Swollen belly, how, when and why.

see also swollen belly and ascites

personal notes from dr. Claudio Italiano, hospital interns.

 Abdominal distension.

Building on the success of this simple web page, let us attack to explain to our friendly browsers that reflected the belly swollen (which they say air flatulence), regardless of the misleading claims directed to the subconscious of television audiences unaware, statements recommended diets (see the link at the top and serious diet) and water to lose weight or (!!!), yougurth different, is a serious problem of medical relevance and the Interior in particular that should exclude the occurrence of complex diseases, often serious and / or systemic. It is not, obviously only the problem because there is swollen abdomen food dined gasifying and sparkling water (!).

We do not speak here of the momentary sensation "swollen belly" or abdomen that spreads this way and that, and turns like a washing machine (!) (See irritable bowel syndrome), but a symptom precise: the increase in volume abdomen. Recall finally that a belly is always full of air (!) But also fat and there is a definite syndrome called Metabolic Syndrome (cf. on this website: Obesity and fat metabolism, sugar metabolism and the belly and the sides: The metabolic syndrome stomach and hips = infarction and stroke risk The Food Guide Pyramid Obesity Day October 10: the right diet!)

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History.

Collecting patient history we know that a patient has recently had the need to enlarge the belt or to change size of her skirt or pants, noting an increase in volume of the abdomen. Sometimes presented an unusual abdominal pain, localized:

Right hypochondrium (and we think the liver, liver stagnation, liver cancer, cancer of the right flexure, or pleura process bronchopneumonic baseline right etc..) (see right upper quadrant pain)

the right side (and we think of ascending colon cancer (?), the right kidney, urinary tract, if it is an abdominal muscle wall etc..) (see lower right abdomen pain)

the left side (and we think colon, sigmoid junction cancer, urinary tract, female genitals if even a pregnancy extratubarica if the clinical picture is dramatic, the patient agitated and pale, often sweaty, a cold sweat; then run to the nearest hospital and then un'emocromo to see if there is anemia (see anemia pain
.

In Ascites (see also how to cure ascites) pain is not present, except as a heavy feeling of anguish or breathing and may ascites recognizing various causes, to which you refer to this page on the website of medicine, but usually think cirrhosis undergoing ascitic decompensation, for which the peritoneal fluid, so to speak, "oozes" from the liver, because the alteration of the portal circulation and collects in the abdominal cavity, or it takes care of tumors of female genital sphere or cancer in general (see Section index cancer). In the case of ascites will be appreciated "the sign of the surge," that is beating the abdominal wall with a stethoscope, you can earn as a stream, ie ascites slamming. It is also appreciable dulness hips, sometimes you feel a buzz venous flow pathophysiological periumbilical sign, with the intent to download the portal circulation to compensatory pathways. With ultrasound it is possible to quantify, however, initial ascites.

Examination.

The careful examination is the basis of the establishment of the first investigations of the case (see approach to the patient gastroenterology). The observation of the contours of the abdomen may direct, for example, in research of spider nevi, that is the spider angioma, suggestive of liver cirrhosis and circles of compensation. If, however, on the contrary, that the flow is directed toward the navel, we think of obstruction of inferior vena cava. If there are no palpable lymph nodes in the supraclavicular (Virchow's node) suspected abdominal neoplasms. Epigastric palpable mass suggests a new formation and if peristalsis is right, left will be expected to pyloric obstruction.

eAll'auscultazione abdomen can appreciate borborygmi typical high tones, which are the movements of peristalsis, in order, for example, to overcome obstruction. The writer has happened several times to see patients of this type, for example, a patient with megaretto with chronic constipation and intense borborygmi: evacuation every week only with the help of enemas!

Returning ascites is difficult to palpate an abdomen ascites: liver may appear of increased consistency, or frankly wooden or hard, painful. If the consistency is remarkable, if one feels hard nodules, one thinks of a cancer of the liver. Once perceived abdominal mass, we need to understand what it is. They do, after the visit, less invasive investigations that we can already steer: abdominal ultrasound.

THE LAST THING TO BE CONSIDERED (!!):

And 'the abdominal air or wind, or aerophagia the patient has a slow digestion and industrious, who suffers from constipation, torpid with peristalsis and evacuation of hard stools or scibale goats or subjects suffering from chronic diarrhea with flatulence and borborygmi (see these links: The irritable bowel syndrome Treatment with plants in irritable bowel syndrome, malabsorption syndrome constipation and diarrhea Diarrhea - Diarrhea physiopathology and pathogens acute and chronic diarrhea, a visit to the patient Diarrhea: How to treat, which drugs and which are not Constipation: how to determine and how to cure it. The defecation and constipation - intestinal obstruction physiology Diverticula and diverticulosis, how to treat. Constipation in children the proper care of constipation with macrogol)
Consider, for example, the irritable bowel syndrome, constipation varieties to which we refer for treatment. Meanwhile, we implement and regulate the dietary treatment of psychological support, especially when it comes to women who are very sensitive and emotional!

DIAGNOSIS.

Always refers to the various topics in a clear and specific index of this site, we say that the instrumental investigations include:

direct radiography or abdomen, to assess whether there are air fluid levels of free air or ground, an expression of acute abdomen or abdominal surgery.

Ultrasonography of the abdomen to give a first approach to the patient and collect some information about cysts, nodules, gallstones, masses detectable, loops etc. edematous or infiltrated.

Tac abdomen with MEDC, or CT without contrast in urgency, for example, allergies to contrast medium, hypoalbuminemia, renal failure (Inquest case should schedule a dialysis session, or performed before the CT scan with contrast and then dialysis, immediately after.

MRI abdomen or MRI cholangiography for complete study of the abdominal organs, when indicated, or complete the study if totally abandons TAC has given little information or are contraindicated radiation.

Treatment of ascites.

Relies more and loop diuretics, a strict diet without salt, other potassium-sparing diuretics, the therapy with albumin and paracentesis.

Treatment of flatulence in general:

Uses of medicines and food does not gasifying carminative; be abolished sodas, potatoes, onions, broccoli, beans, legumes in general and favorite foods such as rice, pasta, beef, apples, pears etc.. (Cf. the treatment with plants in irritable bowel syndrome diet for diarrheal syndromes! Diets for irritable bowel syndrome! Diet for Constipation Treatment with plants in irritable bowel syndrome!)


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