Abdominal Distension, Swelling

What Causes Swollen, Enlarged, Or Distended Abdomen?

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.

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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:

  • Research the topic
  • Find a doctor with the time
  • Use a diagnostic computer system.
The process is the same, whichever method is used.

Step 1: List all Possible Causes

We begin by identifying the disease conditions which have "swollen, enlarged, or distended abdomen" as a symptom.  Here are eight of many possibilities (more below):
  • Kidney Stones
  • Gluten Sensitivity
  • Ovarian Cancer
  • Intussusception
  • Hernia
  • Sarcoidosis
  • Enlarged Lymph Nodes
  • Rapid Stomach Emptying

Step 2: Build a Symptom Checklist

We then identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
occasional unexplained nausea
very pale stools
shortness of breath when at rest
past episodes of bloodshot eyes
multiple swollen inguinal nodes
acute abdominal pain
abnormal vaginal discharge
feeling false urges to urinate
history of kidney stones
excessive flatulence
recent onset vomiting
major unexplained weight gain
... and more than 80 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of swollen, enlarged, or distended abdomen:
Cause Probability Status
Rapid Stomach Emptying 93% Confirm
Sarcoidosis 25% Unlikely
Gluten Sensitivity 19% Unlikely
Enlarged Lymph Nodes 3% Ruled out
Kidney Stones 3% Ruled out
Intussusception 2% Ruled out
Hernia 1% Ruled out
Ovarian Cancer 0% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate abdominal discomfort, The Analyst™ will ask further questions including this one:
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
Based on your response to this question, which may indicate either slight abdominal distension or significant abdominal distension, The Analyst™ will consider possibilities such as:
(Prescription) Drug Side-Effects

Certain medications, including those containing lactulose or sorbitol, may cause bloating.

Abdominal Hernia

A strangulated hernia may cause abdominal distension.

Enlarged Lymph Nodes

Enlarged Lymph Nodes also suggests the following possibilities:

Hormone Imbalance

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.

Nutritional Deficiency

Low protein intake can manifest as edema of the hands and feet, swollen abdomen, irritability, anorexia, a peeling rash, hair discoloration, and a large fatty liver.  The abdominal swelling is due to (1) ascites caused by hypoalbuminemia and (2) an enlarged fatty liver.

Ovarian Cancer

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.

Problems Caused By Being Overweight

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.

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