Abdominal discomfort

Introduction Normal people have a certain amount (about 100 ~ 200ml) of gas in the gastrointestinal tract. The gas is mostly located in the stomach and colon. The gas in the small intestine is less. When the excess gas is accumulated in the gastrointestinal tract, the upper abdomen may have stomach and peristaltic waves. Intestinal and intestinal peristaltic waves can be seen in intestinal obstruction, and bowel sounds are hyperthyroidized or weakened. Patients with peritonitis may have tenderness and muscle tension. Gastric disease is one of the important causes of abdominal distension. It is found in chronic gastritis, chronic atrophic gastritis, peptic ulcer, gastric dilatation, gastric torsion, gastroptosis, pyloric obstruction and gastric cancer.

Cause

1. Stomach disease: It is one of the important causes of abdominal distension. It is found in chronic gastritis, chronic atrophic gastritis, peptic ulcer, gastric dilatation, gastric torsion, gastroptosis, pyloric obstruction and gastric cancer.

2. Intestinal diseases: It is also an important cause of abdominal distension. It is more common in acute and chronic intestinal infections (such as bacterial dysentery, amoebic enteritis, intestinal tuberculosis, Crohn's disease, ulcerative colitis, etc.). Sign, acute, chronic intestinal obstruction, pseudo-intestinal obstruction, intestinal diverticulosis, constipation caused by various reasons.

3. Gastrointestinal functional diseases: such as gassing, intractable hiccups, functional dyspepsia (non-ulcer dyspepsia), irritable bowel syndrome (IBS).

4. Liver disease: It is also an important cause of abdominal distension, more common in acute and chronic hepatitis, especially in severe hepatitis (abdominal swelling is one of the main and stubborn symptoms), cirrhosis (abdominal swelling is often the main symptom of early cirrhosis), Liver abscess, liver cancer and so on.

5. Biliary diseases: such as acute and chronic cholecystitis, cholelithiasis and biliary obstruction caused by various reasons.

6. Pancreatic diseases: such as acute and chronic pancreatitis, giant pancreatic cysts, pancreatic cancer, etc.

7. Peritoneal diseases: such as acute suppurative peritonitis, tuberculous peritonitis, peritoneal cancer, and the like.

8. Acute infectious diseases: such as shock pneumonia, typhoid fever, severe tuberculosis and sepsis.

an examination

Related inspection

Fiber gastroscopy peak gastric acid secretion

Accompanying symptoms

(1) abdominal distension with abdominal pain: with acute abdominal pain should consider the possibility of acute cholecystitis, pancreatitis, intestinal obstruction, acute peritonitis, mesenteric vascular embolism or thrombosis, intestinal torsion, intussusception and other diseases.

(2) abdominal distension with vomiting: more common in pyloric obstruction, intestinal obstruction and other lesions, followed by liver biliary and pancreatic lesions. Functional dyspepsia and functional diseases such as gassing can sometimes cause vomiting.

(3) abdominal distension with hernia: common in gassing, functional dyspepsia, chronic atrophic gastritis, gastroptosis, ulcer disease and pyloric obstruction.

(4) abdominal distension with constipation: more common in habitual constipation, irritable bowel syndrome (constipation type), intestinal obstruction, left colon cancer.

(5) abdominal distension with diarrhea: more common in acute intestinal infection, cirrhosis, chronic cholecystitis, chronic pancreatitis, malabsorption syndrome.

(6) abdominal distension with anal exhaust increased: more common in food after intestinal fermentation, excessive gas in the colon, irritable bowel syndrome.

(7) abdominal distension with fever: more common in typhoid fever, acute intestinal inflammation, intestinal tuberculosis, tuberculous peritonitis and sepsis.

(8) abdominal distension with intestinal type or water sound: abdominal distension with intestinal type or abnormal peristaltic wave is more common in intestinal obstruction, such as the stomach has a water sound, more consideration for gastric retention or pyloric obstruction.

(9) abdominal distension: upper abdominal distension is more common in atrophic gastritis, functional dyspepsia, cirrhosis, pyloric obstruction, gastric dilatation or gastric cancer, pancreatic cancer, etc.; middle and upper abdominal distension is more common in liver and biliary tract lesions, hepatic syndrome The levy of the left upper abdomen is more common in gastric diseases, splenic syndrome, etc.; left lower abdominal swelling is more common in colonic flatulence (such as megacolon); full abdominal flatulence is more common in the small intestine or colon cavity, excessive gas accumulation, paralytic ileus, etc. .

Differential diagnosis

Identification:

Abdominal fullness: It is a symptom that refers to the fullness or fullness of the abdomen. It can make people feel uncomfortable and troubled. When it is determined that it is cold and hot, it is full of pain and the pain is true. When you are full, you can reduce it to cold, and you can reduce it to heat.

Abdominal pain: It is one of the common clinical symptoms, which can be acute or chronic, and its etiology is complicated. Most of them are organic and functional. They are mostly caused by intra-abdominal organ diseases and can also be caused by extra-abdominal organ diseases. Therefore, comprehensive consideration should be made in the diagnosis, and the medical history and various examination results should be analyzed in detail.

Stomach suffocation: Chinese medicine believes that long-term eating disorders, seven emotional internal injuries, excessive fatigue, cold temperature disorders and other factors lead to liver qi stagnation, cross-counterfeiting stomach, or spleen loss, or spleen qi stagnation, or biliary dysfunction The disease is reduced, and there are wet turbidity, food stagnation, blood stasis, etc., with cold, heat, imaginary and real differences. The initial illness is more real, and the chronic illness is more complicated or weak.

Abdominal stomach: ankle discomfort, fullness after meals, can occur in chronic hepatitis, cirrhosis, chronic cholecystitis, cholelithiasis, chronic gastritis, visceral drooping and other diseases.

Abdominal mass: refers to an abnormal mass that can be touched during abdominal examination. Common causes include swelling of organs, swelling of hollow organs, tissue hyperplasia, inflammatory adhesions, and benign and malignant tumors.

diagnosis:

(1) Age: Adult abdominal distension is more common in liver, biliary and pancreatic diseases, and functional dyspepsia is also more common. Children and adolescents should consider dystrophic diseases such as intra-abdominal tuberculosis and B vitamin deficiency.

(2) Diet: Eating a large amount of foods containing sugar and overeating are prone to bloating.

(3) Past history: Patients should be asked whether they have previous history of gastritis, peptic ulcer, gastroptosis, pyloric obstruction or intestinal obstruction, history of tuberculosis, hepatitis, cirrhosis, pancreatitis, history of abdominal surgery, history of trauma.

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