Brief Answer: It is possibily fluid accumulation Detailed Answer: Hi, I appreciate your concern. If I see such a patient in my clinic with abdominal distension , I would like to rule out presence of Ascites (accumulation of fluid in abdomen) or it might be just abdominal obesity. Since you a giving a long history , it is unlikely to be due to accumlation of flatus or faeces. As you have long standing COPD, you might have developed Cor Pulmonale. Cor pulmonale is defined as an alteration in the structure and function of the right ventricle caused by a primary disorder of the respiratory system like COPD in your case. It may cause respiratory symptoms alongwith abdominal distension, peripheral edema, Right upper abdomen discomfort , jaundice etc. Diuretic drugs along with vasodilator drugs are used in treatment of corpulmonale. I would suggest you to discuss about this possibility with your treating doctor. If he agrees, the dose of water pill (diuretic) that you are on needs to be increased. Besides that I also suggest that you keep your limbs elevated at most times. Monitor your waist/ abdominal circumference daily along with daily weight check. In case sudden increase , it might denote water retension. Your doctor may want to arrange for investigations like Chest XRay, ECG, Echocardiography and ultrasound abdomen to confirm the cause. Hope it helps Dr XXXXXXX XXXXXXX

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