My Stomach Feels Swollen – Is It Really Swollen?

Hello. This is Baengnokdam Korean Medicine Clinic.

Let's begin today's discussion with these common experiences:

“It's not like I ate a lot, but my stomach constantly feels bloated.”

“My stomach feels full, and I can't even burp.”

“My epigastrium feels heavy and uncomfortably tight, like it's being pressed down.”

However, when you go to the hospital and get an endoscopy, the doctor often states definitively:

“There are no significant abnormalities.”

But, dear readers, that doesn't mean everything is truly okay. Today, we'll examine 'the feeling of a swollen stomach,' this enigmatic symptom, point by point.

1. Is Your Stomach Truly Swollen?

Let me tell you the conclusion first. In most cases, the stomach is not actually swollen. 'A swollen stomach,' to be precise, refers to "a feeling of something being full in the stomach," or "a feeling of obstruction," or "a feeling of abdominal distension."

However, if it were truly swollen, there would be inflammation in the stomach tissue, or the organ itself would be swollen due to edema, or there would be a large tumor inside. In such a state, it wouldn't just be simple bloating, but severe pain, vomiting, fever, or weight loss would also definitely appear.

But the 'uncomfortable feeling' we're talking about is mostly just a 'feeling' itself. The brain perceives it that way.

2. So why do you feel that way?

There are four main reasons for this:

1. Functional Gastrointestinal Disorder - This is the most common cause. Even though there are no abnormalities on endoscopy or abdominal ultrasound, the sensory system within the gastrointestinal tract becomes hypersensitive, causing the brain to interpret even slight distension as 'excessive bloating.'
2. Delayed Gastric Emptying - The stomach acts as a pump, gradually sending the food we eat into the small intestine. However, if this function slows down, food remains in the stomach for a long time, leading to a feeling of fullness.
3. Autonomic Nervous System Issues - The gastrointestinal tract does not operate independently. The autonomic nerves, especially the vagus nerve, regulate gastric motility and acid secretion. When under a lot of stress, the sympathetic nervous system becomes overly activated, which halts gastric motility and increases stomach acid secretion.
4. Gas and Air Issues - There is a phenomenon called aerophagia (swallowing air). You unconsciously swallow air during fast eating, chewing gum, consuming carbonated drinks, and even in stressful situations.

3. Gastric Distension from a Korean Medicine Perspective

In Korean medicine, this is referred to as 'Changman (脹滿).' 脹 signifies distension and tension, while 滿 refers to a feeling of fullness and obstruction within. This feeling commonly appears when Liver Qi (肝氣) is stagnant due to stress, when the Spleen and Stomach are weak leading to poor digestion, or in a condition of Food Stagnation (食積) where food is not properly broken down.

4. So, is treatment necessary?

Absolutely. Just because there's no specific diagnosis doesn't mean treatment isn't needed. If this feeling recurs, it can lead to anxiety about eating, chronic burping, abdominal discomfort, and in severe cases, even to irritable bowel syndrome (IBS) and acid reflux.

In the early stages, recovery is possible with just dietary adjustments, abdominal relaxation, diaphragmatic breathing, and light exercise, but if left untreated, sensory hypersensitivity can become fixed, and eventually, it may not respond well to medication.

The 'feeling of a swollen stomach' might actually indicate that your nervous system, not your stomach, is overstimulated. While tests may be normal, your body is clearly sending distress signals. In such cases, don't just endure it; observe your patterns, adjust your lifestyle, and seek functional treatment if necessary.

Sensations are information interpreted by the brain. If those sensations are repetitive, it means the brain is sending structured signals. Do not ignore those signals.

Thank you.