Distended Abdomen

What is Distended Abdomen?

Distended abdomen is where the abdomen becomes swollen or enlarged. Distended abdomen is called distended stomach. It is characterized by bloating, pain and discomfort. An enlarged abdomen may be as a result of not serious problems in your digestive system or serious medical conditions such as cancer and bowel obstruction².

Causes of Distended Abdomen

There are numerous internal and external factors that can cause a distended stomach. They are as follows:

Irritable bowel syndrome

It is a condition that occurs in your large intestine. The causes of this condition are not known but there some factors that play a big role in this disorder.

Normally, intestinal muscles relax and contract in a synchronized manner as they push food via your stomach into the intestinal tracts. If you have irritable bowel syndrome, two things can happen:

• These contractions may be stronger and last for a long time than normal, this causes bloating, gas and diarrhea. Another way is that these contractions may be weak leading to slow flow of food causing dry and hard stools.

Another possible cause of irritable bowel syndrome is problems in gastrointestinal nervous system. Signals between your intestines and brain may be poorly synchronized and make your body over respond to changes in digestive process. This over response can cause constipation, pain and diarrhea.

Triggers

There are also stimuli’s that may trigger irritable bowel syndrome. They include:

• Some types of food we eat can cause irritable bowel syndromes. Although the idea behind food has not clearly shown how this is connected to irritable bowel syndrome. People say that when they eat these types of food such as cabbage, fruits, alcohol, milk, etc cause pain and constipation.
• Symptoms of irritable bowel syndrome can also get worse when you are depressed or stressed. It is important to note that stress on its own does not cause signs and symptoms of this condition it only makes them worse.
• Hormonal changes also cause irritable bowel syndrome. This is true to women and they report having symptoms of irritable bowel syndrome during menstrual period. They may have irregular periods and pains in addition to symptoms of an enlarged abdomen.

Coeliac disease

It is also known as gluten-sensitive enteropathy. It is a condition where your body immune system reacts to gluten, a protein in wheat, barley and rye. This reaction may damage the villi (hair projections) that line your intestine after sometime. When these hair projections are damaged, you will not be able to absorb nutrients. This damage to your intestine may result into bloating, loss of weight, fatigue and diarrhea.

Small intestinal bacteria overgrowth

This is a condition where bacteria reproduce and increase in number in the small intestine. Small intestinal bacteria overgrowth occur when a nerve or muscle of the intestines is not working properly as well as obstruction in your intestines or presence of blind loop (bypassed small intestine).⁵

When you have small intestinal bacteria overgrowth, you will experience the following symptoms:

• You feel pain in the abdomen which may be accompanied by bloating, enlargement or swelling. You may have excess gas in the stomach and diarrhea. In some cases, you may lose weight and even have insufficient nutrients in your body.

Other Causes

Other causes of distended abdomen are:

• Cancers that start from the colon or small intestine may also cause the abdomen to be distended, although it is a rare occurrence. In case you have cancer, you may experience persistent bloating and digestion complications will be more.
• Another cause is bowel obstruction. This occurs when an overgrowth tissue or tumor forms in the digestive tract. This prevents the bowel from moving and it causes severe pain, constipation and nausea.

Symptoms of Distended Abdomen

People with an enlarged abdomen may exhibit the following symptoms²:

• People feel uncomfortable and may have nausea with the urge of vomiting and diarrhea. They feel pain in abdomen and may also have fever or chills. People feel easily fatigued and experience constipation and cramping problems. In some cases, people may have blood in your urine and stool. They may also experience short breath.

Diagnosis

You need a proper diagnosis to identify the cause of a distended abdomen. Since there are many causes of this condition, diagnosis will involve your medical history so that your health professional understands your condition. From the information you give, your doctor conducts various tests to diagnose the condition⁴.

Management and Treatment

A distended abdomen can be managed effectively when the underlying conditions are treated properly. Management of this condition can include lifestyle changes and medications to treat the underling conditions:^{1, 3, 4, 5}

Lifestyle changes

Changing your lifestyle can go a long way in treating a distended abdomen. Lifestyle changes include making a change in the food you eat which may be contributing to this condition. There are foods we eat which are not well digested and are passed into the large intestine. These foods are then decomposed by bacteria in the large intestine causing too much gas.

Foods high in fiber can cause gas and enlargement of the abdomen. You should avoid these foods: beans, cabbage and broccoli because they have a lot of sugar and fiber.

Patients who cannot withstand dairy products should avoid these foods because they contribute to a distended abdomen.

In case celiac disease is the cause of a distended abdomen, you need to avoid foods that contain gluten such as wheat, barley, malt, semolina, rye etc. You need assistance from a nutritionist or dietician to help you come up with a gluten free diet. By avoiding gluten foods, you will be able to reduce inflammation in your intestine.

In addition to diet changes, you need to exercise regularly to strengthen intestinal muscles so that they work properly. Also drink plenty of fluids to control constipation.

Medications

Your doctor may prescribe medications to treat symptoms of a distended abdomen. Drugs such as activated charcoal- simethicone and probiotics can help treat a distended abdomen. Probiotics works by enhancing gut flora and digestion and as result decrease gas produced in the stomach. These drugs do not cure distended abdomen but help decrease the amount of gas in the stomach which is one of the symptoms of a distended abdomen.

Other drugs that can be used include antibiotics to treat bacterial infections. You may be given antidepressant medications if the cause is stress or depression. Your doctor may also recommend anticholinergic and antispasmodic drugs such as Levsin to ease painful bowel movements.

Fiber supplements such as citrucel, psyllium and fluids are also used to regulate constipation. Drugs such as Imodium can be used to control diarrhea.

Pictures

Reference list

1. Irritable Bowel Syndrome. http://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/basics/treatment/con-20024578
2. https://www.epainassist.com/abdominal-pain/stomach/what-is-distended-stomach
3. http://www.mirror.co.uk/lifestyle/health/bloated-stomach-5-common-causes-1196763
4. Distended Abdomen. http://www.doctorshealthpress.com/general-health-articles/distended-stomach/
5. Small Intestine Overgrowth. http://www.emedicinehealth.com/small_intestinal_bacterial_overgrowth/page2_em.htm
6. Celiac Disease. http://www.mayoclinic.org/diseases-conditions/celiac-disease/diagnosis-treatment/treatment/txc-20214635
7. https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/
8. digestivehealthguide.com/distended-abdomen/
9. www.bmj.com/content/343/bmj.d3614