ABDOMINAL DISTENSION

SUPERVISED BY : DR.BASIM ALMGOTER .

DONE BY : ZAINAB AHMED HABEB.
 DEFINITION

• Abdominal distension is defined as an increase in the volume of the

abdominal cavity.
• Apparent abdominal distension secondary to poor posture, the natural
lordosis of childhood, abdominal wall weakness, obesity, and pulmonary
hyperinflation may be mistaken for true abdominal distension.
• Abdominal distension occurs when substances, such as air (gas) or fluid,
accumulate in the abdomen causing its expansion.
• It is typically a symptom of an underlying disease or dysfunction in the
body, rather than an illness in its own right.
• People suffering from this condition often describe it as "feeling bloated",
Sufferers often experience a sensation of fullness, abdominal pressure
and possibly nausea, pain or cramping ,In the most extreme cases,
upward pressure on the diaphragm and lungs can also cause shortness of
breath. Through a variety of causes, bloating is most commonly due to
buildup of gas in the stomach, small intestine or colon. The pressure
sensation is often relieved, or at least lessened, by belching or flatulence.
• Medications that settle gas in the stomach and intestines are also
commonly used to treat the discomfort and lessen the abdominal
distension.

COMMON CAUSES OF ABDOMINAL DISTENSION

• Aerophagia (crying, feeding) .

• Gastroenteritis .
• Obstipation .
• Pregnancy .
• Traumatic ileus .
• Intestinal obstruction (mechanical) .
• Obstructive uropathy (infants) .
• Pneumonia/sepsis .
• Peritonitis .
• Intra-abdominal bleeding .
• Hemolytic disease .
• Congestive heart failure .
• Hepatitis .
LIFE-THREATENING CAUSES OF ABDOMINAL DISTENSION

Infectious : Others :
• Peritonitis Intestinal obstruction (mechanical).
• Sepsis/pneumonia. Electrolyte abnormality.
• Botulism. Renal failure.
• Pancreatitis Poisoning.
• Congenital syphilis Necrotizing enterocolitis .
• Hepatitis Intestinal perforation .
• Tuberculosis Shock.
• Congenital Budd-Chiari syndrome .
• Tyrosinemia Congestive heart failure .
• Galactosemia Pericarditis.
• Hemolytic disease Portal hypertension.
• Traumatic Acquired immunodeficiency
• Intra-abdominal bleeding syndrome.
• Neoplastic
• Leukemia and other malignancies .

DIAGNOSIS

The first step in diagnosis is to determine the etiology of abdominal

distension. After making a differential diagnosis of abdominal distension, it is
important to take a careful medical history. Here are the most common
causes of abdominal distension classified as an underlying cause and as a
secondary disease.
As an underlying disease cause:
• Constipation
• Lactose intolerance and other food intolerances
• Overeating (due to overproduction of gases in the digestion process )
As a secondary disease cause:
• Celiac disease
• GERD (gastroesophageal reflux disease)
• Peptic ulcer disease
• Accumulation of fluid in the peritoneal cavity (e.g. ascites)
TREATMENT

Bloating is not life-threatening. In most cases, bloating can be handled with

simple home remedies and changes in lifestyle. Persistent or recurrent
bloating may be caused by intestinal parasites, other infections, or other
medical conditions.

• Foods
Certain foods have been known to worsen bloating. Poorly digested
components of many foods are excreted into the large intestine where they
are degraded by bacteria, producing excess gas. Depending on the
undigested component, this may affect the odor and the volume of gas
created.
Excess dietary fiber intake is a known cause of belching, gas and bloating.
Many vegetables are known to cause bloating due to high levels of fiber and
undigestible sugars such as raffinose (e.g. beans, cabbage, broccoli).
There are many individuals who are unable to tolerate dairy products
because of lactose intolerance. Such foods should be eliminated from the
diet if symptoms develop.

• Medications
For some people, recurrent distension symptoms worsen their quality of life
and thus many resort to health supplements or medications. Dietary
supplements containing various enzymes, for example Beano, are
formulated to help break down complex carbohydrates and vegetables in
order to reduce substances in the gut that cause bacterial overgrowth and
subsequent bloating. Though these enzymes can help reduce gas and
.belching, they may not always reduce bloating
Other over the counter formulas recommended for bloating include
simethicone and activated charcoal. Probiotics are also used to treat bloating
based on the theory that improved gut flora will improve digestion and lessen
gas generation.