What Is Abdominal Distension? Causes and Treatment

In the U.S., approximately 17 million Americans report having frequent gas each year. While 27 million Americans suffer from excessive bloat. Bloating and gas discomfort may sometimes be preventable or treatable, but we want to teach you how to deal with them if they occur.

Abdominal distension is defined as a gastrointestinal disorder where there is excessive gas accumulation in the abdomen. This causes discomfort and pain, and often related to functional dyspepsia, functional bloating, and IBS. 

This article will cover abdominal distension symptoms, causes, how to treat them, and prevent them.

Abdominal Distension Symptoms

It is important to understand the symptom differences between abdominal distension vs bloating first. 

Abdominal Bloating occurs when there’s an increase in gas inside your stomach and makes it feel larger. 

Abdominal Distension is the actual “physical” finding that your abdominal area is larger than normal and protrudes outward.

Feeling bloated can occur without actually being distended.

For example, after eating a large meal, you might feel bloated, but are not actually distended. The abdomen needs to increase in size to be distended, which you can find out if it’s you measure the abdominal circumference.

Distension is more serious than bloating, and is caused by three things:

  • Air
  • Fluid
  • Tissue

If you want to find the source of your distension, you need to first identify if it’s continuous or intermittent distension. Continuous distension is when the abdomen swells for a long period of time with no relief.

The swelling could be caused by a number of things:

  • Organ enlargement inside the abdomen. Usually the liver – hepatomegaly or spleen – splenomegaly.
  • Tumor or growth in the abdomen. The growth can be benign (e.g., uterine fibroids) or malignant, which includes tumors of various intra-abdominal organs.
  • Ascites that develop and lead to a fluid increase around abdomen organs. Ascites will come from kidney disease, liver disease, certain infections, heart failure, and some cancers. 
  • Obesity
  • Gas and/or stool

Intermittent distension can come and go and is usually triggered by ailments which inhibit proper digestion, and cause an accumulation of fluid, stool  or gas within the digestive system.

Identifying and separating bloating and distension are important because your treatment will vary based on diagnosis.

Abdominal Distension Causes

Bloating, distension, gas and flatulence may be caused by several factors. It’s essential to identify your cause before treating any condition.

One common cause for abdominal distension irregular digestion.

Food digestion occurs when chemicals break down food molecules into smaller parts, called components. These components provide the nutrients and energy to the body to use for fuel.

The food that doesn’t break down is waste that is eliminated from your body. Waste from some foods may come in the form of odors that are odorless and are easily dealt with by the digestive system.

If your digestive system isn’t working well, then sulfur-bearing gasses may collect inside your stomach and intestines. Gas causes pain by stretching out your intestines, which produces the uncomfortable feeling of bloating.

Sulfur-bearing gases can be caused by:

  • Lactose intolerance and other food intolerance
  • Irritable bowel syndrome (What is IBS in Medical Terms?)
  • Food allergies
  • Gas-producing fruits and vegetables such as beans, broccoli, cabbage, brussel sprouts, onions, artichokes, asparagus, pears, apples, peaches
  • Whole grains – whole wheat, bran
  • Soft drinks (carbonation) and fruit juices
  • Milk and other dairy products
  • Artificial sweeteners – sorbitol and xylitol

The production of gases is not the only cause of bloating, distenson, gas and flatulence. Other common causes of pain and discomfort could be:

  • Overeating
  • Constipation
  • Menstruation and premenstrual syndrome
  • Polycystic ovary syndrome and ovarian cysts

Abdominal Distension Diagnosis

Bloating, gas and flatulence can be diagnosed through various types of medical tests. Your doctor will take your medical history and perform a physical exam to assess your symptoms, and if the distension is continuous or intermittent. 

If the doctor diagnoses that the symptoms are intermittent or tied to certain foods, then the distension causes could be from an increase in gas. Then the distension can be treated with diet and lifestyle changes. 

However, if the doctor diagnoses the symptoms are continuous, the distension could be caused by something more serious, like a digestive disease, enlarged abdominal organs, excess abdominal fluid, obesity or tumors. 

To identify and diagnose causes, more comprehensive tests are usually needed. They may include:

  • An abdominal X-ray checks for the presence and location (if any) of large accumulations of gas or stool or if there’s a blockage.
  • MRI, CT scans, and ultrasounds help to identify the presence of enlarged abdominal organs, tumors,  and abdominal fluid.
  • Breath tests measure the hydrogen or methane levels in an individual after a meal, which help to identify bacterial overgrowth that can lead to increased gas production.

While gas may be an embarrassing symptom, it’s not necessarily indicative of a serious condition. If the gas is becoming more uncomfortable and hard to manage, see your doctor to help you manage the gas. 

See your doctor if you experience abdominal pain, diarrhea, constipation, vomiting, weight loss, and/or bleeding from the anus. 

Abdominal Distension Treatment and Prevention

Common abdominal distension symptoms include an increase of gas production, constipation or less serious digestive ailments. Treatment for these conditions may include increasing dietary fiber intake, taking probiotic supplements, and making some simple adjustments to your diet and lifestyle.

If sudden increases in fiber cause bloating and gas, then increasing the amount of fiber in your diet slowly may help prevent these symptoms from worsening.

Another good solution for treating symptoms is replacing the natural digestive enzymes lost as we get older. A good digestive enzyme supplement contains multiple enzymes, because each type of food requires different enzymes to break it down.

One of the easiest lifestyle and diet changes to make is by keeping a food diary. Write down what you eat, how much you eat, what time you eat, and how you feel afterwards every day. 

The food journal will help you to identify what foods, food combinations, and eating times that led to uncomfortable symptoms. This will help you adjust your eating behaviors, so you can avoid certain foods and times that are bringing up symptoms. 

Here are some common diet changes that are made to help with gas, bloating, and flatulence. 

  • Eat fresh fruit and vegetables – They are high in fiber and ease constipation. Drink half your body weight in ounces of clear fluids daily. This helps flush your system, add moisture to your colon, and keep things moving smoothly through your digestive system.
  • Avoid soft drinks and carbonated beverages – Carbon dioxide can become trapped in your bowels, which causes bloating.
  • Eat fresh foods – Packaged foods will contain more preservatives, making them harder to digest.
  • Read labels and avoid high-sodium foods – Sodium will dehydrate and limit your water intake. It can also lead to more fluid retention, which can make you feel bloated.
  • Eat dairy in moderation – If lactose intolerance is a problem for you, this will ease digestion of those products. Look for lactose-free products or try Lactaid if you know you have problems with dairy and can’t eliminate it from your diet.
  • Avoid foods that are too cold or too hot – The extreme temperatures can increase your air intake during a meal.
  • Avoid caffeine – It acts as a stimulant and can over stimulate your digestive system.
  • Avoid high-fat foods – Food with high fat content is hard to digest and empties from stomach slowly. That makes you feel full for longer periods of time.
  • Exercise – Movement encourages bowel activity. It’s best in the morning before breakfast or after a meal.
  • Increase Fiber Intake – Gradually increase fiber to 25-30 grams per day. Fiber helps multiple digestive ailments, including constipation, diarrhea, bloating and gas. Learn more about Fiber For IBS.

Implement these changes gradually, tackling only one or two at a time. Don’t make many sudden changes simultaneously.

Studies show people can best modify their behavior by making gradual changes and focusing on a limited number of goals at one time. Remember to keep track of your progress, so you will know what changes work better than others.

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Julie C. Guider MyGoodGut

Medically reviewed by Julie Guider, M.D.

Dr. Julie Guider earned her medical degree from Louisiana State University School of Medicine. She completed residency in internal medicine at the University of Virginia. She completed her general gastroenterology and advanced endoscopy fellowships at University of Texas-Houston. She is a member of several national GI societies including the AGA, ACG, and ASGE as well as state and local medical societies.