Expert commentary bloating, distension, and the irritable. He went to see his local provider and was found to have abdominal distension figure 1 thought to be secondary to newly developed cirrhosis and ascites. Abdominal distension is a sense of increased abdominal pressure that involves an actual measurable change in the circumference of a persons abdomen. Other symptoms of diverticulitis include fever, nausea, and vomiting. Past medical history was significant for coronary artery disease status post stent placement 5 years prior, systolic heart failure, and colon cancer status after segmental resection 15 years prior. All of our patients had abdominal pain that was dull, nagging, and chronic. Abdominal distension is symptom of a wide variety of mild to serious diseases, disorders and conditions. Abdominal distension or tenderness inability to stand without severe dizziness or light headedness new or worsened incontinence, pain with urination, blood in urine very low urinary output new skin condition e. Abdominal distension an overview sciencedirect topics. Bloating and distension have been reported in up to 96% of patients with irritable bowel syndrome. He also described fevers, drenching night sweats, chills, and a 4kg weight loss over 2 months.
Pdf ten to 25% of healthy persons experience bloating. Parker, 1959, abdominal distension was among the first symptoms experienced by most patients. The gastric reservoir is well known for its rich vascular network which generally protects it from ischemia when significant gastric distension occurs, so gastric necrosis is a very rare event. Abdominal distension causes, symptoms, diagnosis, treatment. Abdominal distension caused by ascites occurs at some time in almost every patient with bcs. The patient was taking nutritional supplements but no prescription medications. Distension definition is the act of distending or the state of being distended especially unduly or abnormally. Gastric infarction as a complication of acute gastric dilatation is an unusual associated circumstance. It is typically a symptom of an underlying disease or dysfunction in the body, rather than an illness in its own right. It is a commonly reported symptom and is sometimes associated with distension, or the visible increase in the width of the area between your hips and chest abdominal girth. Apr 06, 2018 a distended stomach is a condition where there is swelling or distension of the abdomen and not actually of the stomach. Bloating is more commonly seen in patients with ibs, whereas. Melissa conrad stoppler, md a distended stomach is a term usually used to refer to distension or swelling of the abdomen and not of the stomach itself. However, many healthcare providers are concerned that symptoms of bloating and abdominal distention are signs of small intestinal bacterial overgrowth sibo.
Diagnoses range from benign entities eg, irritable bowel syndrome ibs to lifethreatening diseases eg, ruptured abdominal aortic aneurysms aaas. The causes of localized distension may differ depending on the location one of the four abdominal quadrants. In a us household survey, 16% of the population reported having bloating or distension, and three quarters of them found it to be moderate to severe. Apr 26, 2020 the term abdominal distension is used to describe a few different possible conditions, relating to both the perception that bloating is occurring in the stomach and also actual physical bloating with a noticeable increase in the size of the stomach.
A man in his 70s with hypotension and increasing abdominal. Abdominal distension differential diagnosis free questions and answers for doctors and. The parents reported that his abdomen would become more and more distended as the day. Distension abdominal abdominal distension sciencedirect. One of the most common causes of lower left side abdominal pain. Rectal examination to determine any obvious enlargement large animals is also helpful. Clinical assessment will usually indicate the nature of abdominal distension ie whether ascites, gastrointestinal gas, pregnancy, etc but further investigations are often required to determine the precise aetiology. While the cause of bloating remains unknown old explanations such as a excessive intestinal gas, exaggerated lumbar lordosis and psychiatric.
To be updated when it is complete please like us on facebook, follow us on twitter or subscribe on youtube using the follow us buttons. Abdominal bloating and distension in functional gastrointestinal. Abdominal distension also occurs in individuals with lactose intolerance, bacterial food poisoning, parasitic infections like giardia, bacteria like helicobacter pylori h. Feb 26, 2019 abdominal distension is a manifestation of functional gastrointestinal disorders, such as irritable bowel syndrome ibs, and is characterized by an increase in abdominal pressure together with a. These pouches can tear, swell, and become infected. Abdominal distension symptoms, diagnosis, treatments and.
It is particularly common in persons with the irritable bowel syndrome and constipation. A 32monthold boy was referred to the encopresis clinic at the university of iowa because of abdominal distension during the past 4 weeks. Abdominal distension occurs when substances, such as air gas or fluid, accumulate in the abdomen causing its outward expansion beyond the normal girth of the stomach and waist. Acs is potentially fatal, with a mortality rate of 40 100%. The first pivotal step in diagnosing abdominal pain is to identify the location of the pain. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease. Distension definition of distension by merriamwebster. Pdf functional abdominal bloating with distention researchgate. A man in his 70s was brought to the emergency room by his family for 2 days of altered mental status. It is described as a feeling of abdominal tension or swelling of the abdomen and may or. What causes abdominal swelling abdominal distension.
Abdominal distention american academy of pediatrics. Observation of the abdominal symmetry allover the abdomen. Abdominal pain is the most common cause for hospital admission in the united states. Management strategies for abdominal bloating and distension ncbi. The content on this site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. Briefly, abdominal bloating is the subjective symptom and dis.
Pathophysiology, evaluation, and treatment of bloating. He also experienced increasing abdominal distention, a declining appetite, and persistent nausea. The patient said that he was unable to urinate and had not had a bowel movement in 6 days. In the large collected series mitchell et al, 1982. Approximately 50% of patients with a sensation of bloating also describe abdominal distension. Abdominal distention can be a challenging clinical problem. Jan 10, 2005 although abdominal distension formed part of the original diagnostic criteria for ibs described by manning and colleagues, later studies have suggested that bloating distension is not a reliable indicator of the disease, especially in men,9,11 and this was confirmed in factor analyses leading to the development of the current rome criteria. Differential diagnosis for abdominal distension oxford medical. Immigrant with stomach pain, distension, nausea, and fever.
Differential diagnosis for abdominal distension oxford. This is a pdf file of an article that has undergone enhancements after. Individual patients may weight differently the impact. Interact care paths and change in condition file cards. After the failure of conservative treatment, a colonoscopic decompression was required. Abdominal distension is the swelling or enlarging of the abdomen in the area between the ribs and the groin. Abdominal distension can result from infection, malignancy, inflammation, trauma, fluid retention, obstruction and other abnormal. Bloating can be described as the feeling that there is an inflated balloon in the abdomen. Bloating, as a symptom and abdominal distension, as a sign, are both common functionaltype complaints and challenging to manage effectively. A woman, 82 years of age, presented to the emergency department with an 8 day history of worsening generalised abdominal pain, nonfaecal emesis and abdominal distension associated with a background history of 20 kg weight loss over the past few months. Localized distension means that the enlargement is more prominent in one part of the abdomen.
Distended stomach causes entire abdomen or certain quadrants. The case is presented of a patient with alzheimer disease, who was referred to the hospital emergency department for primary care due to an abdominal distension of several days onset. Functional abdominal bloating with distention ncbi. Common and important causes of abdominal distension for doctors and. It is particularly common in persons with the irritable bowel syndrome and.
Conditions that cause distended stomach include indigestion, lactose intolerance, malabsorption, problems in bowel function ibs, or constipation. Rise in iap causes tissue hypoperfusion which can lead to multiple organ dysfunction syndrome and impair the function of nearly every organ system. New suggestions include recent weight gain, weak or inappropriately relaxed abdominal. While the cause of bloating remains unknown old explanations such as a excessive intestinal gas, exaggerated lumbar lordosis and psychiatric problems have been disproved. Abdominal distension is a manifestation of functional gastrointestinal disorders, such as irritable bowel syndrome ibs, and is characterized by an. Careful history taking and abdominal examination are essential. Management strategies for abdominal bloating and distension. Thus, abdominal pain should not usually be expected to be a feature, except with abdominal distension due to gas in bowel obstruction. While the cause of bloating remains unknown old explanations such as a excessive intestinal gas, exaggerated lumbar.
Abdominal distension occurs when substances, such as air gas or fluid, accumulate in the abdomen causing its expansion. Distension spelled distention in many style regimens generally refers to an enlargement, dilation, or ballooning effect. The extensive gaseous abdominal distension was due to aerophagia and withholding of stool and flatus. Diverticulitis can develop when small pouches called diverticula. There are no statistical definitions of distention available to pediatricians. So if there is distension, it may be unilateral or bilateral. Treatment for distended stomach includes making dietary changes and medications. Aerophagia as cause of gaseous abdominal distention in a tod. Excessive gas flatulence, frequent burping eructation, and abdominal rumbling borborygmi are some of the other bloatingrelated symptoms that may be present in some patients. Abdominal distension, typically a symptom of an underlying disease or dysfunction in the body, rather than an illness in its own right. Sigmoid volvulus 8% of all intestinal obstructions, more common in elderly. Common and important causes of abdominal distension for doctors and medical students this page is currently being written and will be available soon. Following the visit, however, his abdominal pain worsened.
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