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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Medical
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Experience:  14 years experience in the field of Family Practice
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What is the reason for a distended stomach with a hard abdomen?

Resolved Question:

What causes a severely distended, hard abdomen with sudden weight gain?

Submitted: 6 years ago.
Category: Medical
Expert:  Anthony Bray, MD replied 6 years ago.


This is somewhat of a loaded question. It would be significant whether or not the abdomen was tender to press on it was not. If the abdomen were very tender and/or there was a great deal of pain then there becomes a concern that there could be an intra-abdominal infection >>> which would be a medical emergency. Presuming that there is not a significant degree of pain or tenderness of the abdomen then constipation is one possibility. Retention of fluid in the abdominal cavity could be another scenario and this would bring up several more serious possible scenarios. Ascites is the retention of fluid in the abdominal cavity and this can occur with liver disease, pancreatitis, ovarian cancer, heart failure as some of the major examples.

Of the different possible scenarios, we will hope that nothing more serious than constipation is going on. If you can provide further details of your symptoms and the time course, then this information would be helpful. Also if you have further questions then please let me know and I'll be happy to get back with you.

Indications that you may need to seek immediate medical care would include developing increasing abdominal pain. A 6 out of 10 is too much pain to allow sleep on my scale. Increasing nausea and vomiting would be a concerning sign. Development of jaundice (yellowing of the skin and whites of the eyes) would be a very concerning symptom. Shortness of breath would be an important warning sign.

I hope this information helps. Further questions are welcome.

Customer: replied 6 years ago.

Mostly I am feeling stuffed up and a little heavy shortness of breath, or rather like I am very pregnant. I have no uterus, but do still have ovaries. The abdomen (upper and lower) are hard as a rock...mostly uncomfortable and I have severe gerd, almost like my food doesn't digest or move from my stomach to intestines. A little nauseated too.This came on almost overnight and is getting worse by the day for about 3 weeks. I am getting an abdominal CT scan next week, but Dr. did not want to speculate on what he might be looking for. I would appreciate your thoughts and "could be..." diagnosis. So far your answers are great. Appreciate your straight forward answers.

Expert:  Anthony Bray, MD replied 6 years ago.

Hello again!

Well, constipation is one possible reason for the symptom. A partial obstruction of the bowel at some point could be a reason for this pattern and this would affect the treatment of course.

If you had some intra-abdominal infection then this can cause an ileaus where the bowels are kind of in shck and there is a lack of the normal peristalsis or bowel movement. If you do not hear any rumbling of the bowels and pass no gas then that could be consistent with an ileus as a possibility. If you do have some bowel sounds, pass gas or have a bowel movement then this would go against there likely being an ileus as the problem. (People who are recovering from intra-abdominal surgery usually have a period of time with an ileus for example).

Since you have these symptoms I would recommend that you eat a very light bland diet for now.

The tense swelling of the abdomen could be due to ascites which is a collection of fluid in the abdominal cavity but not so much within the intestines themselves. I mentioned many of the potential reasons for ascites. Inflammatory bowel disease could be associated with it. Liver disease such as acute hepatitis or chronic liver disease with cirrhosis could produce ascities. Acute pancreatitits can cause ascities but if you had this you would probably have severe abdominal pain and nausea. As I mentioned ovarian cancer is a potential cause if ascities is present. The abdominal CT should be very useful to help establish what is going on but may not be able to give the final answer. I agree that the abdominal CT sounds like a good choice as your next test. You might ask if the test includes both the abdomen and pelvis (it might be useful and might expedite the diagnostic process>>> just a thought)

I hope this helps. Further questions are welcome if you have any.

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