Abdominal distension Flashcards
Differentiate and classify the causes of abdominal distension
Abdominal distension is a sign of obstruction.
Think of 6Fs: Fat, Foetus, Flatus, Faeces, Fluid, Filthy great tumour
Can be a sign of a range of conditions including
GI: ascites, coeliac’s disease, cystic fibrosis, diverticulitis, giardiasis, hookworm disease, IBD, kidney stones, kwashiorkor, lactose intolerance, obstructed bowel, liver cirrhosis
Cardiac: HF,
Gynae: ovarian cancer, pregnancy
Other: weight gain
What are the most common causes of abdominal distension classified as an underlying cause
constipation
lactose intolerance and other food intolerances
overeating (due to overproduction of gases in the digestion process)
what are the most common causes of abdominal distension classified as a secondary disease
Coeliac’s disease
GORD
Peptic ulcer disease
Accumulation of fluid in the peritoneal cavity e.g. ascites
Recall the initial investigation of abdominal distension
Examination: on percussion, flatus will be resonant, fluid dull- shifting dullness for ascites
FBC: raised WCC in infection or malignancy, anaemia with abnormal vaginal bleeding associated with fibroids, or as a consequence of malignancy.
U&Es: renal dysfunction; hypokalemia or uraemia may cause nonmechanical bowel obstruction
LFTs: liver failure etc
Urinalysis: show haematuria in pts with tumours of kidney/bladder
Pregnancy test
AXR- barium enema: constipation, large bowel pathology, obstruction
Abdo US
Sigmoidoscopy, colonoscopy
Further Ix may include CT scan and paracentesis
Recall the management of abdominal distension
Diet - reduce foods known to worsen bloating e.g. excessive fibre, vegetables, cut out dairy as many people lactose intolerant
Medication- supplements e.g. enzymes help digest carbs and veg - reduce overgrowth bac and less gas. Low dose antidepressants found to help - alter gut perception of fullness
