Swollen, enlarged, or distended abdomen can have various causes, ranging in severity from 'minor' to 'generally fatal'. Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.
Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms. In order to diagnose swollen, enlarged, or distended abdomen, we could:
Cause | Probability | Status |
---|---|---|
Ascites | 97% | Confirm |
Enlarged Lymph Nodes | 21% | Unlikely |
Enlarged Bladder | 18% | Unlikely |
Intestinal Obstruction | 4% | Ruled out |
Giardia | 1% | Ruled out |
Rapid Stomach Emptying | 0% | Ruled out |
Drug Side-Effects | 0% | Ruled out |
Fibroids | 0% | Ruled out |
Do you experience any abdominal swelling / distension that does not appear to be meal-, gas- or weight-related? In other words, is your abdomen larger than it should be?
Possible responses:
→ No / probably meal/gas/weight-related / don't know→ Slight, comes and goes with or without meals → Slight, always present with or without meals → Significant, comes and goes with or without meals → Significant, always present with or without meals |
Certain medications, including those containing lactulose or sorbitol, may cause bloating.
A strangulated hernia may cause abdominal distension.
A study of 51 women, 26 with endometriosis and 25 without, found that a significantly larger proportion of women with endometriosis than control subjects experienced abdominal bloating (96% vs. 64%) [J Obstet Gynaecol Can. 2009 Dec; 31(12): pp.1159-71]
Hormonal fluctuations such as those occurring with pregnancy or at the start of a menstrual period (these raise progesterone levels) can slow down gut motility and cause food to pass more slowly through the digestive system, sometimes causing bloating and/or constipation.
Abdominal swelling/bloating/clothes being too tight is a possible early warning sign. The symptoms of ovarian cancer are vague, which means that it is often diagnosed too late. If bloating is continuous and you have other symptoms such as abdominal fullness and pain, it should be considered.
The classic 'beer belly' is usually caused by high levels of visceral fat. This is not the same as subcutaneous fat, which lies immediately under the skin. Visceral fat or "gut fat" surrounds the internal organs and causes central obesity.