Abdominal Distension: Causes and Concerns

Abdominal issues?

Doctor, I would like to ask you about something.
Yesterday at noon, I ate about 8 pieces of watermelon, and I also swallowed the seeds.
Recently, my stools have been shaped like a log but are somewhat watery, not diarrhea.
I noticed that when I stand up straight, my lower abdomen, particularly the left side, is more protruded than the right side.
When I press on it with my hand, there is no pain, and there are no lumps.
When I lie down and touch my abdomen, it feels normal without any swelling, but when I stand up, one side is higher.
When I lean back, my stomach also retracts with me, and when I lean forward, it protrudes again.
Today, I went to the school health room to show the nurse, and she tapped my lower abdomen and said it was gas, and that my stool might be stuck there.
However, I don’t feel any bloating.
I would like to ask the doctor what this means, and is it normal for my abdomen to move forward and backward with my body?

Xiao Er, 10~19 year old female. Ask Date: 2020/06/15

Dr. Hong Yuanbin reply Internal Medicine

Hello, when you mention the lower abdomen, are you referring to the area close to the groin, which is also near the scrotum? If that is the case, and if the abdomen bulges more when you exert yourself or stand, you should be cautious as it may indicate a hernia.
I recommend visiting a surgical outpatient clinic for confirmation.
However, if the discomfort is not in that lower area but rather in the abdomen, it is more likely due to fecal impaction, which should resolve with regular bowel movements.
Thank you for your question.

Reply Date: 2020/06/15

More Info

Understanding abdominal distension can be quite complex, as it involves various physiological and anatomical factors. Based on your description, it seems you are experiencing some unusual sensations and observations regarding your abdomen, particularly with the left side appearing more prominent than the right when standing. Let's break down the potential causes and concerns related to your symptoms.

Possible Causes of Abdominal Distension
1. Gas and Bloating: One of the most common reasons for abdominal distension is the accumulation of gas in the gastrointestinal tract. This can occur due to dietary choices, such as consuming large amounts of fruits like watermelon, which can lead to gas production during digestion. Even if you do not feel bloated, the presence of gas can cause asymmetrical distension.

2. Dietary Factors: The consumption of high-fiber foods, particularly fruits and vegetables, can lead to changes in bowel movements and gas production. Watermelon, while hydrating and nutritious, can also contribute to increased gas if consumed in large quantities, especially if your digestive system is sensitive.

3. Bowel Movements: You mentioned that your stools are "stringy" and watery. This could indicate a change in your bowel habits, possibly due to dietary changes or mild gastrointestinal upset. It's important to monitor your bowel movements, as changes can sometimes signal underlying issues.

4. Muscle Tone and Posture: The way your abdomen appears when standing versus lying down can also be influenced by muscle tone and posture. When you stand, gravity affects the distribution of abdominal contents, which may cause one side to appear more prominent than the other. This is generally normal, especially if there is no pain or discomfort associated with it.

5. Structural Issues: While less common, structural issues such as hernias or organ enlargement can cause asymmetrical abdominal distension. However, since you mentioned that there is no pain or palpable mass, this is less likely.

Concerns and Recommendations
- Monitor Symptoms: Keep an eye on your symptoms. If the abdominal distension persists, worsens, or is accompanied by other symptoms such as severe pain, vomiting, or changes in appetite, it would be wise to seek medical attention.

- Dietary Adjustments: Consider moderating your intake of high-fiber foods and monitor how your body responds. Keeping a food diary can help identify any specific triggers that may contribute to your symptoms.

- Hydration: Ensure you are drinking enough water, especially if your bowel movements are watery. Proper hydration can help maintain healthy digestion.

- Consult a Healthcare Provider: If your symptoms do not improve or if you have concerns about your abdominal distension, it would be advisable to consult a healthcare provider. They may recommend further evaluation, such as imaging studies or gastrointestinal assessments, to rule out any underlying conditions.

Conclusion
In summary, while the asymmetrical appearance of your abdomen when standing may be concerning, it is often a benign issue related to gas, dietary factors, or normal anatomical variations. However, ongoing monitoring and consultation with a healthcare professional are essential to ensure that there are no underlying health concerns. Your awareness of your body and its changes is a crucial first step in maintaining your health.

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