Swollen Belly - Distended Abdomen

The term swollen belly is often used by people to describe a feeling of increased abdominal volume associated with discomfort, usually by excess gas. Not being a medical term, the "bloated belly" has no clear definition, can mean completely different situations, from a simple and innocent gas buildup to the presence of an abdominal tumor, through pregnancy and belly fat accumulation.

Swollen belly
Swollen belly

In this text we will clarify the main factors which may lead to complaints of swollen belly. We will address not only the swollen belly, but also all other terms that describe similar situations, as distended abdomen, hard belly, excess gas, big belly, abdominal swelling, distended stomach, high stomach, bulky abdomen, abdominal swelling, etc.

Swollen belly causes

The best term to describe a bloated stomach is bloating. A distended abdomen is one that is with increased volume by the presence of some substance inside, either gas, liquid or solid.

There are also situations where the complaint is swollen belly patient, but, visually, we did not notice a real change in abdominal volume. The patient usually complains of excessive gas in this situation. Therefore, the patient feels her swollen belly and full of gas, but in fact it is almost the same size. Let's start addressing this feeling of bloating and follow then with the other causes of abdominal distension.

1. Excess gases and feeling bloated belly

As just mentioned, the feeling of abdominal bloating is often attributed to excess gas. However, the relationship between the amount of intestinal gases and the feeling of swollen abdomen is not linear. In a study comparing the average volume of intestinal gas in patients with feeling bloated stomach complaints and people without any complaint, it was noted that the gas amount in both groups was very similar (176 and 199 mL, respectively). Studies with plain radiographs and abdominal CT scans also showed no evidence of significant increase of gas in patients with gaseous distension complaint.

Many of these patients present with bloating after ingestion of certain types of foods. The most common are the oligosaccharides, a type of carbohydrate that is more difficult to be digested. Associated with malaise, the patient really starts to eliminate more gases, whether in the form of belching (burping) or flatus (pum). Examples of foods that can lead to increased emissions are:
  • Beans
  • Eggs
  • Milk
  • Potato
  • Corn
  • Wheat bran
  • Cereals
  • Broccoli
  • Asparagus
  • Garlic
  • Cabbage
  • Carbonated drinks
  • Cauliflower

Some people have some degree of intolerance to sugars contained in certain foods. Two common examples are:
  • Fructose contained in dried fruits, honey, onions and artichokes.
  • Sorbitol, a sugar substitute contained in some candy and said chewing gum without sugar.

The consumption of these foods can lead to increased gas and feeling of bloating in some people.

It is important to note that the fact of eliminating more gases does not necessarily mean that the belly is visibly swollen. A small increase in intestinal gas production may be sufficient to cause discomfort and increased frequency of flatus, but not enough to distend the abdomen visible. The patient therefore has symptoms of bloating, but the abdominal volume is virtually unchanged.

Many of the patients who complain of excessive gas and bloating, without real increase in abdominal volume, may have a milder form of irritable bowel syndrome. These patients have a greater sensitivity to gaseous distension of the intestines, feeling discomfort and swelling with small increases in intestinal gas volume, which in most people goes unnoticed.

2. Irritable bowel syndrome

The irritable bowel syndrome (IBS) is a functional bowel disorder. A functional disorder means that there is a problem with the function of the organ, but no change in structure is identified. In irritable bowel syndrome no visible lesion of the bowel, but the motility of the same is changed and the patient presents several gastrointestinal symptoms whose origin could not fully explain such as episodes of alternating constipation, diarrhea, feeling of swollen stomach, pain and abdominal cramps, increased release of gas, malaise, fatigue, nausea and others.

The irritable bowel syndrome can only cause a feeling of bloating, but can also lead to a real stretch abdominal volume caused by colonic dilatation excess gas.

3. Constipation

Constipation, called popularly constipation is a possible cause for increased abdominal size. The more intense the cold, the greater the patient's risk of abdominal distension.

Constipation may be idiopathic, ie not have a known cause, but can also be a result of health problems such as intestinal tumors, diverticula, diabetes, thyroid disease, neurological damage... Some medications can also behold the lazy bowel, leading to constipation. The most common are opioid analgesics, antidepressants, antipsychotics, antihistamine, iron and aluminum-containing antacids.

4. Celiac disease

The celiac disease is an immunological disorder characterized by the occurrence of an inflammatory reaction in the small intestine every time it is exposed to foods containing gluten, a protein present in many cereals such as wheat, oats, rye or barley.

One of the symptoms of celiac disease is the increased production of gas, cramps and feeling of swollen stomach.

5. Abdominal fat

An increase in stomach volume may be caused by accumulation of abdominal fat. Even if you feel full of gas, remember that people with excess gas can gain. Often, the reason for that pants no longer close in the abdomen may not be exactly a swollen belly, but, deposition of fat located in the abdominal region. The increase in body weight is a tip because gases do not make a patient 1,2 or 3 kilos more in the balance.

6. Pregnancy

It may seem silly talk in pregnancy, but the truth is that many women reach the advanced stages of pregnancy without knowing that they are pregnant. This is particularly common in overweight women, who already have a protruding belly, and those with very irregular menstrual cycle, which makes it difficult to know when menstruation is delayed for too long.

Even when the fetus is still too small to cause expansion of the uterus, some women may notice some swelling in the abdominal region, which is already as preparing the body to support the uterine growth. The real growth of the belly begins to appear around the 16th week of pregnancy, but in pregnant women for the first time and with a good abdominal muscles, the "pregnant belly" can only give signals later.

Pregnancy causes an increase in abdominal volume with hard belly, which is different from most other causes of swollen belly.

7. Ascites

Ascites, popularly called belly of water, is the name given to the accumulation of fluid within the abdominal cavity. Ascites is often the sign of a more serious disease, such as cirrhosis.

In most cases, ascites is not the only sign of disease the patient has, therefore, if you complains only swollen belly, and not liver diseases carrier, kidney or heart, is unlikely to have you ascites.

In more severe cases, fluid accumulation in the abdominal area can be pretty intense, reaching several liters, which causes a very swollen, hard and painful belly. Some patients have even difficulty breathing when lying down.

8. Lactose intolerance

Lactose intolerance occurs when your body has difficulty digesting lactose, the sugar found in most milk-based. Symptoms of lactose intolerance include diarrhea, cramps and bloating after consuming milk or other dairy products. Not all people have diarrhea. If you often present feeling bloated abdomen up to two hours after eating dairy, lactose intolerance may be the cause.

9. Increased intra-abdominal organs or pelvic

Organs within the abdominal or pelvic cavity that grow too can also cause increased abdominal size. Some examples:
  • Liver increased in schistosomiasis.
  • Bulky fibroids.
  • Polycystic Kidneys.
  • Tumors of the ovary.
  • Tumors of the abdominal organs.
  • Obstruction of the bladder by an enlarged prostate.

10. Parasites

Colic, gas excesses and diarrhea can be symptoms of parasitosis. The most common are giardiasis and strongyloidiasis.

11. Menstruation

During the pre-menstrual period, women may notice symptoms of swollen belly, with complaints of rising gas, feeling of heaviness in the stomach and tiredness. These symptoms are more severe in women who suffer from PMS (premenstrual syndrome).
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