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When I see patients report chronic bloating and “looking pregnant”, a common cause besides constipation and excess wind is abdomino-phrenic dyssynergia (APD). This is a disorder where the diaphragm inappropriately contracts and descends during breathing, resulting in abdominal protrusion. The primary treatment involves retraining co-ordination between the diaphragm and abdominal wall through breathing exercises. Targeted abdominal massages can help but benefits are likely to be temporary.
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