What causes a hard abdomen when standing, and what should be done about it?

Under normal circumstances, a hard abdomen when standing may be caused by various factors such as normal physiological changes, intestinal gas, constipation, muscle spasms, or abdominal wall hernia. Patients are advised to seek medical evaluation at a reputable hospital and receive symptomatic treatment under a doctor's guidance based on the underlying cause. Specific details are as follows:

1. Normal phenomenon

If the abdomen feels hard when standing but soft when sitting, and there are no accompanying discomforts, this may be a normal physiological occurrence. When standing, abdominal muscles tend to be more tense, making the abdomen feel firm; whereas when sitting, the muscles relax, resulting in a softer feel. This condition is considered normal and generally requires no special treatment.

2. Intestinal gas

Consuming foods high in legumes, carbonated beverages, or high-fiber foods, or having conditions such as indigestion or small intestinal bacterial overgrowth, may lead to excessive gas accumulation in the intestines, causing intestinal distension and a sensation of abdominal hardness. It is recommended that patients engage in mild physical activity after meals, which may help alleviate symptoms to some extent.

3. Constipation

In cases of constipation, intestinal motility is typically slowed, contributing to stool retention in the intestines. Slowed peristalsis allows feces to remain in the intestine for longer periods, potentially leading to a hard-feeling abdomen when standing. Patients may follow medical advice to use medications such as senna granules, lactulose oral solution, or mosapride citrate tablets to relieve symptoms.

4. Muscle spasm

Muscle spasms may occur in the abdominal or abdominal wall muscles, causing these muscles to become tense and contract. When abdominal muscles are overly tense, patients may experience a stiff or tight sensation in the abdomen. During episodes of muscle spasm, changing posture—such as bending forward or flexing the abdomen—may help reduce discomfort or relieve the spasm.

5. Abdominal wall hernia

An abdominal wall hernia may cause increased tension in the surrounding abdominal muscles, especially during physical exertion or when standing. Under a doctor’s supervision, patients may use traditional Chinese medicines such as Buzhong Yiqi Pills, Shangqi Neixiao Pills, or Juhewan to help alleviate symptoms.

In summary, the aforementioned issues may arise from multiple causes. If symptoms persist or worsen, prompt medical consultation is recommended to prevent serious complications.