Feeling this way must have been truly frustrating. In modern medicine, abdominal distension and gas represent an issue far too complex to be explained by simple dyspepsia alone. What Donguibogam calls impaired transportation and transformation of the spleen can be understood in modern medicine as symptoms arising from a combination of several factors.
The first factor is gut dysbiosis. Countless microorganisms live inside our intestines, and they naturally produce gas while breaking down food. However, when harmful bacteria outnumber beneficial bacteria, or when conditions like small intestinal bacterial overgrowth occur where bacteria proliferate excessively in the small intestine, gas production increases abnormally and disrupts intestinal motility, leading to abdominal distension. People sensitive to specific carbohydrates (FODMAPs) also experience these symptoms easily.
Another key factor is the role of the autonomic nervous system. When stress occurs, sympathetic nerve activity rises while parasympathetic nerve activity declines, leading to reduced digestive enzyme secretion and decreased intestinal peristalsis. In other words, just as when the spleen is exhausted, food cannot be properly digested and moved along. The brain and the gut are closely connected through a pathway called the gut-brain axis, meaning psychological factors like stress and anxiety directly affect gut function. The vagus nerve plays a central role in this process. The vagus nerve extends from the brain down to the digestive organs, regulating digestive fluid secretion and intestinal motility. When this nerve fails to function properly due to stress, gastrointestinal symptoms such as dyspepsia and abdominal distension can emerge.
In addition, a deficiency of digestive enzymes related to the pancreas or bile secretion can also cause abdominal distension. When digestive enzyme secretion is impaired due to aging or underlying conditions, food is not properly broken down, becoming fuel for gut microbiota and producing excessive gas. Simple habits such as swallowing air (aerophagia), eating too quickly, or talking while eating can also worsen gas and abdominal distension. Abdominal distension is a complex bodily signal created when multiple elements—the gut environment, nervous system, digestive enzymes, and lifestyle habits—interact. Listening to this signal and addressing these components is essential.
