Abdominal distension

One of the causes of abnormal bloating is excessive eating and air swallowing, known as aerophagia.{{Cite journal |last1=de Jesus |first1=Lisieux Eyer |last2=Cestari |first2=Ana Beatriz C.S.S. |last3=da Silva |first3=Orli Carvalho |last4=Fernandes |first4=Marcia Antunes |last5=Firme |first5=Livia Honorato |date=2015 |title=Pathologic aerophagia: a rare cause of chronic abdominal distension |journal=Revista Paulista de Pediatria |volume=33 |issue=3 |pages=371–375 |doi=10.1016/j.rpped.2015.01.003 |issn=0103-0582 |pmc=4620966 |pmid=26100594}} Other causes of bloating and distension include inflammatory bowel diseases such as Crohn's disease{{cite journal |last1=Götz |first1=Vera Nina |title=Crohn's disease—What the medical registrar and acute physician needs to know! |journal=Journal of Acute Medicine |date=December 2013 |volume=3 |issue=4 |pages=132–137 |doi=10.1016/j.jacme.2013.10.001 |doi-access= }}{{cite journal |last1=Nóbrega |first1=Viviane Gomes |last2=Silva |first2=Isaac Neri de Novais |last3=Brito |first3=Beatriz Silva |last4=Silva |first4=Juliana |last5=Silva |first5=Maria Carolina Martins da |last6=Santana |first6=Genoile Oliveira |title=The Onset of Clinical Manifestations in Inflammatory Bowel Disease Patients |journal=Arquivos de Gastroenterologia |date=September 2018 |volume=55 |issue=3 |pages=290–295 |doi=10.1590/S0004-2803.201800000-73 |pmid=30540094 |doi-access=free }} and ulcerative colitis, irritable bowel syndrome, diabetes, functional dyspepsia, or transient constipation. In rare cases, bloating may occur in individuals who have milk intolerance (lactose intolerance), parasite infections such as giardia, food poisoning (bacteria), celiac disease, severe peptic ulcer disease, bowel obstruction, or after certain types of abdominal surgery.{{Cite journal |last1=Xavier |first1=Ramnik J |last2=Thomas |first2=Harry J |date=2013 |title=Gastrointestinal Diseases |journal=Hunter's Tropical Medicine and Emerging Infectious Disease |pages=18–27 |doi=10.1016/B978-1-4160-4390-4.00003-5 |pmc=7173482|isbn=9781416043904 }}

Heart failure and cirrhosis are also a common cause of distension. In both of these disorders, fluid accumulates in the abdomen and creates a sensation of fullness. Abdominal distension can also be a symptom of ovarian cancer. Women are more prone to bloating and often identify these symptoms during menstruation.American College of Gastroenterology. [http://www.gi.org/patients/gihealth/belching.asp "Belching, Bloating and Flatulence"] {{Webarchive|url=https://web.archive.org/web/20100501211238/http://www.gi.org/patients/gihealth/belching.asp |date=2010-05-01 }} 2010-01-27. Some individuals who develop distension may have either poor motility of their intestines or may be hypersensitive to gut sensations.Goldfinger, Stephen E, MD. [https://archive.today/20120805210603/http://www.utdol.com/patients/content/topic.do?topicKey=~/S6QjVerpW9eT4 "Gas and bloating overview"] 2010-01-27. Certain medications, such as antidepressants and anti-spasmodics, can contribute to reduced gut motility. Studies have shown that swallowing air during eating or delayed emptying of the stomach from hyperacidity leads to bloating after a meal. Individuals who are constipated also complain of bloating. In some individuals who are hypersensitive, any volume of air may be perceived as fullness and there may not be actual abdominal distension.{{cite web|url=https://my.clevelandclinic.org/health/symptoms/21819-abdominal-distension-distended-abdomen

|title=Abdominal Distension (Distended Abdomen)

|publisher=Cleveland Clinic

}}

Abdominal distension (or "distended abdomen") can be a sign of many other conditions, including:

• Ascites
• Capillaria philippinensis
• Celiac disease
• Coccidiosis
• Cystic fibrosis
• Diverticulitis
• Eosinophilic gastroenteritis
• Fasciolosis
• Gastroparesis
• Giardiasis
• Hookworm disease
• Inflammatory bowel disease (Crohn's disease and ulcerative colitis)
• Kidney stones
• Kwashiorkor
• Lactose intolerance
• Obstructed bowel
• Ovarian cancer
• Polycystic liver disease
• Pregnancy
• Premenstrual syndrome
• Pseudomonas aeruginosa infection
• Small bowel bacterial overgrowth syndrome
• Strongyloidiasis
• Tropical sprue
• Weight gain
• Whipple's disease
• Anterior pelvic tilt (lower cross syndrome)

Persistent or recurrent bloating may be caused by intestinal parasites, other infections, or other medical conditions.{{citation needed|date=July 2020}}

The first step in diagnosis is to determine the etiology of abdominal distension. After making a differential diagnosis of abdominal distension, it is important to take a careful medical history.{{Cite journal |last1=Mari |first1=Amir |last2=Abu Backer |first2=Fadi |last3=Mahamid |first3=Mahmud |last4=Amara |first4=Hana |last5=Carter |first5=Dan |last6=Boltin |first6=Doron |last7=Dickman |first7=Ram |date=2019 |title=Bloating and Abdominal Distension: Clinical Approach and Management |journal=Advances in Therapy |volume=36 |issue=5 |pages=1075–1084 |doi=10.1007/s12325-019-00924-7 |issn=0741-238X |pmc=6824367 |pmid=30879252}}

Here are the most common causes of abdominal distension classified as an underlying cause and as a secondary disease.

As an underlying disease cause:

• Constipation
• Lactose intolerance and other food intolerances
• Overeating (due to overproduction of gases in the digestion process)

As a secondary disease cause:

• Celiac disease
• GERD (gastroesophageal reflux disease)
• Peptic ulcer disease
• Accumulation of fluid in the peritoneal cavity (e.g., ascites)

Bloating is not life-threatening. In most cases, bloating can be handled with simple home remedies and changes in lifestyle.{{Cite web |date=2022-05-27 |title=Abdominal bloating: Causes, symptoms and remedies |url=https://www.medicalnewstoday.com/articles/321869 |access-date=2022-11-29 |website=www.medicalnewstoday.com |language=en}}

Certain foods have been known to worsen bloating. Poorly digested components of many foods are excreted into the large intestine where they are degraded by bacteria, producing excess gas. Depending on the undigested component, this may affect the odor and the volume of gas created.{{Cite journal |last=Hasler |first=William L. |date=2006 |title=Gas and Bloating |journal=Gastroenterology & Hepatology |volume=2 |issue=9 |pages=654–662 |issn=1554-7914 |pmc=5350578 |pmid=28316536}}

Excess dietary fiber intake is a known cause of belching, gas and bloating. Many vegetables are known to cause bloating due to high levels of fiber and undigestible sugars such as raffinose (e.g., beans, cabbage, broccoli).{{cite web |url=http://digestive.niddk.nih.gov/ddiseases/pubs/gas/ |title=Gas in the Digestive Tract – National Digestive Diseases Information Clearinghouse |publisher=Digestive.niddk.nih.gov |access-date=2014-01-22 |archive-url=https://web.archive.org/web/20141011063704/http://digestive.niddk.nih.gov/ddiseases/pubs/gas/ |archive-date=2014-10-11 |url-status=dead }}

There are many individuals who are unable to tolerate dairy products because of lactose intolerance. Such foods should be eliminated from the diet if symptoms develop.{{Cite journal |last1=Szilagyi |first1=Andrew |last2=Ishayek |first2=Norma |date=2018-12-15 |title=Lactose Intolerance, Dairy Avoidance, and Treatment Options |journal=Nutrients |volume=10 |issue=12 |pages=1994 |doi=10.3390/nu10121994 |issn=2072-6643 |pmc=6316316 |pmid=30558337|doi-access=free }}

For some people, recurrent distension symptoms worsen their quality of life and thus many resort to health supplements or medications. Dietary supplements containing various enzymes, for example Beano, are formulated to help break down complex carbohydrates and vegetables in order to reduce substances in the gut that cause bacterial overgrowth and subsequent bloating. Though these enzymes can help reduce gas and belching, they may not always reduce bloating.{{Cite journal |last1=Celleno |first1=Leonardo |last2=Tolaini |first2=Maria Vittoria |last3=D'Amore |first3=Alessandra |last4=Perricone |first4=Nicholas V. |last5=Preuss |first5=Harry G. |date=2007-01-24 |title=A Dietary supplement containing standardized Phaseolus vulgaris extract influences body composition of overweight men and women |journal=International Journal of Medical Sciences |volume=4 |issue=1 |pages=45–52 |doi=10.7150/ijms.4.45 |issn=1449-1907 |pmc=1796956 |pmid=17299581}}

Other over-the-counter formulas recommended for bloating include simethicone and activated charcoal. Probiotics are also used to treat bloating based on the theory that improved gut flora will improve digestion and lessen gas generation.{{Cite journal |last1=Lacy |first1=Brian E. |last2=Gabbard |first2=Scott L. |last3=Crowell |first3=Michael D. |date=2011 |title=Pathophysiology, Evaluation, and Treatment of Bloating |journal=Gastroenterology & Hepatology |volume=7 |issue=11 |pages=729–739 |issn=1554-7914 |pmc=3264926 |pmid=22298969}}

• Gastric distension

{{Reflist}}

• [https://www.nlm.nih.gov/medlineplus/ency/article/003123.htm MedlinePlus/NIH] – Abdominal bloating
• [https://www.nlm.nih.gov/medlineplus/ency/article/003122.htm MedlinePlus/NIH] – Abdomen – swollen

{{Medical resources

| DiseasesDB = 30819

| ICD10 = {{ICD10|R|14||r|10}}, {{ICD10|R|19|0|r|10}}

| ICD9 = {{ICD9|787.3}}, {{ICD9|789.3}}

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{{Digestive system and abdomen symptoms and signs}}

{{DEFAULTSORT:Abdominal Distension}}

Category:Symptoms and signs: Digestive system and abdomen