Why is my tummy so bloated?

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G, 43, had a rude shock and felt devastated a year ago when she was diagnosed with ovarian cancer. She was unaware that the bloated feeling in her tummy was associated with the disease.

“I had nausea and a bloated feeling in my tummy for a week. My family doctor diagnosed me as having tummy upset and treated me with gastric medications” G recalled, “but the symptoms persisted and I began to lose my appetite. She then arranged for me to have an ultrasound examination of the pelvis which showed a 5 cm tumour in my left ovary.”

When I examined G, the abdomen was distended with fluid. The left lower abdomen was slightly tender.  MRI (Magnetic Resonance Imaging) scan confirmed the left ovarian cyst with solid areas in its wall.  There was ascitic fluid in the abdominal cavity with a suggestion of tumour spreading to the peritoneum, the inner lining of the abdominal cavity. The blood level of ovarian tumour marker, CA125, was raised many times above normal.

She had an extensive surgery a week later with removal of the left ovarian tumour together with the uterus, the right ovary and the omentum, the fatty tissue apron covering the intestines. Microscopic examination of the tumour confirmed ovarian cancer with spread to the omentum and peritoneum. The cancer was classified as stage III and chemotherapy was soon administered after she recovered from the surgery.

Ovarian cancer is the second most common gynaecological cancer and the 5th commonest cancer in Singapore. There are 359 cases diagnosed yearly based on the Singapore Cancer Registry 2011-2015.