Definition

Abdominal Distension (also bloating) is an abnormal general swelling of the abdomen.

History

Quality

Does it feel like fluid or gas?

Severity

How big is the distension?
What is it stopping you from doing?

Time Course

Onset-Offset

Has the distension come on slowly or quickly?

Duration

How long have you had the distention for?

Temporal Profile

Does it come and go?
Have you had this problem before?

Context

Can you think of anything that may have caused this?
Are there any foods that make this worse?

Aggravating Factors

Is there anything that makes it worse?

Relieving Factors

Is there anything that makes it better?

Associated Features

Have you noticed anything else apart from the abdominal distension?
Have you had any of the following?

Past History

Have you ever had:

Medications

Family History

Has anybody in your family had:

Social History

  • Can you tell me about you where you live?
  • Where do you work?
  • What are your hobbies?
  • Do you smoke?
  • Do you drink alcohol? Take a detailed alcohol history. See Alcohol abuse

Examinations and Investigations

Bloods

Imaging

  • Plain radiology of the abdomen
  • Ultrasound
  • CT
  • MRI

Other

  • Ascitic fluid analysis

Differential Diagnosis

The 6 F's

Red Flags

  • Rectal Bleeding - must rule out Colon Cancer as the underlying cause
  • Projectile Vomiting - must rule out Small Bowel Obstruction
  • Female of reproductive age - must rule out pregnancy

Management

Varies greatly depending on underlying cause