INTRODUCTION
Abdominal distension is a symptom caused by the presence of gas or liquid inside the stomach, intestine, or peritoneal cavity; it manifests itself with the appearance of swelling and an increase in abdominal circumference, as well as being associated with other symptoms including:
- Belching,
- Nausea and vomiting,
- Constipation or diarrhea,
- Flatulence ,
- Abdominal pain with cramps,
- Generalized malaise and asthenia.
Many times, abdominal distension is a rather mild disorder, due to dietary and lifestyle errors; in other patients, it becomes a symptom of a real pathology, sometimes quite serious.
In case of abdominal distension that lasts for several days or is associated with pain and other important symptoms. It is advisable to contact a doctor, who can prescribe any necessary tests and diagnose a possible cause of the disorder, Thus prescribing therapeutic approaches more appropriate.
CAUSES
The causes of abdominal distension can be easily memorized with the “6 F rule”:
- Flatus (i.e. meteorism from gas accumulation),
- Fat (presence of abdominal fat),
- Fluid (presence of liquid),
- Fetus (pregnancy),
- Feces (feces, i.e. alterations of the hive),
- Fatal growth (malignant formation, i.e. the presence of a mass, such as a tumor).
In most cases, however, there are no real pathologies at the basis of abdominal distension, but simple functional disorders that can occur in the case of:
- Food binges,
- Eating unhealthy foods is defined as “junk foods”,
- Premenstrual syndrome,
- Excessive consumption of carbonated drinks, alcohol, and coffee,
- Seasonal gastroenteritis (the so-called intestinal flu ),
- Irritable bowel syndrome.
Meteorism
Normally in the abdominal area, there are about 200 ml of gas, which comes from the air ingested with food and from intestinal bacterial fermentation.
The most frequent causes of meteorism, i.e. an excessive presence of gas, are:
- Aerophagia (literally the ingestion of air), which occurs in the case of:
- Hasty ingestion of food,
- Frequent use of chewing gum,
- Lactose or gluten intolerance ( celiac disease ), conditions that increase bacterial fermentation and the production of intestinal gas.
Abdominal fat
Obesity and overweight lead to an increase in fat deposits, especially in the abdominal area, with a feeling of abdominal distension. It should be remembered that obesity is also an important risk factor for diabetes and cardiovascular disease.
Abdominal fluid
The term ascites refers to the presence of liquids in the peritoneal cavity, sometimes in particularly large quantities (several liters of liquid), with considerable abdominal distension.
The most frequent causes of ascites are:
- Cirrhosis of the liver ,
- Heart failure,
- Portal hypertension ,
- Severe malnutrition,
- Budd-chiari syndrome,
- Pancreatitis ,
- Primary or metastatic tumors affect various organs, both abdominal and other sites.
Pregnancy
It is one of the physiological causes of abdominal distension. It appears from the 12th week of gestation when the uterus begins to enlarge and moves from the pelvis to the abdomen.
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In case of alteration of the alvo (or of the function of defecation), it is possible that there is a stagnation of stool in the colon due to a functional or mechanical occlusion. In this case, they are often associated with relaxation too
- ABDOMINAL PAIN,
- NAUSEA AND VOMIT.
Malignant formation
The presence of masses in the abdomen can be secondary to enlargement of the abdominal organs such as:
- Hepatomegaly (enlargement of the liver),
- Splenomegaly (enlargement of the spleen),
- Abdominal aortic aneurysm (saccular dilation of the aorta),
- Distension or bladder globe (enlargement of the bladder due to obstruction of the outflow of urine).
Other masses can be explained by the presence of:
- Massive abscesses (collections of pus),
- Abdominal hernias (visceral organs that dislocate from their original location and, crossing areas of least resistance, push towards the abdominal wall),
- Cyst,
- Tumors affect the various abdominal or pelvic organs.
SYMPTOMS
Abdominal distension can be accompanied by a number of associated symptoms that vary according to the underlying cause, including:
- Belching,
- Nausea and vomit,
- Constipation or diarrhea,
- Flatulence,
- Abdominal pain with cramps,
- Weight loss (weight loss with weight loss),
- Generalized malaise and asthenia,
- Headache,
- Melaena or rectorrhagia ( loss of blood in the stool , in case of tumors),
- Dyspnoea (if abdominal distension becomes such as to make breathing difficult).
DIAGNOSIS
The first step in a correct diagnosis involves the doctor asking the patient several questions about the presence of the various symptoms, paying particular attention to warning signs such as:
- Weight loss,
- Night sweats ,
- Presence of blood in the stool,
- Sudden changes in the alveum (such as constipation lasting several days) that indicate a functional intestinal obstruction (paralytic ileus) or mechanical (presence of masses that block normal intestinal transit),
Presence of chronic disorders such as:
- Alcoholism and jaundice (potential causes of liver disease),
- Heart failure and kidney failure (manifesting as ascites).
Finally, objective signs such as enlarged lymph nodes should be sought, the cause of which may be the presence of advanced malignant tumors.
Physical examination is an important tool in the doctor’s hands and generally consists of 4 phases:
Inspection of the abdomen may reveal asymmetrical distention or a noticeable mass.
Auscultation, which may show the absence of intestinal noises or, conversely, the presence of pathological noises, indicative of a possible abdominal occlusion.
Percussion, helps the doctor to differentiate distension caused by liquids, from one caused by gas and one caused by a solid mass; the sound will be tympanic in the first case and obtuse in the other two.
Palpation of the abdomen may eventually reveal frank pain, the presence of a mass, hepatomegaly, and splenomegaly.
Instrumental examinations
Radiography of the abdomen may reveal enlarged bowel loops suggestive of functional or mechanical bowel obstruction.
The ultrasound of the abdomen is instead useful to highlight the presence of
- Ascitic fluid,
- Liver and splenomegaly,
- A nodular (cirrhotic) liver
- Or the presence of masses.
As second-level tests, in the suspicion of a tumor, an abdomen-pelvis CT scan is usually prescribed.
Laboratory tests
With blood tests, it is possible to study the functionality of the various abdominal organs, the heart, and the kidneys and to arrive, together with the other investigations carried out, at a certain diagnosis, which is then the starting point for implementing an adequate and effective therapy.
TREATMENT, REMEDIES, AND PREVENTION
If the abdominal distension is caused by a real pathology, the treatment is causal type, ie aimed at removing the underlying cause.
In the event that abdominal distension is instead be referred to as a simple temporary episode caused by a functional disorder, the following therapeutic measures can be used:
- Avoid “forbidden” foods in case of gluten or lactose intolerance.
- Lose weight with adequate nutrition and sports activity.
- Eat slowly to avoid aerophagia and avoid excessive use of carbonated and alcoholic drinks.
- Drink about 2 liters of water a day.
- Maintain an optimal fiber intake through the consumption of fruit and vegetables (at least 5 servings throughout the day).
- Avoid big binges and “junk” foods.
- Avoid going to bed immediately after eating.
