Abdominal distension happens when matters like gas or fluid accumulate in the abdomen, causing its expansion. It is also known as a distended stomach. Patients suffering from this also complain about nausea, pain, cramps or feeling bloated. People may also experience abdominal distension, followed by constipation which can be caused by metabolic disorders like hypokalemia or endocrine disorders like hypothyroidism.

Let us have a look at various abdominal distension causes:

  • Aerophagia or excessive eating and air swallowing
  • Higher water content
  • Intestinal gases
  • Altered intestinal gas movement
  • Contents of colon
  • Inflammatory bowel diseases like IBS or transient constipation
  • Other factors like heart attack, stress or anxiety
  • Bacterial food poisoning

Causes of constant abdominal distention may be intestinal parasites, other infections, or other medical conditions. An increase in colonic contents due to constipation can result in abdominal distention due to constipation. Excessive bacterial growth in the small intestine may lead to abdominal distention of the small intestine. Long term use of medications can also lead to abdominal distention constipation.

However, Abdominal distension is not an illness in itself, it can be a sign of other medical conditions like :

  • Ascites
  • Cystic fibrosis
  • Inflammatory bowel disease
  • Kidney stones
  • Ovarian cancer
  • Polycystic liver disease
  • Pregnancy or premenstrual syndrome
  • Cirrhosis
  • Hookworm disease
  • Lactose intolerance

The 6 Fs of abdominal distention :

The six Fs examination helps the doctor to conclude about the cause efficiently. the 6Fs include-

  1. Fetus
  2. Faeces
  3. Fat
  4. Fluid
  5. Flatus
  6. Fatal mass

Some of the abdominal distension symptoms include :

  • Sense of fullness and pressure
  • The feeling of stomach bloated
  • Pain and cramps
  • Shortness of breath
  • Diarrhoea
  • Belching

Patients may encounter other symptoms too, like nausea, vomiting, fever and fatigue. If you notice any of these symptoms, then you should rush to your nearest gastroenterologist as these signs can be indicative of an underlying medical illness. Early diagnosis can save you from abdominal distention complications. People with Irritable Bowel Syndrome (IBS) are more likely to have bloating and abdominal distension; whereas, patients with functional constipation may experience bloating without abdominal distension.

Abdominal distention treatment :

The treatment for abdominal distention is individualized. It depends on the age, medical history, and current medical diseases of the patient. Sometimes, working on an individual’s diet and lifestyle can help in overcoming the side effects of this medical condition. Excess dietary fibre is a common cause of distention and gastroenterologists advise their patients to keep a low fibre diet by avoiding foods rich in fibre such as cabbage, dry beans, broccoli. People should be physically active. If the patient is lactose intolerant, then he is advised to avoid dairy products. People may also take some over-the-counter medications such as antibiotics to treat bloating.

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Case Review

This case study presents a patient with abdominal distention and constipation. A 39-year-old man was brought into the hospital with a complaint that he had acute pain in his abdomen. He was bloated and constipated for a week. He denied nausea and vomiting. The patient’s family rushed him into the hospital. The patient was taken to the emergency room for evaluation. As told by the family, he had a past medical history. He had diet-controlled type 2 diabetes, gastroesophageal reflux disease, hypercholesterolemia, hypertension, and hypothyroidism. The patient had a history of kidney stones. Due to his health conditions, he was on several medications. In the emergency room, when the patient was under observation by one of the renowned gastroenterologist and transplant hepatologist in New Delhi and her team, they were able to diagnose from his symptoms that it was an abdominal distention followed by constipation. The patient went for a few scans including, abdominal X-Ray, abdominal ultrasound, Sigmoidoscopy, colonoscopy, CT, blood and urine tests.

Case Discussion

Though most of the abdominal distention causes remain unknown, with the help of her team, the doctor was able to find out the reason for this one. The abdominal distention caused in this case was due to Ascites. His scans came out to be slightly problematic. An abdominal ultrasound was conducted again to rule out any further possibility. Some of the parameters in his blood and urine culture were not within the normal range. Thankfully, the patient was in the hands of one of the best liver specialist in Delhi, and she, along with her team, took care of the complications. There was evidence of shifting dullness or bulging flanks in the reports of the patient. The crew decided to start with the treatment while keeping him under observation for the next 48 hours.

Clinical Symptoms

According to the condition reported by his family i.e.- fast weight gain, indigestion, along with swelling in knees were some other clinical symptoms of ascites. When the doctor talked to the family of the patient, she was able to get a clearer picture. It further helped doctors to eliminate all doubts, and after looking at the lab results, they made out it was ascites. The doctor then performed paracentesis. It is a procedure to remove large amounts of excess fluid through a needle inserted into your belly. This procedure helped her to find out the cause of the condition so that, the patient undergoes the appropriate treatment for his ailment.

Management

The first and foremost management required when treating the patient with severe constipation abdominal distention is calming the patient down. Our team of doctors were able to counsel the patient and explain his medical condition to the family. After a complete diagnosis, the patient was taken to the Intensive Care Unit, followed by operation theatre, where he had undergone surgery. The doctor prescribed him drugs and advised him of some modifications in his diet and lifestyle to control any future problems while administering the existing one. The doctor is the best gastroenterologist and transplant hepatologist in New Delhi. She was able to manage and cure the patient before any additional complexities. The patient got his discharge in due time and was sent back home in a healthy and happy condition.

FAQ:

1. Can people with covid-19 develop abdominal distention and constipation?

Yes, people can be diagnosed with abdominal distention covid. The reason being many symptoms of covid like vomiting, fatigue, diarrhoea overlap with symptoms of abdominal distention.

2. How can one prevent abdominal distension followed by constipation?

Limiting intake of carbonated drinks, exercising regularly, avoiding chewing gums, keeping a watch on sodium, salt in the diet can be fruitful in preventing this ailment. Along with these, one should also follow a less fibre diet and lactose-free products.

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