Sudden Abdominal Swelling and Pain: Gastrointestinal Issues

Sudden abdominal distension followed by acute abdominal pain, then a decrease in abdominal swelling, accompanied by weight loss?

Over the past five years, I went from weighing 60 kg to around 72 kg.
Recently, I realized that my stomach has become very large and round; when I sit down or bend over, it feels like there's a bulge pressing against me.
I have been consistently drinking at least 2000 ml of warm water daily and have also been taking probiotic capsules for over two months to try to improve my digestive function.
(I have no issues drinking iced milk.) Due to staying up late and waking up late during the summer vacation (around 2 or 3 PM), I usually only have one normal meal a day.
My weight has decreased by about one kilogram over the past two months, but my stomach is still quite prominent.
However, I can slightly feel some of my ribs now.
Recently, a family member had gastroenteritis, and I might have inadvertently ingested some of their saliva, so during that time, I was mostly experiencing watery stools (I didn't realize it at the time).
One night, after they ate my food, I forgot and continued eating.
A few hours later, I started feeling discomfort in the right side of my abdomen.
At that time, I had just eaten and was tidying up my room when I suddenly felt discomfort similar to after running, so I didn't think much of it.

When I woke up, I found that walking, standing, or sitting was extremely uncomfortable! I couldn't pinpoint the exact pain, only that it was on the right side.
I thought I would lie down and rest to see if it would get better, so I endured it for another two days.
I felt slightly better, but I still clearly felt discomfort when walking or moving, and there was a sharp pain in my abdomen.
On the third day, I finally had time to see a gastroenterologist.
He didn't specify the exact issue but prescribed medication to relieve spasms, gastritis, and bloating.

The next morning, I noticed that my previously round stomach could suddenly be contracted to become flat, and the whole area felt soft and pliable.
I even weighed myself at the clinic and found I had lost another kilogram! I just finished taking the medication, and I feel much better, but my weight has been dropping steadily over the past three days.
I haven't experienced vomiting or severe diarrhea, but I'm extremely worried about what's happening.
The sudden abdominal pain and the disappearance of my large stomach have made me very anxious.
I looked online and found information about cancer, which has added to my fear.
I've lost about four kilograms in total, and all of this has happened within seven days.

Now that I've finished the medication, should I go back to see a gastroenterologist? I'm really worried.

H, 20~29 year old female. Ask Date: 2023/08/23

Dr. Chen Shidian reply Gastroenterology and Hepatology

There is no need to worry about cancer for now; you can discuss it during your follow-up appointment.

Reply Date: 2023/08/23

More Info

Sudden abdominal swelling and pain can be concerning, especially when accompanied by significant weight loss and changes in bowel habits. Based on your description, it seems you've experienced a rapid onset of symptoms, including abdominal discomfort, swelling, and a noticeable change in your body weight. While I cannot provide a diagnosis, I can offer some insights into potential gastrointestinal issues and the importance of seeking medical attention.

Firstly, the sudden increase in abdominal size and discomfort could be attributed to several factors, including gastrointestinal disturbances such as bloating, gas accumulation, or even fluid retention. The fact that you mentioned experiencing diarrhea after potential exposure to someone with gastroenteritis suggests that your digestive system may have been affected. Gastroenteritis can lead to inflammation of the stomach and intestines, causing symptoms like abdominal pain, diarrhea, and nausea. However, since you also mentioned that you have not experienced vomiting or severe diarrhea, it is possible that your symptoms are more related to functional gastrointestinal disorders.

The medications prescribed by your gastroenterologist for relieving spasms, gastritis, and bloating indicate that your doctor is considering conditions like irritable bowel syndrome (IBS) or functional dyspepsia. IBS is characterized by abdominal pain and changes in bowel habits, which can include diarrhea, constipation, or alternating between both. Stress, dietary changes, and infections can exacerbate these symptoms.
Your weight loss, while concerning, may be a result of changes in your eating habits, particularly if you have been eating less due to discomfort. However, losing weight rapidly without trying can be a red flag and warrants further investigation. It is essential to monitor your symptoms closely. If you continue to experience abdominal pain, swelling, or if your weight loss persists, it is crucial to follow up with your gastroenterologist.

In addition to the medications you are taking, consider keeping a food diary to track what you eat and any symptoms that arise afterward. This can help identify potential food intolerances or triggers that may be contributing to your discomfort. Also, maintaining a regular eating schedule and ensuring you consume a balanced diet can support your digestive health.

Given the rapid changes you've experienced, it is advisable to consult your gastroenterologist again, especially if your symptoms do not improve or if they worsen. They may recommend further diagnostic tests, such as imaging studies or endoscopic procedures, to rule out more serious conditions, including inflammatory bowel disease (IBD) or other gastrointestinal disorders.

In summary, while your symptoms may be related to functional gastrointestinal issues, the combination of sudden abdominal swelling, pain, and weight loss should not be taken lightly. It is essential to communicate openly with your healthcare provider about your concerns and symptoms. They can provide the necessary guidance and treatment options to help you manage your condition effectively. Remember, early intervention can lead to better outcomes, so do not hesitate to seek further medical advice.

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