Hello,

I am 43 years old and I'm married with no children. I am very slim but
my tummy is quite bulged and distended. I've had
heavy and painful periods for years, but only over the last couple of
years I have also been  experiencing rectal spasms - especially round
my periods -  and difficulty in emptying my bladder completely. My
tummy has become more prominent and distended than usual over the last
6 months or so.

Can this be due to some gynecological condition? (I also have IBS)

Thank you so much in advance

Daniela Webbe
Hospital Pharmacist

Hello - thanks for asking your question.    
  
Although I am an internal medicine physician, please see your primary
care physician for specific questions regarding any individual cases –
please do not use Google Answers as a substitute for medical advice.
I will be happy to answer factual medical questions.

There are a variety of gastrointestinal and gynocological conditions
that can present with bloating and a distended belly.

Of course, IBS itself makes the abdominal viscera more sensitive -
which can lead to the sensation of bloating and gas.

Other considerations would be the various causes of dyspepsia (i.e.
peptic ulcer disease, inflammation of the esophagus or stomach, or
GERD), and abdominal obstruction which can also manifest as bloating
and distention.

A disease known as gastroparesis can also result in bloating. 
Otherwise known as delayed gastric emptying, this is associated wtih a
variety of neurological and systemic diseases (i.e. diabetes).

Finally various malabsorption syndromes (i.e. Celiac disease, fat or
carbohydrate malabsorption) can also cause abdominal distention and
bloating.

In conjunction with your personal physician, an upper GI series or
upper endoscopy (to evaluate for upper GI anatomical lesions, ulcers
or inflammation), gastric emptying scan (to evaluate for
gastroparesis), abdominal CT scan (looking for obstruction) and
various tests for malabsorption (antibodies for Celiac disease, tests
for fat and carbohydrate malabsorption), can all be considered.

Regarding gynocological causes for abdominal distention.  Ovarian
cancer can also present this way.   Other symptoms include lower
abdominal discomfort or pressure, bloating, constipation, irregular
menstrual cycles, low back pain, fatigue, urinary frequency, or
dyspareunia (pain on intercourse).  An ultrasound can be discussed
with your personal physician to further evaluate this possibility.

Other gynocolocial conditions that you may want to discuss include
other ovarian diseases - including ovarian cysts, abscesses,
infections or torsion -endometriosis, uterine masses (cancer or benign
tumors) or intrauterine or ectopic pregnancy.

This answer is not intended as and does not substitute for medical
advice - the information presented is for patient education only.
Please see your personal physician for further evaluation of your
individual case.     
     
Please use any answer clarification before rating this answer. I will
be happy to explain or expand on any issue you may have.           
                 
Thanks,                  
Kevin, M.D.   
 
Search strategy:     
No internet search engine was used in this answer.  All sources are
from physician-written and peer-reviewed sources.

Bibliography:
Chen et al.  Diagnosis and staging of ovarian cancer.  UptoDate, 2003.

In specific answer to your question; yes, various gynecologic problems
could cause distention. In the absense of any intestinal symptoms such
as cramps, nausea, etc, one would think of ovarian tumor or cyst, for
example. The only way to find out what's going on is to see someone
about it; I'd guess the most fruitful step would be an
abdominal/pelvic CT scan

I had a similiar situation and had both a ruptured ovarian cyst and a
tubalovarian absess. I strongly suggest you get a pelvic sonogram.