From the Guidelines
Abdominal distension is most commonly caused by bowel obstruction, which can be due to various factors such as adhesions, hernias, neoplasms, and other conditions that lead to mechanical intrinsic luminal obstruction or extrinsic compression 1. The causes of abdominal distension can be broadly categorized into several groups, including:
- Excess gas accumulation
- Fluid retention
- Constipation
- Certain digestive disorders, such as irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), lactose intolerance, celiac disease, and inflammatory bowel diseases like Crohn's disease or ulcerative colitis
- Functional gastrointestinal disorders that lead to bloating and distension due to altered gut motility and visceral hypersensitivity
- Ascites from liver disease or heart failure
- Gynecological conditions like ovarian cysts or fibroids
- Malignancies in the abdomen
- Certain medications, such as opioids, anticholinergics, and some antidepressants, that can cause abdominal distension as a side effect by slowing gut motility It is essential to identify and treat the underlying cause of abdominal distension, which may require dietary modifications, medications targeting specific conditions, or in some cases, surgical intervention for structural abnormalities. In some cases, abdominal distension can be a sign of a more severe condition, such as bowel obstruction or acute mesenteric ischemia, which requires prompt medical attention 1. The diagnosis of abdominal distension can be challenging, and a thorough evaluation, including a focused history, physical examination, and diagnostic imaging, is necessary to determine the underlying cause 1. The management of abdominal distension should prioritize the identification and treatment of the underlying cause, and in cases where the diagnosis is uncertain or complications are suspected, further diagnostic testing, such as CT imaging, may be necessary 1.
From the Research
Abdominal Distension Causes
Abdominal distension can be caused by various factors, including:
- Food intolerances 2
- Previous infection that perturbed the intestinal microbiota 2
- Disordered visceral sensation 2
- Delayed intestinal transit 2
- Abnormal viscero-somatic reflux 2
- Ascites, which is the pathologic accumulation of fluid in the peritoneal cavity, often associated with liver failure and portal hypertension 3
- Intestinal obstruction, which can be caused by intra-abdominal adhesions, malignancy, and herniation 4
- Acute pancreatitis, which can cause substantial morbidity and mortality, especially in severe cases with persistent organ failure 5
Specific Causes
Some specific causes of abdominal distension include:
- Gallstones and ethanol, which are common causes of acute pancreatitis 5
- Hypertriglyceridaemia and drugs, which are notable among many causes of acute pancreatitis 5
- Intra-abdominal adhesions, malignancy, and herniation, which are common causes of intestinal obstruction 4
- Liver failure and portal hypertension, which are often associated with ascites 3
Associated Conditions
Abdominal distension can be associated with other functional gastrointestinal disorders, such as: