Abdominal distension
Abdominal distension is often described as feeling bloated.
Abdominal distension is the expansion of the abdomen due to accumulation of substances such as air or fluid. It is typically a symptom of an underlying disease or dysfunction rather than a standalone illness. Affected individuals often describe the sensation as "feeling bloated" and may experience fullness, pressure, nausea, pain, or cramping.
Quick Facts
- Field
- Gastroenterology
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Causes
Abnormal bloating can result from excessive eating and air swallowing, known as aerophagia. Other causes include inflammatory bowel diseases such as Crohn's disease and ulcerative colitis, irritable bowel syndrome, diabetes, functional dyspepsia, or transient constipation. In rare instances, bloating may occur with lactose intolerance, parasite infections like giardia, food poisoning, celiac disease, severe peptic ulcer disease, bowel obstruction, or after certain abdominal surgeries. Heart failure and cirrhosis commonly cause distension through fluid accumulation in the abdomen. Ovarian cancer can also present with abdominal distension. Women are more prone to bloating, often identifying symptoms during menstruation. Some individuals have poor intestinal motility or are hypersensitive to gut sensations. Certain medications, including antidepressants and anti-spasmodics, can reduce gut motility. Swallowing air while eating or delayed stomach emptying from hyperacidity may lead to post-meal bloating. Constipated individuals frequently complain of bloating. In hypersensitive people, any volume of air may be perceived as fullness without actual distension.
Diagnosis
The first diagnostic step is to determine the etiology of abdominal distension. After making a differential diagnosis, a careful medical history is important. Common underlying disease causes include constipation, lactose intolerance and other food intolerances, and overeating. Secondary disease causes include celiac disease, gastroesophageal reflux disease, peptic ulcer disease, and accumulation of fluid in the peritoneal cavity such as ascites.
Treatment
Bloating is not life-threatening and can often be managed with simple home remedies and lifestyle changes. Certain foods worsen bloating; poorly digested components are degraded by bacteria in the large intestine, producing excess gas. Excess dietary fiber intake is a known cause of belching, gas, and bloating. Vegetables high in fiber and undigestible sugars like raffinose, such as beans, cabbage, and broccoli, can cause bloating. Individuals with lactose intolerance should eliminate dairy products if symptoms develop. Dietary supplements containing enzymes, such as Beano, help break down complex carbohydrates to reduce gas, though they may not always reduce bloating. Over-the-counter options include simethicone and activated charcoal. Probiotics are used based on the theory that improved gut flora lessens gas generation.
More in Symptoms and Signs: Digestive System and Abdomen
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