Stomach bloating is uncomfortable. Trying to figure out if your stomach is bloated because of something you ate or something more serious can add mental and emotional stress to the discomfort. As a first step, take a deep breath and try not to jump to the worst conclusion.

Yes, abdominal swelling can be a symptom of leukemia, a cancer of the blood and bone marrow, or it can be a side effect of leukemia treatment. But it can also be caused by gastrointestinal issues, other underlying health conditions, or take-out food of questionable origin. Once you identify the cause, you can work on finding a solution.

If you are living with leukemia and feel pain or swelling in your abdomen, you are not alone. Stomach bloating is associated with all four main types of leukemia:

• Chronic lymphocytic leukemia/small lymphocytic leukemia (CLL/SLL)
• Chronic myeloid leukemia (CML)
• Acute myeloid leukemia (AML)
• Acute lymphoblastic leukemia (ALL) — Also referred to as acute lymphocytic leukemia

“Abdominal issues are a misery,” shared one MyLeukemiaTeam member. “My abdomen is a miserable part of my body now,” agreed another.

Abdominal Bloating in Leukemia

Someone who is experiencing stomach bloating may report feeling full, despite not having eaten a large meal. Or, they may describe the feeling as a swelling sensation in their belly. This full or swollen feeling can be a result of leukemia cells building up in the liver or spleen.

“I have an enlarged spleen, which is causing abdominal discomfort,” shared one MyLeukemiaTeam member. Another said, “I just had blood tests done and an ultrasound on my abdomen to see if my spleen has increased in size. At my last scan — two years ago — it had doubled.”

Does Leukemia Cause Stomach Bloating?

If you are experiencing abdominal pain or discomfort, you may care more about feeling better than discovering its origin. By identifying the cause, however, you and your doctor may be able to work together to find you some relief. In many cases, stomach bloating is triggered by an accumulation of cancer cells, a side effect of medication, or changes in lifestyle or eating habits. In some cases, it may be caused or worsened by all three.

Leukemia may cause stomach bloating and abdominal discomfort when cancer cells accumulate in the liver and spleen, increasing the size of one or both organs. The medical term for an enlarged liver is “hepatomegaly.” The medical term for an enlarged spleen is “splenomegaly.”

A healthy spleen filters and stores blood cells. It also destroys old or damaged red blood cells and creates white blood cells called lymphocytes that help your body fight infections. When leukemia cells accumulate in the spleen, they can distend it, causing it to press against the stomach and other organs. The result may be discomfort or pain. If you have an enlarged spleen, your doctor may be able to feel it on the left side of your body.

When cancer or other health conditions compromise your liver, you may experience stomach bloating due to ascites, a condition that causes fluid buildup in the abdomen. Although it is possible to have a swollen abdomen caused by ascites with leukemia and other types of blood cancer, it is more commonly associated with solid tumor malignancies, like ovarian and breast cancer.

Is Abdominal Bloating a Side Effect of Leukemia Treatment?

Some leukemia treatments may cause stomach bloating and abdominal discomfort. One example is chemotherapy, a standard treatment for leukemia, lymphoma, and other types of cancer. Chemotherapy often slows the passage of food through the digestive tract, causing pain or abdominal discomfort. This type of bloating is known as “chemo belly.”

Chemotherapy can also cause stomach bloating through constipation, a condition when you have fewer bowel movements than usual or stop passing stool altogether. Someone who is constipated may feel bloated and gassy or have a stomachache.

Targeted leukemia treatments can also cause abdominal discomfort. One example is ibrutinib (Imbruvica), a targeted therapy used to treat CLL/SLL, and other types of cancer. “I was on Imbruvica and had tarry stools and bloating,” said one MyLeukemiaTeam member.

Another added, “I’ve been taking Imbruvica for a little over a year, and I get belly pain and bloating. I also have a decreased appetite now.”

Members also report having constipation while taking dasatinib (Sprycel), venetoclax (Venclexta), and rituximab (Rituxan).

Tell your oncologist if you are experiencing stomach bloating or abdominal pain you suspect may be side effects of cancer treatment. They can verify the cause and may be able to adjust your dose (if it’s related to leukemia therapy) or recommend medication to minimize your discomfort.

What Else Causes Abdominal Bloating With Leukemia?

Bloating can also stem from other quality-of-life issues that often affect people with leukemia. Fatigue, for example, may lead to a decrease in physical activity because you don’t feel like you have the energy to exercise. Low activity levels can slow down digestion, resulting in bloating or discomfort.

Another example is dehydration, which can be a side effect of treatment or a result of not feeling well enough to eat and drink, leading to a loss of appetite, weight loss, or constipation.

In some cases, abdominal bloating can be caused by an intestinal blockage requiring surgery.

If you are experiencing severe pain, cramping, vomiting, or other abdominal distress, seek immediate medical attention.

Tracking Abdominal Symptoms

Before your next doctor’s appointment, start keeping track of what symptoms you feel and when. These clues will help your doctor uncover the cause of your stomach bloating and develop a treatment strategy. Consider this list from the National Institute on Aging as you track your symptoms:

• Would you classify the abdominal sensation as pain, fullness, discomfort, or all three?
• On a scale of one to 10, how uncomfortable does this symptom make you?
• Is stomach bloating a new symptom?
• Is there a time of day when it occurs most frequently?
• What medications are you currently taking? This list should include over-the-counter medications and prescription drugs, as well as supplements and vitamins.
• Have you tried any new foods recently?

Add anything else that you think may help guide the conversation with your doctor. Some people feel embarrassed to bring up symptoms or don’t feel comfortable complaining. However, your doctor won’t know you’re having symptoms if you don’t tell them. Be open and honest with your doctor to ensure you’re getting the best care possible for all symptoms of leukemia and the side effects of treatment.

Managing Abdominal Bloating in Leukemia

Although stomach bloating may not be completely avoidable while living with leukemia, MyLeukemiaTeam members who experience it have discovered strategies to manage this symptom and maintain their quality of life.

Diet

Changing when, what, and how much you eat may be one way to manage or reduce stomach bloating and abdominal discomfort. “I have stopped eating large meals,” said one member. “Now, I graze all day and eat really light at night.” Another added, “I keep peppermint candy canes on hand for after meals. Ginger ale also helps me.”

It may be a process of trial and error to see if changing your diet can help you manage stomach bloating, but here are a few strategies to consider:

• Avoid or limit your intake of gassy foods like beans, broccoli, cauliflower, and cabbage.
• Replace soda and other carbonated beverages with plain water or green tea.
• Try probiotic-rich foods like yogurt, kefir, and kombucha.
• Experiment with non-dairy alternatives like almond milk and oat milk.
• Increase your fiber intake with quinoa, oatmeal, bananas, and other fiber-rich foods.
• Chew your food slowly. Smaller pieces are easier to digest.

One MyLeukemiaTeam member adds a daily dose of fiber to meals. “I use one teaspoonful of a flavorful Metamucil in about eight ounces of cold water daily,” the member said.

Before making any changes to your diet, talk to your doctor to create a specific plan based on your treatment options and overall health.

Exercise

Daily physical activity offers many benefits, including weight management, improved brain health, and stronger bones and muscles. It can also reduce bloating. “Stay positive, eat good meals, and exercise. This will go a long way,” said one MyLeukemiaTeam member.

“Eat clean, avoid sugar and processed foods, and exercise,” added another.

The good news is that you don’t have to run a marathon or join a gym to reap the benefits of exercise. A short walk after meals can improve digestion and release trapped gas, which may help you feel less bloated. A relaxing at-home yoga session or a bike ride around the block may provide the same benefits.

Before starting a new exercise program or increasing the intensity of your current routine, talk to a health care professional.

Medications

If you experiment with diet and exercise and the symptoms persist, you may find that over-the-counter or prescription medication can help. “I experimented with Gas-X, and it worked for me,” said one MyLeukemiaTeam member. “Now, I take a capsule after every meal.”

Other commonly used over-the-counter bloat remedies include Beano, Pepto-Bismol, and activated charcoal. Before taking any medications or supplements, however, talk to your oncologist, as some of these may interfere with (or reduce) the efficacy of drugs used to treat cancer. Also, ask your doctor if there are any prescription remedies they recommend or if adjusting the timing of your leukemia medications can reduce stomach bloating and abdominal pain.

Treatment for Splenomegaly

If your abdominal bloating is caused by splenomegaly, your doctor may recommend radiation therapy to reduce the size of the spleen or splenectomy (surgical removal of the organ).

Talk With Others Who Understand

MyLeukemiaTeam is the social network for people living with leukemia and their loved ones. On MyLeukemiaTeam, more than 11,000 members come together to ask questions, give advice, and share their stories with others who understand life with leukemia.

Are you living with stomach bloating and leukemia? Share your experience in the comments below, or start a conversation by posting on your Activities page.