Abdominal Bloating

Abdominal bloating, also known as abdominal distension, is the feeling of heaviness or pressure in the abdomen. This swelling is usually caused by the accumulation of gas, fluid, tissue, or digestive contents within the abdominal structures, particularly in the gastrointestinal tract.

Abdominal distension may be classified into two types depending on how the swelling presents:

• Postprandial: occurs transiently after eating.
• Persistent: results from chronic digestive disorders or systemic conditions.

The prognosis of abdominal inflammation depends on its underlying cause. In general, these are usually mild conditions that resolve within a short period of time. However, when symptoms persist, patients should consult a specialist to assess the cause and severity.

Symptoms

The characteristic symptoms of abdominal bloating include:

• Visible abdominal swelling, with the abdomen appearing firm and distended.
• A feeling of heaviness.
• Excess gas, causing frequent belching and intestinal noises.
• Pain or cramps.
• Pressure in the stomach.
• Nausea.
• Early satiety when eating.
• Constipation.

Causes

Abdominal bloating can have many different causes, including:

• Gas accumulation: usually caused by:
  • Consumption of fermentable foods, such as legumes, broccoli, cauliflower, cabbage, onions, carbonated soft drinks, or beer.
  • Food intolerances (to lactose, gluten, fructose, sucrose, or histamine).
  • Dysbiosis: imbalance of the intestinal microbiota.
• Ascites: the accumulation of excess fluid in the abdomen, commonly caused by:
  • Cirrhosis: liver damage resulting from prolonged liver inflammation.
  • Liver failure: impaired liver function.
  • Heart failure: inability of the heart to pump oxygen-rich blood effectively.
  • Nephrotic syndrome: a disorder affecting the kidney blood vessels, causing inadequate filtration of waste products from the blood.
  • Pancreatitis: inflammation of the pancreas that interferes with its function.
• Intestinal obstruction: a partial or complete blockage that prevents the passage of food and fluids through the intestine. It may be caused by:
  • Abdominal adhesions: formation of bands of scar tissue connecting structures that should normally remain separate.
  • Hernias: protrusion of an organ or tissue through the cavity in which it is normally contained.
  • Crohn's disease: a chronic inflammatory bowel disease.
  • Diverticulitis: inflammation of small pouches that form in the intestinal wall.
  • Certain medications, such as opioids, antidepressants, or calcium channel blockers.
  • Tumours: due to their size, they may obstruct the colon or small intestine.
• Irritable bowel syndrome: a chronic disorder that causes pain and changes in bowel movements.
• Constipation: difficulty passing stools or having fewer than three bowel movements per week on a regular basis.
• Functional dyspepsia: stomach discomfort without a clear cause.
• Small intestinal bacterial overgrowth (SIBO): excessive growth of bacteria in the intestine, particularly in the small intestine, which disrupts normal body function.
• Peritonitis: inflammation of the peritoneum, the membrane lining the inner abdominal wall.
• Polycystic ovary syndrome (PCOS): a hormonal imbalance that causes enlarged ovaries and the development of numerous follicles.
• Uterine fibroids: benign tumours that develop in the uterus.
• Endometriosis: growth of endometrial-like tissue outside the uterus.
• Hormonal changes: menstruation or the early stages of pregnancy often cause abdominal bloating.
• Cancer: tumour growth may increase abdominal size, although abdominal enlargement may also be related to ascites caused by cancer. The most common cancers include:
  • Stomach cancer.
  • Colon cancer.
  • Pancreatic cancer.
  • Liver cancer.
  • Uterine cancer.
  • Bladder cancer.
  • Ovarian cancer.

Risk Factors

The risk of abdominal distension increases in the following situations:

• Having any of the conditions described above.
• Women experiencing hormonal changes.
• Smoking: chemicals present in tobacco irritate the digestive tract.
• Eating too quickly or chewing gum.
• Sedentary lifestyle.
• Poor abdominal muscle tone.

Complications

In addition to complications arising from the underlying diseases that may cause it, abdominal bloating can worsen if left untreated and lead to:

• Chronic pain.
• Malnutrition and weight loss, because inflammation interferes with proper nutrient absorption.
• Fistulas: formation of abnormal connections between organs that are not normally connected.
• Abscesses: infection and accumulation of pus within fistulas.

What doctor treats abdominal bloating?

Depending on its cause, abdominal distension may be managed by specialists in Family and community medicine, Gastroenterology, General and digestive system surgery, Medical oncology, Radiation oncology, or Gynecology and Obstetrics.