Abdominal Distension, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Abdominal Distension, Diagnosis and Treatment and Related Diseases such as Flatulence and Belching

An abdomen may be distended by many things such as fat, flatus, feces, fetus and fluid but it invariably causes a lot of tightness in the abdomen and discomfort.

The term "abdominal distension" is meant for an actual rise in abdominal girth while the term "abdominal bloating" should be used to depict the feeling of the distension by the patient.

It is important to understand that the 2 phenomena may not be exactly the same.

It is natural to have intestinal gas, and to pass gas by the rectum (flatus) is very frequent.

Flatulence happens in the average person about 20 times a day.

The volume within the normal range (in studies that have looked at this) is anywhere from 200 cc to 2000 cc of rectal flatus.

Farts travel an average of 10 feet (3 meters) per second, or nearly 7 miles per hour

Belching, also called burping (medically referred to as eructation), is the action of expelling gas from the stomach out through the mouth.

The normal cause of belching is a distended (inflated) stomach produced by swallowed air.

The distension of the stomach produces abdominal discomfort, and the belching expels the air and alleviates the discomfort.

Abdominal distension can be generalized, or may be localized to a distinct mass or enlargement of an organ.

Abdominal distension may occasionally happen in apparently healthy people, but are much more frequent in patients with functional gastrointestinal disorders.

Abdominal bloating happens when the abdomen feels full and tight due to filling with air or gas.

When the patient is distended, the patient feels as if he or she has eaten a big meal and there is no room in the abdomen.

The abdomen may be uncomfortable or painful.

The abdomen may really appear bigger.

It can induce the clothes to fit tighter.

Most people depict bloating as feeling full, tight, or swollen in the abdomen.

The abdomen may also be swollen (distended), hard, and painful.

Abdominal distension is a frequent and objective sickness which can involve patients of all ages

The main causes of generalized abdominal distension are:
1. Fat (obesity)
2. Feces (constipation)
3. Fetus (pregnancy)
4. Flatus (gastrointestinal)
5. Fluid (ascites)

The most frequent causes are:
1. Obesity
2. Pregnancy
3. Irritable bowel syndrome
4. Constipation
5. Fibroids
6. Enlarged bladder

Abdominal distension is often accompanied by:
1. Pain
2. Excessive gas (flatulence)
3. Frequent burping or belching
4. Abdominal rumbling or gurgles

Abdominal distension can disrupt the ability to work and take part in social or recreational activities.

People who have abdominal distension use more sick days, visit the doctor more frequently, and take more medicines than other people.

Investigations

1. FBC: raised white cell count in infection or malignancy, anemia with abnormal vaginal bleeding as a result of malignancy.

2. U&Es: renal dysfunction; hypokalemia or uremia may cause non-mechanical bowel obstruction.

3. LFTs: liver failure, cholestatic hyperbilirubinemia with carcinoma of pancreas, hypoalbuminemia linked with ascites

4. Urinalysis: may show hematuria in tumors of kidney or bladder

5. Pregnancy test

6. Abdominal X-ray, barium enema: constipation, large bowel pathology, bowel obstruction

7. Abdominal ultrasound

8. Sigmoidoscopy, colonoscopy

The treatment of abdominal distension is dependent on the diagnosis of the underlying cause.

The best way to alleviate and even avoid symptoms of abdominal bloating and gas, is a healthy diet and regular exercise.

Rifaximin can reduce gas production

TABLE OF CONTENT
Introduction
Chapter 1 Abdominal Distension
C

• Language: English
• Publisher: Kenneth Kee
• Release date: Aug 10, 2020
• ISBN: 9781005862114

Kenneth Kee

Medical doctor since 1972. Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009. Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993. Dr Kenneth Kee is still working as a family doctor at the age of 70. However he has reduced his consultation hours to 3 hours in the morning and 2 hours in the afternoon. He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com. His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com This autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com. From which many free articles from the blog was taken and put together into 1000 eBooks. He apologized for typos and spelling mistakes in his earlier books. He will endeavor to improve the writing in futures. Some people have complained that the simple guides are too simple. For their information they are made simple in order to educate the patients. The later books go into more details of medical disorders. He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter. The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks. He does not do any night duty since 2000 ever since Dr Tan had his second stroke. His clinic is now relocated to the Buona Vista Community Centre. The 2 units of his original clinic are being demolished to make way for a new Shopping Mall. He is now doing some blogging and internet surfing (bulletin boards since the 1980's) starting with the Apple computer and going to PC. The entire PC is upgraded by himself from XT to the present Pentium duo core. The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive. He is also into DIY changing his own toilet cistern and other electric appliance. His hunger for knowledge has not abated and he is a lifelong learner. The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned. This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale. Dr Kee is the author of: "A Family Doctor's Tale" "Life Lessons Learned From The Study And Practice Of Medicine" "Case Notes From A Family Doctor"

Book preview

Abdominal Distension,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2020 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Abdominal Distension, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Abdominal Distension)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Abdominal distension

An abdomen may be distended by many things such as fat, flatus, feces, fetus and fluid but it invariably causes a lot of tightness in the abdomen and discomfort.

The term abdominal distension is meant for an actual rise in abdominal girth while the term abdominal bloating should be used to depict the feeling of the distension by the patient.

It is important to understand that the 2 phenomena may not be exactly the same.

What is Abdominal distension?

Abdominal distension can be generalized, or may be localized to a distinct mass or enlargement of an organ.

Abdominal distension may occasionally happen in apparently healthy people, but are much more frequent in patients with functional gastrointestinal disorders.

Abdominal bloating happens when the abdomen feels full and tight due to filling with air or gas.

When the patient is distended, the patient feels as if he or she has eaten a big meal and there is no room in the abdomen.

The abdomen experiences fullness and tightness.

It may be uncomfortable or painful.

The abdomen may really appear bigger.

It can induce the clothes to fit tighter.

Most people depict bloating as feeling full, tight, or swollen in the abdomen.

The abdomen may also be swollen (distended), hard, and painful.

Abdominal distension is a frequent and objective sickness which can involve patients of all ages

It may be linked with any of the causes of abdominal bloating but is most often linked with irritable bowel syndrome.

Abdominal bloating can have a most important force both socially and psychologically.

What are the causes of Abdominal distension?

Causes

The main causes of generalized abdominal distension are easily remembered by the five Fs:

1. Fat (obesity)

2. Feces (constipation)

3. Fetus (pregnancy)

4. Flatus (gastrointestinal)

5. Fluid (ascites)

The most frequent causes are:

1. Obesity

2. Pregnancy

3. Irritable bowel syndrome 

4. Constipation

5. Fibroids

6. Enlarged bladder

Causes of generalized abdominal distension

Non-obstructive causes

1. Obesity.

2. Pregnancy.

3. Gas – e.g., irritable bowel syndrome

4. Ascites - e.g., congestive cardiac failure, cirrhosis, nephrotic syndrome, peritoneal carcinomatosis, peritoneal tuberculosis

5. Lymphadenopathy

6. Intra-abdominal bleeding - e.g., ruptured aortic aneurysm.

7. Mechanical bowel obstruction

8. Neoplasms: intra-luminal, extra-luminal.

9. Infections: diverticular disease, intra-abdominal abscess, parasitic infections.

10. Foreign bodies: bezoar, ingested foreign body.

11. Miscellaneous: adhesions, endometriosis, pregnancy, strangulated hernia, volvulus, intussusception, gallstones, fecalith/meconium ileus, hematoma, pneumatosis intestinalis (pneumatosis coli), superior mesenteric artery syndrome, annular pancreas, Hirschsprung's disease, stenosis (radiation, surgical anastomosis site, Crohn's disease, and tuberculosis).

Non-mechanical bowel obstruction

1. Vascular insufficiency: thrombosis, embolism.

2. Retroperitoneal irritation: renal colic, neoplasm, infection.

3. Extra-abdominal infection: sepsis, pneumonia, empyema, spinal osteomyelitis.

4. Metabolic/toxic: hypokalemia, uremia, lead poisoning.

5. Chemical irritation: perforated peptic ulcer, pancreatitis, biliary peritonitis.

6. Miscellaneous: excessive intra-intestinal gas, intra-abdominal infection, injury, mechanical ventilation, and other sources of peritoneal inflammation, severe pain and non-steroidal anti-inflammatory drugs (NSAIDs).

Localized causes of abdominal distension

Right upper quadrant

1. Hepatomegaly, hepatoma, liver cancer

2. Gallbladder - e.g., mucocele, empyema, secondary to carcinoma of pancreas

3. Right colon - e.g., colonic carcinoma, feces, cecal volvulus, and intussusception

4. Right kidney – e.g., polycystic kidney, hydronephrosis, cyst, renal tumor, tuberculosis

Left upper quadrant

1. Splenomegaly.

2. Stomach: stomach cancer, gastric bloating (e.g., pyloric stenosis).

3. Pancreas - e.g., pseudocyst, carcinoma.

4. Left kidney - e.g., polycystic kidney, hydronephrosis, cyst, tumor, tuberculosis

5. Colon - e.g., carcinoma, feces, diverticular mass

Epigastrium

1. Abdominal wall - e.g., lipoma, hernia

2. Stomach - e.g., carcinoma, bloating due to pyloric stenosis.

3. Pancreas - e.g., pseudocyst, carcinoma.

4. Transverse colon - e.g., carcinoma, feces, diverticular mass.

5. Hepatomegaly

6. Retroperitoneum - e.g., aortic aneurysm, lymphadenopathy

7. Omentum - e.g., secondaries from stomach or ovary

Umbilical

1. Hernia, paraumbilical or umbilical

2. Stomach - e.g., carcinoma

3. Transverse colon -