Abdominal distension (patient information)
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Abdominal distension is most commonly caused by gas or intolerance of certain foods, but sometimes it is a sign of a more serious underlying disease or condition. For this reason, if the abdominal distension is new, different, or does not respond to over-the-counter medications, it is recommended that you see your doctor who will recommend some tests.
What are the symptoms of abdominal distension?
- Passing an excessive amount of gas or burping too frequently.
- Abdominal bloating
- Cramping abdominal pain
- Feeling of fullness in the stomach
- Pre-menstrual or menstrual discomfort
What causes abdominal distension?
- Air swallowing (a nervous habit)
- Gastroesophageal reflux
- Irritable bowel syndrome
- Lactose intolerance and other food intolerances
- Small bowel bacterial overgrowth
- Weight gain
More serious causes of abdominal distension or bloating are:
- Ascites which is fluid that accumulates in the belly.
- Celiac disease, which is a condition caused by an allergy to a component of food called gluten.
- Dumping syndrome, which is a syndrome causing gastrointestinal side effects due to a tumor.
- Ovarian cancer
- When the pancreas is not able to make enzymes needed for digestion (pancreatic insufficiency)
Who is at highest risk?
- Female gender
- High body mass index or high BMI
When to seek urgent medical care
By themselves, gas-symptoms are not worrisome or indicative of any underlying serious condition. A visit to the doctor may be helpful if the symptoms are very bothersome and there are other associated symptoms that may benefit from further testing and or treatment. Symptoms that should be further evaluated by a doctor include abdominal pain, vomiting, diarrhea, constipation, weight loss, bleeding from the gastrointestinal tract and sometimes heartburn. Worrisome symptoms are:
- The abdominal swelling is getting worse and does not go away
- The swelling occurs with other unexplained symptoms
- Your abdomen is tender to the touch
- You have a high fever the touch
- You have severe diarrhea or bloody stools
- You are unable to eat or drink for more than 6 - 8 hours
Depending on your symptoms, the diagnosis of the cause of your abdominal distension may include the following:
- Laboratory studies - such as blood tests to check for a disease called celiac sprue, and to check your liver function.
- Imaging studies - X-rays of the stomach and the small intestine.
- A procedure to look inside the esophagus and the intestines - colonoscopy, sigmoidoscopy or an upper endoscopy.
- A lactose tolerance test - to determine whether lactose intolerance is the cause of your bloating.
- An examination of your stool - to look for blood, the amount of fat present, or whether you have a parasite called giardia.
- A pregnancy test.
- See a doctor to ensure your abdominal distension is not a result of a serious condition such as liver disease or ovarian cancer.
- Diet changes - keeping a diary of the foods you consume and your symptoms can help identify certain foods that may be causing the abdominal distension. These can include dairy products, fruits and vegetables, artificial sweeteners, carbonated beverages, and whole grains.
- For irritable bowel syndrome Increase dietary fiber, reduce stress, and antispasmodics.
- For persons who are lactose intolerant, there are lactase supplements. If you are going to avoid milk and other dairy products, be sure to take calcium and vitamin D supplements.
- Over-the-counter medications for gas can be helpful, such as simethicone.
- Over-the-counter medications such as bismuth can help with the associated symptoms of diarrhea.
- For swallowing air, awareness is key:
- Sip hot beverages
- Avoid carbonated beverages
- Chew gum/suck on candies
- Eat slowly
- Drink through a straw
- Treatment of underlying liver diseases (management of complications)
- You may need surgery if the underlying cause is a bowel obstruction, a hernia, or a tumor.
- You may need to stay in the hospital and receive antibiotics if you have sudden bloating or abdominal distension, as it may be caused by a condition called spontaneous bacterial peritonitis.
- You may need further evaluation if the cause of your bloating is thought to be a result of liver disease.
What to expect (Outlook/Prognosis)
The outlook and prognosis for abdominal distension is fairly good if the cause is gas or a dietary intolerance. Prognosis is poor if ovarian cancer is the cause of the bloating, and varies with liver disease depending on the severity of the liver disease. Other causes will have a variable prognosis and is based on the diagnosis and the time at which the diagnosis is made.
Complications are few if the cause of the abdominal distension is gas or a dietary intolerance. Complications of celiac sprue include malnutrition. Some causes of abdominal distension can lead to death, such as an abdominal aortic aneurysm, spontaneous bacterial peritonitis and ovarian cancer. Bowel obstruction can lead to bowel necrosis and death.