Abdomen - swollen
Swollen belly; Swelling in the abdomen; Abdominal distention; Distended abdomen
A swollen abdomen is when your belly area is bigger than usual.
Uterine fibroids are common, non-cancerous or benign tumors that can grow in a woman's womb, or uterus. You might be surprised to learn that one in five women may have this sometimes painful problem during their childbearing years and half of all women will probably have them by age 50. So, let's talk about uterine fibroids. Fibroids are abnormal growths made of smooth muscle cells. The cause of uterine fibroids is unknown, but their growth has been linked to estrogen, a hormone that plays a vital role in pregnancy and how your body uses calcium and maintains healthy cholesterol levels. As long as a woman with fibroids is menstruating, a fibroid will probably continue to grow, usually slowly. As many as 40% though will shrink on their own. Fibroids can be tiny, detectable only by microscope, or they may grow very large, even filling the entire uterus. Most fibroids are small and cause no symptoms at all. If you do have symptoms, the most common symptoms of fibroids is heavy or prolonged periods. Bleeding between periods is not typical of fibroids. Fibroids can also cause fullness, pressure, or pain. For instance, a fibroid pressing on the bladder can make the bladder seem smaller, or more difficult to empty. A fibroid pressing on the rectum, can cause constipation. Particularly painful periods are often reported by many women with fibroids, especially those who pass blood clots or who have very heavy flow. Fibroids that change the shape of the inside of the uterus can make it difficult to conceive, or to carry a baby to term. To treat uterine fibroids, your doctor will first perform a pelvic exam to see if you have a change in the shape of your uterus. You may need an ultrasound or a pelvic MRI to confirm the diagnosis of fibroids. Your doctor may take a sample of tissue called a biopsy to rule out cancer. Once your doctor diagnoses fibroids, treatments may include birth control pills to manage heavy periods, intrauterine devices that release the hormone progestin to help reduce heavy bleeding and pain, or iron supplements to prevent or treat anemia due to heavy periods. Women who have fibroids growing inside the uterine cavity may need an outpatient procedure to remove the tumors. A procedure called uterine artery embolization can stop the blood supply to a fibroid, causing it to shrink and die. Surgery called myomectomy removes fibroids, especially for women who want to have children. Finally, some women may need a hysterectomy, or the removal of the uterus, if medicines do not work and other surgeries and procedures are not an option. Most women with fibroids may have no symptoms at all and may need no treatment at all. During pregnancy, existing fibroids may grow due to increased blood flow and estrogen levels. But they usually return to their original size after the baby is born. Call your health care provider if you have changes in your periods, including heavier bleeding, increased cramping, or a feeling of fullness or heaviness in your lower belly area.
Causes
Abdominal swelling, or distention, is more often caused by overeating than by a serious illness. This problem also can be caused by:
- Air swallowing (a nervous habit)
- Buildup of fluid in the abdomen (this can be a sign of a serious medical problem)
- Gas in the intestines from eating foods that are high in fiber (such as fruits and vegetables)
- Irritable bowel syndrome
- Lactose intolerance
- Ovarian cyst or cancer
- Partial bowel blockage
- Pregnancy
- Premenstrual syndrome (PMS)
- Uterine fibroids
- Weight gain
Home Care
A swollen abdomen that is caused by eating a heavy meal will go away when you digest the food. Eating smaller amounts will help prevent swelling.
For a swollen abdomen caused by swallowing air:
- Avoid carbonated beverages.
- Avoid chewing gum or sucking on candies.
- Avoid drinking through a straw or sipping the surface of a hot beverage.
- Eat slowly.
For a swollen abdomen caused by malabsorption, try changing your diet and limiting milk. Talk to your health care provider.
For irritable bowel syndrome:
For a swollen abdomen due to other causes, follow the treatment prescribed by your provider.
When to Contact a Medical Professional
Contact your provider if:
- The abdominal swelling is getting worse and does not go away.
- The swelling occurs with other unexplained symptoms.
- Your abdomen is tender to the touch.
- You have a high fever.
- You have severe diarrhea or bloody stools.
- You are unable to eat or drink for more than 6 to 8 hours.
What to Expect at Your Office Visit
Your provider will perform a physical exam and ask questions about your medical history, such as when the problem began and when it occurs.
The provider will also ask about other symptoms you may be having, such as:
- Absent menstrual period
- Diarrhea
- Excessive fatigue
- Excessive gas or belching
- Irritability
- Vomiting
- Weight gain or loss
Tests that may be done include:
- Abdominal and pelvic CT scan
- Abdominal and pelvic ultrasound
- Blood tests
- Colonoscopy
- Esophagogastroduodenoscopy (EGD)
- Paracentesis
- Sigmoidoscopy
- Stool analysis
- Urine tests
- X-rays of the chest or abdomen
References
Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Abdomen. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Seidel's Guide to Physical Examination. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 18.
Landmann A, Bonds M, Postier R. Acute abdomen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 46.
McQuaid KR. Approach to the patient with gastrointestinal disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 118.
Version Info
Last reviewed on: 10/9/2024
Reviewed by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
