Abdominal distension occurs when substances, such as air (gas) or fluid, accumulate in the abdomen causing its outward expansion beyond the normal girth of the stomach and waist. 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 diaphram and lungs can also cause shortness of breath. Through a variety of causes (see below), 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 burping (belching) or passing gas (flatulence). Medications that settle gas in the stomach and intestines are also commonly used to treat the discomfort and lessen the abdominal distension.
Experts believe that a major cause of abnormal bloating is excessive eating and sleep swallowing, known as aerophagia. Other causes of bloating include inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis, irritable bowel syndrome, diabetes, functional dyspepsia or transient constipation. In rare cases, bloating may occur in individuals who have milk intolerance (lactose intolerance), parasite infections like giardia, food poisoning (bacteria), celiac disease, severe peptic ulcer disease, bowel obstruction or after certain types of abdominal surgery.
Heart failure and cirrhosis are also a common cause of distension. In both of these disorders, fluid accumulates in the abdomen and creates a sensation of fullness. Abdominal distension can also be a symptom of ovarian cancer. Women are more prone to bloating and often identify these symptoms during menstruation. Some individuals who develop distension may have either poor motility of their intestines or may be hypersensitive to gut sensations. Certain medications, such as antidepressants and anti-spasmodics, can contribute to reduced gut motility. Studies have shown that swallowing air during eating or delayed emptying of the stomach from hyperacidity leads to bloating after a meal. Individuals who are constipated also complain of bloating. In some individuals who are hypersensitive, any volume of air may be perceived as fullness and there may not be actual abdominal distension.
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