What is the common cause of a big belly?

A big belly may be caused by obesity, ascites, flatulence, uterine fibroids, ovarian cysts and other diseases. The cause needs to be determined based on specific symptoms.

1. Obesity:

Abdominal fat accumulation is the most common physiological cause, which is related to long-term high-calorie diet and lack of exercise. Excessive visceral fat may be accompanied by excessive waist circumference ≥90 cm for men and ≥85 cm for women, which can be confirmed through body fat testing. It is recommended to adjust the diet structure, increase aerobic exercise such as brisk walking, swimming, etc., and lose weight under the guidance of a nutritionist if necessary.

2. Ascites:

Pathological ascites is mostly related to liver cirrhosis, heart failure or malignant tumors, and manifests as abdominal distention, tight skin, and dullness upon percussion. It may be accompanied by symptoms such as lower limb edema and dyspnea, and needs to be diagnosed through abdominal B-ultrasound and puncture examination. Treatment needs to be targeted at the primary disease. For example, patients with liver cirrhosis need to limit sodium intake and use the diuretic spironolactone combined with furosemide.

3. Flatulence:

Functional dyspepsia or irritable bowel syndrome can lead to intestinal gas accumulation, which is manifested as abdominal distension after meals, tympany on percussion, and may be accompanied by burping and bowel sounds. It is related to eating too fast, excessive intake of gas-producing foods, beans, and carbonated drinks. It is recommended to eat small meals frequently, appropriately supplement with probiotics such as Bifidobacterium, and abdominal massage can promote flatulence.

4. Uterine fibroids:

If women of childbearing age experience asymmetric bulging of the lower abdomen, it may be caused by the enlargement of multiple uterine fibroids, which is often accompanied by symptoms such as heavy menstruation and frequent urination. The size and location of fibroids can be determined through gynecological ultrasound. For fibroids larger than 5 cm, laparoscopic removal should be considered. For smaller fibroids, Guizhi Fuling Capsules and other blood-activating and blood-stasis-removing drugs can be tried.

5. Ovarian cysts:

Pathological cysts such as teratomas, serous cystadenoma, etc. can cause the lower abdomen to bulge, which may be accompanied by compressive pain or menstrual disorders. Ultrasound examination can identify the nature of cysts, and detection of tumor marker CA125 can help determine the risk of malignancy. Laparoscopic exploration is recommended for cysts with a diameter of more than 5 cm. Physiological cysts usually resolve spontaneously within 3 months.

It is necessary to monitor changes in abdominal circumference on a daily basis and record accompanying symptoms such as sudden weight gain, loss of appetite, etc. It is recommended to do 30 minutes of moderate-intensity exercise every day, reduce the intake of refined carbohydrates in the diet, and increase dietary fiber. If abdominal distension continues to worsen or warning symptoms such as vomiting blood or blood in the stool occur, you should seek immediate medical attention from a gastroenterologist or gynecologist. People over 40 years old are recommended to undergo abdominal ultrasound and tumor marker screening every year, and those with a history of liver disease need to regularly monitor liver function.