Distended Stomach: Causes, Symptoms, Diagnosis & Treatments

The human stomach is a hollow organ which is located in the upper left quadrant of the abdominal cavity and is responsible for the digestion of food. After consuming a meal, the walls of the stomach and the organ itself can stretch to several times of its original size when empty. This enlargement is typically unseen from outside the body, as the room inside the abdominal cavity allows the stomach to expand. The human abdominal cavity is made of the peritoneum or the inner abdominal protective lining, skin, and also subcutaneous tissue including different amounts of fat and muscles.

As this abdominal cavity is not caged by any skeletal system, it could expand after accumulating blood, fluid, gas or any kinds of mass. The whole abdomen can distend with gas and liquid, or there could be signs of protrusion (localized distention) with masses. The word stomach is often incorrectly used to refer to the abdominal cavity, and hence, the phrase distended stomach is typically said to indicate a distended abdomen.

Causes

  1. Constipation: Insufficient fiber and fluid intake and not regularly exercising can cause constipation, and the intestinal tract gets overextended with stool.
  2. Indigestion: Gas, stomach distention, and bloating are typical signs of issues related to digestion. Gastro-enteric diseases like irritable bowel syndrome or IBS, celiac disease, and ulcerative colitis are directly associated with it.
  3. Retention of fluid: When body fluids are accumulated in the abdominal cavity, and also in the nearby area, the medical condition is known as ascites or edema. A person suffering from this issue feels as if the clothes have become shorter in size or the finger ring has become much tighter. Cancer and liver disease can also be the cause of fluid retention.
  4. Infection: An infected abdomen can lead to a bloated and inflamed stomach. One should also look for additional symptoms like reddening, fever, pain, shiver, and swelling of lymph nodes.
  5. Dehydration: An imbalance in consumption and output of fluids, as well as electrolytes, can cause dehydration, which in turn leads to indigestion and eventually a distended abdomen.
  6. Sensitivity to foods: Foods like shellfish, dairy products, nuts and derivatives of bread can cause gas and even allergic responses leading to irritation and a distended stomach.
  7. Small Intestinal Bacterial Overgrowth or SIBO: When a person is suffering from SIBO, the lining of the stomach gets damaged and further leading to bloating. The uncontrollable growth of disease-causing bacteria can happen due to prolonged use of specific prescription drugs, inflammation, and indigestion.
  8. Bowel obstruction: A scar tissue or a tumor inside the bowel can obstruct it. Constipation, nausea, vomiting, intolerable pain and unable to move bowels are the accompanying symptoms which one should take into account aside from a distended stomach.
  9. Hormones: Hormonal imbalance at the time of menstruation can cause bloating in the lower stomach, constipation and fluid retention. A person suffering from severe distention of abdomen coupled with intense pain due to irregular periods, fibroids or cramps should get in touch with the healthcare service as soon as possible.
  10. Cancer: Though typically not frequently reported, but this condition can be a sign of colon or uterine cancer. These symptoms may exist when bloating does not go away, and indigestion issues are further elevated.
  11. Pelvic inflammatory disease or PID: It happens when the fallopian tubes, ovaries, or the protective lining inside the uterus is infected. Primary causes include sexually transmitted diseases or STDs like Chlamydia or gonorrhea, medical termination of pregnancy, childbirth, miscarriage, insertion of an intrauterine device or IUD. Typical symptoms of PID include pain, fever, softness in the pelvic area, discharge from the vagina.

When the whole stomach is distended

  • Peritonitis: When the inner lining of the abdominal cavity is inflamed.
  • Ascites: When fluid is accumulated inside the abdominal cavity.
  • Intra-abdominal bleeding: This could happen when internal blood vessels are ruptured succeeded by trauma or due to abdominal aortic aneurysm or AAA.
  • Functional bloating: It is still not known why this happens. It can trigger spontaneously or may be a sign of other functional disorders related to bowels like the irritable bowel syndrome or IBS.

When a particular quadrant is distended (this can happen due to a trauma in the wall inside the abdomen or a hernia)

Distention in the upper right quadrant or URQ

Distention in the upper left quadrant or ULQ

  • Hepatomegaly
  • Splenomegaly
  • Hepatosplenomegaly
  • Kidney disease
  • Pancreas disease
  • Colon disease
  • Abdominal aorta problem

When the umbilical region (the area around the navel and exactly behind it) is distended

  • A hernia
  • Massive hepatomegaly
  • Massive splenomegaly
  • Intestinal obstruction or blocking of bowel
  • Crohn’s disease (in the small intestine)
  • When the suprapubic region (the lower middle abdomen, below the belly button, and just over the external reproductive organ) is distended
  • Bladder disease
  • Prostate disease
  • Uterus problem
  • When the lower (both left and right) quadrant is distended
  • Abscess
  • Tumor
  • Intestinal obstruction or Crohn’s disease.
  • Severe constipation, impacted feces, flatus, colon cancer, colitis, or diverticulosis.
  • Gynecological problem
  • Appendicitis

Symptoms

  • Irritation
  • The feeling of being full
  • Vomiting and nausea
  • Loose Motions
  • Irregular stools
  • Fever
  • Shiver
  • Exhaustion
  • Burping
  • Pain
  • Cramps
  • Bloody stool or urine
  • Watery eyes
  • Hives
  • Inability to concentrate
  • Panting
  • Hemorrhoids

Treatment

  • Large or spicy meals should be avoided as a precautionary measure and allowing enough time for digestion will help to subside the symptoms and the discomfort.
  • One should eliminate beans, broccoli, cabbage and aerated drinks like soda from the diet as they cause gas.
  • Lactose intolerant people should avoid dairy products and should consume lactose-free milk only.
  • De-stressing and increasing the quantity of fiber in the daily menu will soothe the symptoms associated with IBS.
  • Reducing the amount of table salt in the diet and bed rest will help to alleviate the symptoms associated with ascites.
  • Diuretics (to pump out the fluid more efficiently) and antibiotics (when the ascetic fluid is infected) are usually prescribed for severe instances. Cirrhosis also causes ascites. In such cases, surgical removal of fluid or paracentesis is performed.
  • Elaborate pelvic examination and treatment with antibiotics in case of PID.
  • Sophisticated procedures like CAT scan, MRI, video capsule endoscopy is required to diagnose Crohn’s disease, s X-rays and even colonoscopy cannot detect it properly. Dietary change, supplements, and antibiotics are used to treat this condition.

When to visit the healthcare service?

  • If the abdomen continues to enlarge
  • Enlarged abdomen accompanied by fever
  • Enlarged abdomen accompanied by nausea
  • Bloody stool
  • Severe diarrhea
  • Inability to drink or eat for more than eight hours
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