Basic principles of irritable bowel syndrome management. IBS = irritable bowel syndrome. Mayo Clinic Proceedings 2016 91, 1105-1113DOI: (10.1016/j.mayocp.2016.04.017) Copyright © 2016 Mayo Foundation for Medical Education and Research Terms and Conditions