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Abdominal Swelling: 10 Causes & Symptoms

A swollen abdomen is often caused by bloating from conditions like IBS, heartburn, constipation, and menstrual cramps. But may also be a sign of fluid buildup in the abdomen, liver disease, or an intestinal blockage.
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8 most common cause(s)

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10 causes abdominal swelling

Common gastrointestinal causes

Common causes of abdominal swelling include the following.

  • Heartburn: Heartburn, or dyspepsia, is abdominal pain or burning along with bloating or feeling full after meals. It is very common and typically has no known underlying cause. Heartburn may be the cause of mild abdominal bloating or swelling.
  • Irritable bowel: Irritable bowel syndrome (IBS) is a very common cause of abdominal pain, bloating, and diarrhea or constipation. Typically, patients either have either diarrhea or constipation, but can also have alternating diarrhea and constipation. IBS is known as a functional gastrointestinal disorder, which means there is no underlying structural problem to account for the symptoms.
  • Bacterial overgrowth: There are millions of bacteria in a normal, healthy gastrointestinal system. However, some people experience an overgrowth of abnormal bacteria in place of good bacteria which can cause abdominal bloating or swelling. Typically, bacterial overgrowth presents with abdominal pain or discomfort, bloating, gas, and diarrhea, and is usually located in the small intestines.
  • Constipation: Constipation is very common in the adult population and can be associated with a variety of medications, medical conditions, or lifestyle factors. Constipation can present with abdominal pain or discomfort and abdominal swelling symptoms.

Serious underlying illnesses

Abdominal swelling may be due to a serious underlying illness, such as the following.

  • Blockage in the intestine: There are a variety of medical conditions that can lead to blockage in the intestines, also known as bowel obstruction. Some common causes include scar tissue from prior surgery, hernias, tumors, or gallstone. Typically, blockages present with abrupt pain, nausea, vomiting and abdominal distension. You will also be unable to pass stool or gas.
  • Fluid in the abdomen: There are a variety of medical conditions that can lead to fluid building up in the abdomen, also called ascites, which leads to abdominal distention or swelling. Some of the most common causes include end-stage liver disease (cirrhosis) [6], heart failure, or cancer. In many cases, abdominal distension from fluid in the abdomen is painless.
  • Cancer: Any large tumor in the abdomen can lead to abdominal distension or swelling, either as a direct result of the growing tumor or from inflammation or fluid surrounding it. This swelling is typically painless, but you may have other symptoms like weight loss, fevers, or night sweats.

Uterine fibroids

Uterine fibroids are benign growths in the wall of the uterus and most often appear during childbearing years. Fibroids are almost never associated with cancer.

Those at higher risk include black women and women who started their periods at a young age. Other risk factors are vitamin D deficiency, poor diet, obesity, drinking alcohol, and family history of fibroids.

Fibroids can cause pelvic pressure and pain, severe menstrual cramping, and heavy menstrual bleeding that leads to anemia. Quality of life is diminished due to the chronic pain and discomfort. Though fibroids don't always make it impossible to become pregnant, infertility and pregnancy loss may occur as well as pre-term delivery.

Fibroids can be diagnosed through a routine pelvic exam or ultrasound in a doctor's office.

A gynecologist can prescribe various medications to ease the symptoms and regulate the menstrual cycle. There are also a number of surgical techniques, some minimally invasive, to shrink or remove the fibroids while leaving the uterus in place. Hysterectomy, or removal of the uterus, is an option in some cases.

Rarity: Common

Top Symptoms: vaginal bleeding, pelvis pain, abdominal cramps (stomach cramps), painful periods, irregular period

Urgency: Primary care doctor

Small bowel obstruction

The small bowel, or small intestine, is a long, coiled, tube-like structure that connects the stomach to the large intestine (the large bowel, or colon.) If the small bowel is blocked for any reason, food and liquid cannot pass through. This is a medical emergency.

There a number of possible causes. Scar tissue called adhesions can form after any abdominal surgery (including Caesarean section.) Inflammation from Crohn's disease or diverticulitis causes the intestinal wall to thicken and narrow. Hernias or tumors can also cause blockage.

Symptoms include inability to have a bowel movement or pass gas; abdominal cramping and swelling; loss of appetite; and vomiting.

If not treated, a small bowel obstruction can cut off the blood supply to the small intestine. This leads to tissue death, which can then tear and cause an infection in the abdominal cavity called peritonitis. Both of these are medical emergencies.

Diagnosis is made through physical examination, x-ray, CT scan, and/or ultrasound.

Once diagnosed, most patients are hospitalized. Surgery may be necessary to clear the obstruction.

Rarity: Uncommon

Top Symptoms: abdominal pain (stomach ache), nausea, stomach bloating, being severely ill, abdominal cramps (stomach cramps)

Symptoms that always occur with small bowel obstruction: being severely ill

Urgency: Hospital emergency room

Possible pregnancy

The earliest sign of a pregnancy is typically a missed period, but many women do experience symptoms shortly after conception:

  • Implantation bleeding may occur after six to twelve days, when the fertilized egg implants itself into the lining of the uterus. This can cause mild cramping with light bleeding or spotting.
  • Fatigue and increased desire to sleep may happen within a week.
  • Breast tenderness can start as soon as one to two weeks.
  • Nausea ("morning sickness") can occur after two to eight weeks.

If pregnancy is suspected, testing should be done so that proper prenatal care can begin. It's important to avoid some behaviors during pregnancy, such as drinking alcohol or using certain drugs or medications, so an early diagnosis should be made.

Over-the-counter home pregnancy tests are available at any drugstore. A positive test is almost certainly correct, but a negative test in the face of other symptoms may be a false negative and should be tried again after a week.

Ovarian cyst

During her reproductive years, a woman's ovaries release a single egg cell each month. But sometimes the egg remains on the surface of the ovary, where the follicle that enclosed it continues to grow. It then becomes a fluid-filled ovarian cyst.

Ovarian cysts may be caused by hormonal imbalances; by endometriosis tissue, if it attaches to the ovary; and by severe pelvic infections that spread to the ovaries. Cysts may also form during pregnancy.

Small ovarian cysts often cause no symptoms. Larger cysts may cause pelvic pain, backache, unexplained weight gain, abnormal vaginal bleeding, and/or pain during sex. Ovarian cysts are almost never a form of cancer.

Sudden, severe abdominal pain could indicate a ruptured cyst. This is a medical emergency and the patient should go to an emergency room or call 9-1-1.

Diagnosis is made through ultrasound.

Hormonal birth control, such as the pill, injection, or patch, prevents ovulation and therefore prevents the formation of cysts. Surgery to remove the cyst may be necessary in some cases.

Rarity: Rare

Top Symptoms: stomach bloating, vaginal bleeding, pelvis pain, lower abdominal pain, lower back pain

Urgency: Primary care doctor

Ovarian cancer

Neoplasm means "new growth," and an ovarian neoplasm is abnormal tissue appearing on the surface of the ovary. A benign neoplasm is not cancerous, while malignant neoplasm indicates cancer.

Ovarian neoplasm is most common in postmenopausal women with a family history of cancer. Other risk factors include menstruation at a young age with menopause at a late age; having no pregnancies; hormone replacement therapy; endometriosis; and cigarette smoking.

The earliest symptoms of malignant neoplasm, or ovarian cancer, may include abdominal cramping, bloating, and swelling; low back pain; pain during sex; and vaginal bleeding after menopause.

Diagnosis is made through pelvic examination, blood test, and/or ultrasound.

Treatment involves surgery to remove the tumor, followed by chemotherapy and/or radiation therapy.

There is no known prevention, but reducing the number of ovulations a woman experiences in her lifetime seems to reduce the risk of the disease. Late onset of menstruation and earlier onset of menopause lowers the number of cycles, while pregnancy, lactation, and hormonal birth control all suppress ovulation entirely.

Liver failure

Acute liver failure occurs when the liver suddenly struggles to function properly or stop working completely.

Acute liver failure is a very serious disease requiring immediate medical attention. It would be prudent to go to the emergency room immediately.

Lactose intolerance

Lactose intolerance

Lactose is the sugar that naturally occurs in milk. Someone is "lactose intolerant" when the small intestine does not produce enough lactase, the enzyme which digests lactose.

In primary lactose intolerance, the enzyme is produced during childhood but stops once the person becomes an adult.

Secondary lactose intolerance occurs when the small intestine has been damaged through illness, injury, radiation therapy, or surgery.

Sometimes the condition is hereditary.

Lactose intolerance is found most often in adults of African, Asian, Hispanic, and American Indian descent.

Distress appears within two hours of consuming milk, cheese, ice cream, or yoghurt. These symptoms include gas, bloating, diarrhea, and sometimes nausea and vomiting.

Lactose intolerance is not dangerous in itself, but the uncomfortable symptoms can interfere with quality of life. Dairy products are an important source of calcium and avoiding them could lead to a deficiency.

Diagnosis is made by blood test or breath test after drinking a lactose-rich liquid.

Treatment is simply through avoiding lactose-containing foods, or adding products to them to break down the lactose first.

Compartment syndrome

Acute compartment syndrome describes the damage done to certain muscle groups of the arms or legs after a traumatic injury.

All of the long muscles are bundled into sections – "compartments" – by the white sheets of strong, tough connective tissue called fascia. If something interferes with circulation so that blood flow is trapped within the compartment, pressure rises because the fascia cannot stretch. This causes serious damage to the muscles and other tissues within the compartment.

Acute compartment syndrome is caused by a broken bone; a crush injury; burns, due to scarred and tightened skin; and bandages or casts applied before an injury has stopped swelling.

Symptoms can rapidly intensify. They include severe pain and tightness in the muscle; tingling or burning sensation; and sometimes numbness and weakness.

Acute compartment syndrome is a medical emergency which can result in loss of the limb. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history and physical examination.

Treatment involves hospitalization for emergency surgery and, in some cases, skin graft.

Rarity: Rare

Top Symptoms: arm numbness, hand numbness, foot numbness, pain in one leg, thigh numbness

Urgency: Hospital emergency room

Cirrhosis

Cirrhosis is scarring of the liver. Scar tissue forms because of injury or long-term disease. In the United States, alcoholism and hepatitis C are the most common causes. Scar tissue cannot do what healthy liver tissue does - make protein, help fight infections, clean the blood, help digest food and store energy.

You should visit your primary care physician who will likely coordinate care with a specialist. Treatment for cirrhosis usually involves a dietary approach, medication to treat underlying cause, stopping any alcohol use, and liver transplant in serious cases.

Rarity: Common

Top Symptoms:

Urgency: Primary care doctor

Other causes of abdominal swelling

Other causes of abdominal swelling include the following.

  • Skin infection: If the swelling is limited to one section of the abdomen, it may be due to an infection in the skin. Typically, skin infections cause localized redness, swelling, and tenderness. Skin infections are typically caused by bacteria and treated with antibiotics.
  • Obesity: Increased abdominal girth over time can be due to weight gain or obesity.

Hallmarks of abdominal swelling

Abdominal swelling is a bothersome, uncomfortable symptom that can leave feeling more full than you are and that your pants are suddenly two sizes too small. It can be due to common gastrointestinal disorders like heartburn, constipation, or irritable bowel syndrome or disease, and these conditions typically bring discomfort and pain. More serious causes of abdominal swelling include intestinal blockage, fluid in the abdomen, or cancer. Obesity, pregnancy, and local skin infections may also cause abdominal swelling symptoms. In many cases, abdominal swelling can be treated at home with lifestyle changes and over-the-counter remedies. However, the more serious causes of abdominal swelling require evaluation and treatment by a physician.

Common accompanying symptoms of abdominal swelling

If you're experiencing abdominal swelling, you may also experience:

Abdominal swelling treatments

Many causes of abdominal swelling — especially if it's just a little bloating — can be managed effectively at home. For example, there are many over-the-counter and natural remedies for constipation and heartburn. If you are experiencing gastrointestinal symptoms that might be food-related, try to avoid the offending foods and change your diet. However, some causes of abdominal swelling should be evaluated by a physician. Imaging, prescription medication, and surgery are all possible treatments your physician may recommend depending on your specific symptoms and the determined cause.

When abdominal swelling is an emergency

Seek emergency abdominal swelling treatment if you experience very severe abdominal pain with nausea or vomiting.

At-home abdominal swelling treatments

You may find relief from abdominal swelling with the following at-home treatments.

  • Lifestyle changes: If you believe your constipation, irritable bowel, or heartburn is due to a specific type of food, try avoiding the food to help relieve symptoms. Some common offenders for heartburn include fatty foods or acidic foods like coffee, tomatoes, or citrus. Some common offenders for constipation include dairy, white rice or bread, and bananas.
  • Natural constipation remedies: There are many popular natural remedies for constipation including taking magnesium supplements, increasing your fiber intake, or increasing your intake of probiotic foods or supplements.
  • Over-the-counter medications: There are many over-the-counter medications that can treat constipation or heartburn if they are the cause of your abdominal swelling.
  • Enema: An enema is placed into the rectum to relieve constipation. Many are available over-the-counter.

Medical treatments for abdominal swelling

After consulting your physician, he or she may recommend the following measures.

  • Imaging: Your doctor may order X-rays, ultrasound, or CT scans if they suspect an intestinal blockage, fluid in the abdomen, or other possible structural causes of abdominal swelling.
  • Endoscopy (esophagogastroduodenoscopy or EGD) or colonoscopy: If your doctor suspects your abdominal swelling is related to a medical condition, they may recommend a type of imaging that requires using a scope to look at the inside of the gastrointestinal tract, either through the mouth or through the rectum.
  • Medications: Your doctor can prescribe various medications to treat heartburn, bacterial overgrowth, irritable bowel syndrome, constipation, or infections that may be causing your abdominal swelling.
  • Surgery: This is unlikely, however, if a blockage in the intestines is causing abdominal swelling, a doctor may recommend surgery to treat the problem. In this case, your doctor would discuss the risks and benefits of surgery as a treatment for the condition.

Questions your doctor may ask about abdominal swelling

  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • Any fever today or during the last week?
  • Have you experienced any nausea?
  • Have you lost your appetite recently?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

  1. Functional GI Disorders. International Foundation for Functional Gastrointestinal Disorders. Published November 9, 2016.
  2. Small Intestinal Bacterial Overgrowth. Wikipedia. Published September 6, 2018.
  3. What To Do When Medication Makes You Constipated. Harvard Medical School: Harvard Health Publishing. Published August 2017.
  4. Bowel Obstruction. Harvard Medical School: Harvard Health Publishing. Published October 2014.
  5. Understanding Bloating and Distension. International Foundation for Functional Gastrointestinal Disorders. Published August 10, 2018.
  6. Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases.
  7. Bloating. Wikipedia. Updated August, 2018.
  8. Medical Imaging. U.S. Department of Health and Human Services: U.S. Food & Drug Administration. Published August 28, 2018.
  9. Bae SH. Diets for Constipation. Pediatric Gastroenterology, Hepatology & Nutrition. Published December, 2014.
  10. Cox L. What Are Magnesium Supplements? Live Science. Published January 30, 2014.