A common problem that we see at the Atlanta Fibroid Center is the woman who looks pregnant but is not. She may exercise frequently, but can’t lose the bulge in her lower abdomen.
Abdominal swelling or distension can be due to a varied number of medical conditions. The patient often reports feeling bloated which is a buildup of gas in the gastrointestinal system. This can be digestive in nature due to an increase in gas-producing foods (high-fiber, beans, cabbage, etc.), malabsorption or intolerance of certain food substances, or interruption in normal bowel function such as gastrointestinal illness or irritable bowel syndrome (IBS). On rare occasions, this distension is due to an abnormal accumulation of fluid in the abdomen which warrants prompt attention by a physician.
Fibroids, on the other hand, are a very common cause of abdominal enlargement that is often accompanied by bloating. This bloating is cyclic and can begin right before the menstrual, but will subside after the menstrual. A woman often reports that she can see the difference in size each month, particularly when lying on her back. Clothes often fit very tight or not at all during this time.
As the uterus enlarges, it will start to make a woman look pregnant. A simplified estimate of uterine size based on a similar size pregnancy: the length of the uterus is equal to the number of weeks of pregnancy. For example, a 16 cm long uterus is about 16 weeks (4 months) of pregnancy. Women with an enlarging uterus may not know why this is occurring. She may start taking a pregnancy test which will be negative. Even women who exercise frequently will notice this “stubborn area” that continues to make her belly big no matter how much exercise she does. People may even ask them, “When is the baby due?” which is obviously embarrassing for all concerned.
As the belly enlarges due to increasing fibroid growth, there is often added weight gain. This is particularly discouraging to the woman who is eating right and exercising. This weight gain can accelerate if the patient becomes anemic and the associated fatigue decreases or eliminates exercise or if she becomes disheartened by a perceived lack of results.
It may not be discovered as fibroids until this “poochy belly” starts causing symptoms. These symptoms will be determined based on the location of fibroids in her uterus. Fibroids that are in the front of the uterus are the most likely to be felt by the woman. She notices something hard and firm to the touch which is not something she has felt before. These anterior fibroids are likely to cause increased urinary frequency and waking up at night to urinate (nocturia), as the bladder sits right in front of the uterus. These fibroids may even cause the woman to leak urine on occasion due to the increased pressure in the bladder. These symptoms may be initially brushed off by the patient and attributed to increasing age. If you’re waking up multiple times a night to urinate, this should be investigated.
Fibroids in the central part of the uterus next to the cavity are the ones that will cause heavy bleeding. If a woman has these fibroids such called submucosal, they will present much earlier than the women who have fibroids on the outer part of the uterus (subserosal) which causes the bulk-related symptoms (i.e. abdominal pain/pressure, bloating, increased urinary frequency, etc.).
If you have an enlarging belly and you believe it is due to fibroids, make an appointment today with the leaders in the non-surgical treatment of uterine fibroids, Dr. John Lipman and the Staff of the Atlanta Fibroid Center.
