What Is Abdominal Distension?
Abdominal distention is a manifestation of gastrointestinal health and functional gastrointestinal disorders like irritable bowel syndrome. This is characterized by increased abdominal pressure with a visible increase in abdominal diameter. Bloating is a subjective sensation of abdominal heaviness. Both distention and bloating bring pain and discomfort, reducing the quality of life. In conditions like functional dyspepsia, they are likely to have both distention and bloating, whereas bloating without distention is prevalent in individuals with functional constipation. Abdominal distention can signify the presence of gasses, fluids, and solids in the abdominal cavity. The most common cause of abdominal distention is fluid buildup in the abdominal cavity's lining, the peritoneum. This leads to tissues being inflamed due to infection.
What Are the Causes of Abdominal Distension?
The abdominal distention has either functional or organic problems. The organic problem can be explained by physical evidence like disease, and functional problems are unexplainable. Organic Causes:
They are as follows:
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Pregnancy.
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Menstruation.
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Gastroparesis - Partial paralysis of the stomach that causes the buildup of digestive contents.
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Obstruction of small and large bowels causes gas buildup and waste matter.
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Weight gain tends to be stored as intra-abdominal fat and may restrict digestion.
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Some gastrointestinal diseases lead to bloating and gas, like small intestinal bacterial growth (SIBO), exocrine pancreatic disease, celiac disease, and inflammatory bowel disease.
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Peritonitis - Inflammation of the abdominal lining.
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Fluid build-up in the abdomen caused by ascites.
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Organ enlargement from inflammatory growth.
Functional Causes:
Functional reasons for a distended abdomen involve digestion issues that lead to gas and digestive content accumulation. This includes
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Urinary retention.
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Gas from food intolerance, functional indigestion, or irritable bowel syndrome (IBS).
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Abdominal weakness that causes abdominal contents to sag outwards and downward (enteroptosis).
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Disorders of muscle contractions involving digestion cause digestive contents to back up.
What Are the Contributing Factors That Lead to Abdominal Distention While Aging?
The contributing factors that lead to abdominal distension are:
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Higher Water Content: Poorly absorbed short-chain carbohydrates like mannitol and fructose can increase the amount of water in the small intestine through osmotic effects.
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Intestinal Gas: Gas produced from the fermentation of intestinal contents is the main cause of abdominal distention. Poorly absorbed foods like lactulose get fermented by gut microbiota.
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Altered Intestinal Gas Movement: Altered transit of intestinal gas causes undue retention of gas and is associated with abdominal distention.
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Contents of the Colon: Fecal impaction increases colonic content due to constipation and causes colon distension.
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Altered Activity of Diaphragmatic and Abdominal Muscle: Reflex control of diaphragmatic and abdominal muscles causes abdominal distention.
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Visceral Sensitivity: It is a major factor associated with abdominal distention.
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Pathologic Aerophagia: Due to excessive swallowing of air and a contributing factor for abdominal distention.
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Intestinal Motility Disorder: Reduced gastrointestinal muscle contraction rate by gastroparesis. This decreases the movement of food through the gastrointestinal tract.
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Altered Pelvic Floor Function: Pelvic floor reflex control is associated with abdominal distension. The altered recto-anal inhibitory reflex is a response to the internal anal sphincter to rectal distention.
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Other Factors: Stress, anxiety, and psychological factors are related to episodes of distension. Excessive growth of bacteria in the small intestine may lead to abdominal distension by overproduction of gas and fermented products.
What Are the Tests Done to Identify the Cause of Abdominal Distention?
The symptoms are analyzed, and the site is further examined by palpation to identify the cause. Other tests include the following:
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Colonoscopy: A test is done to look for changes like swelling, polyps, and irritated tissues in the colon.
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Abdominal CT: A computed tomography (CT) is an imaging scan to detect abnormalities in the abdomen.
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Paracentesis: It is a procedure to obtain a small sample of drained ascitic fluid for therapeutic and diagnostic purposes.
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Stool Analysis: A detailed stool examination is done to identify any causes of suspicion.
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Abdominal Ultrasound: An imaging examination of the abdomen is performed to detect abnormalities.
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Blood Tests: A series of complete blood tests is done to analyze the abnormalities in the blood.
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Abdominal X-Rays: X-rays are taken to obtain a detailed examination of the abdomen.
How Is Abdominal Distention Treated in the Elderly?
The distended abdomen is treated by analyzing the cause and symptoms by examining the abdomen. The location of the distended abdomen's outward curve helps determine the organs involved and narrow down the causes. To ascertain whether fluids, gasses, or solids exist, physicians can tap or feel the region with their hands and listen to its sound.
The organs of the abdomen are classified as hollow or solid. There can be enlargement of organs due to tumors, abscesses, or cysts. A large growth might be palpable through the skin. Diagnosis can confirm then, and treatment is provided depending on the condition.
Treatment of a distended abdomen is dependent on the cause. This means managing the disease, infection, obstruction, growth, and injury. Acute cases will resolve when the underlying cause is treated. The chronic case may be treated by supplementing diuretics, activated charcoal capsules, and laxatives. Managing functional abdominal distention where the cause is unknown might take some trial and error. A hydrogen breath test helps in determining the cause of excess intestinal gas. Probiotics and enzymes improve digestive processes. Muscle weakness is caused in some cases, and abdominal and pelvic floor exercises are recommended.
What Are the Steps to Prevent Abdominal Distention in the Elderly?
Prevention is easier if the cause of abdominal distention is known. Abdominal distention occurs after a meal, then changing diet can prevent it. For example:
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Identify the food sensitivities and change the diet accordingly.
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Eating smaller amounts of food slowly and waiting longer between meals.
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Trying digestive enzymes and probiotics before meals.
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Drinking more water and consuming more fiber that prevents the accumulation of waste.
Conclusion:
Sigmoid volvulus is the most common and potentially life-threatening in elderly individuals. A volvulus of the colon occurs in the sigmoid region around 40 % of the time. The appropriate management should relieve the volvulus (when a loop of the intestine twists along with the mesentery nerve supply leading to bowel obstruction), thus reestablishing blood perfusion to affect the colon and prevent possible future recurrence. The presence of gangrenous bowel is a major predictor of morbidity and mortality. Laparoscopic sigmoidectomy minimizes surgical complications and shortens the recovery time. This provides a promising alternative for elderly individuals with chronic conditions. A distended abdomen can sometimes be a temporary issue linked to gastric and digestion issues. In some cases, this symptom can be a blessing in disguise and lead to treating an unsuspected condition or helping discover a food intolerance.
