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Stomach disease
Classification and external resources

The location of the stomach in the body.
ICD-10 K30.-K31., Q40.-Q41.
ICD-9 536, 750
MeSH D013272

The stomach is an important organ in the body. It plays a vital role in digestion of foods, releases various enzymes and also protects the lower intestine from harmful organisms. The stomach connects to the swallowing tube (Esophagus) above and to the small intestine below. It is intricately related to the pancreas, spleen and liver. The stomach does vary in size but its J shape is constant. The stomach lies in the upper part of the abdomen just below the left rib cage.

Gastropathy is a general term used for stomach disease.[1]

Examples including the name include:

However, there are many other stomach diseases that don't include the word "gastropathy".

Many stomach diseases are associated with infection. Historically, it was widely believed that the highly acidic environment of the stomach would keep the stomach immune from infection. However, a large number of studies have indicated that most cases of stomach ulcers, gastritis, and stomach cancer are caused by Helicobacter pylori infection. One of the ways it is able to survive in the stomach involves its urease enzymes which metabolize urea (which is normally secreted into the stomach) to ammonia and carbon dioxide which neutralises gastric acid and thus prevents its digestion. In recent years, it has been discovered that other Helicobacter bacteria are also capable of colonising the stomach and have been associated with gastritis.

Having too little or no gastric acid is known as hypochlorhydria or achlorhydria respectively and are conditions which can have negative health impacts. Having high levels of gastric acid is called hyperchlorhydria. Many people believe that hyperchlorhydria can cause stomach ulcers. However, recent research indicates that the gastric mucosa which secretes gastric acid is acid-resistant.

Gastritis and stomach cancer are caused by hellocobacter pylori infection.

Having to little or no gastric acid is known as hypochlorhydria which can have negative health impacts.

There are many types of chronic disorders which affect the stomach. However since the symptoms are localized to this organ, the typical symptoms of stomach problems include nausea, vomiting, bloating, cramps, diarrhea and pain. [2]

Contents

Chronic disorders

Disorders of the stomach are very common and induce a significant amount of morbidity and suffering in the population. Data from hospitals indicate that more than 25% of the population suffers from some type of chronic stomach disorder including abdominal pain and indigestion. These symptoms occur for long periods and cause prolonged suffering, time off work and a poor quality of life. Moreover visits to doctors, expense of investigations and treatment result in many days lost from work and a colossal cost to the financial system. [3]

Gastritis

In the stomach there is a delicate balance between acid and the wall lining which is protected by mucus. When this mucus lining is disrupted for whatever reason, signs and symptoms of acidity result. This may result in upper abdominal pain, indigestion, loss of appetite, nausea, vomiting and heartburn. When the condition is allowed to progress, the pain may become continuous; blood may start to leak and be seen in the stools. If the bleeding is rapid and of adequate volume it may even result in vomiting of bright red blood (hematemesis). When the acidity is uncontrolled, it can even cause severe blood loss (anemia) or lead to perforation (hole) in the stomach which is a surgical emergency. In many individuals, the progressive bleeding from an ulcer mixes with the feces and presents as black stools. Presence of blood in stools is often the first sign that there is a problem in the stomach. [4]

Gastroparesis

Another very common long term problem which is now more appreciated is gastroparesis. Gastroparesis affects millions of individuals and is often never suspected and most patients have a delay in diagnosis. Basically in gastroparesis, the stomach motility disappears and food remains stagnant in the stomach. The most common cause of gastroparesis is diabetes mellitus|diabetes]] but it can also occur from a blockage at the distal end of stomach, a cancer or a stroke. Symptoms of gastroparesis includes abdominal pain, fullness, bloating, nausea, vomiting after eating food, loss of appetite and feeling of fullness after eating small amounts of food.

Reflux

In many patients, acid form the stomach pushes up into the swallowing tube and causes heartburn or reflux. Reflux is common in obese individuals, smokers and those who drink alcoholic beverages. Normally the lower part of the esophagus has a valve which prevents stomach acid from going up- when this valve becomes incompetent, reflux results. The individual often presents with night time episodes of chest pain, foul taste in the mouth and nausea. Prolonged reflux can result in pneumonias, poor dental hygiene and a chronic cough. [5]

Constipation

Constipation happens when the bowels produce less movements than what is normal for a person and is one of the most common troubles suffered. The number of bowel movements is measured differently for each person. Some experience multiple movements each day, while others go days at a time without movements. When the body goes longer than three days without relieve of a bowel movement, the feces hardens and is harder for the body to release. Common causes of constipation include inadequate water and fiber intake, a disruption of regular diet or routine like traveling, inadequate activity or exercise, or consumption of large amounts of dairy products among others. Symptoms are easily recognized and are reported as pain, abdominal swelling, and the infrequency of bowel movements or difficulty having them.

Diarrhea

Another common condition is diarrhea. Opposite from constipation, diarrhea is an increase in the number of bowel movements experienced. It is possible for the amount of feces to decrease with the increasing number of movements. Many conditions will see diarrhea develop as a symptom, so it is important to understand exactly what the condition is. The consistency of stools is different based on people's diets and health conditions. Measuring this consistency is the way that diarrhea is diagnosed. This looseness of stool, which can vary all the way from slightly soft to watery, is caused by increased water in the stool. [6]

During digestion, food is stored in the liquid present in the stomach. The food that is not digested travels to the small intestine and colon in liquid form. These organs begin to absorb the water turning the food into a more solid form. Different viruses or bacteria can increase the amount of liquid that is secreted and moves too quickly through the digestive track for the water to be absorbed. Diarrhea can exist in one of two types, acute diarrhea or chronic diarrhea. The acute diagnosis can last for a few days up to a week of time. Chronic diarrhea lasts for several days or longer periods of time lasting a few weeks. The difference in diagnosis will help determine the cause of the illness.

Lactose Intolerance

Another condition that can be dealt with is lactose intolerance. Depending on ethnic group and nationality, from 2% (Denmark) to 90% (Asian Americans) can be afflicted with this condition [7]. In some persons, the body has a difficult time breaking down lactose in dairy products. Lactose is a term used to described milk sugar. Lactose intolerance is a different condition than having a milk allergy. The problem behind lactose intolerance is a deficiency of lactase - an enzyme produced by the lining of your small intestine [8]. It is possible for someone to have low levels of lactase and not be affected by the condition. To be diagnosed with lactose intolerance, a person must have both low lactase levels and the symptoms associated with it. Most common symptoms include nausea, diarrhea, bloating, gas, and abdominal cramps. Products are available that allow those with the intolerance to enjoy dairy products with more ease.

Crohn's Disease

Crohn's Disease is a more serious condition than the previous mentioned and is an inflammation on the walls of the intestine that can be affected at any place along the digestive tract. Currently, there is not a known cause for the disease, but it is known that an immune system that is not functioning correctly can develop into Crohn's Disease. Researchers believe that a dysfunction of the immune system results in the intestine overreacting to an environmental, dietary, or infectious agent [9].

Symptoms include abdominal pain, loss of appetite, and weight loss. Diarrhea is also a symptoms that can develop, so checking stools for the appearance of blood is important. It is possible for symptoms of Crohn's Disease to remain with a person for weeks or go away on their own. Reporting the symptoms to a physician is recommended to prevent further complications.

Cancers

Cancers of the stomach are rare and the incidence has been declining worldwide. Stomach cancers usually occur in the absence of acidity and may present with vague symptoms of abdominal fullness, weight loss and pain. The actual cause of stomach cancer is not known but has been linked to the h.pylori bacteria [10]. Of all the conditions that can be experienced, cancers of the stomach are among the most serious ones. Cancer develops in the cells of tissues that make up all the bodies organs. In the normal process, cells grow, divide, die, and make room for new cell life. Sometimes, this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor. These tumors can be either malignant and cancerous, or benign and not cancerous. Symptoms are experienced that cause mutliple stomach troubles. Talking to a physician about any of the symptoms experienced is the best way to ensure the proper diagnosis and treatment.

Prevention

Smoking has been linked to a variety of disorders of the stomach. Tobacco is known to stimulate acid production and impairs production of the protective mucus. This leads to development of ulcers in the majority of smokers. Chronic stomach problems have also been linked to excess intake of alcohol. It has been shown that alcohol intake can cause stomach ulcer, gastritis and even stomach cancer. Thus, avoidance of smoking and excess alcohol consumption can help prevent the majority of chronic stomach disorders.

One of the most causes of chronic stomach problems is use of medications. Use of aspirin and other non steroidal ant inflammatory drugs to treat various pain disorders can damage lining of the stomach and cause ulcers. Other medications like narcotics can interfere with stomach emptying and cause bloating, nausea, or vomiting.

The majority of chronic stomach problems are treated medically. However, there is evidence that a change in life style may help. Even though there is no specific food responsible for causing chronic stomach problems, experts recommend eating a healthy diet which consists of fruits and vegetables. Lean meat should be limited. Moreover people should keep a diary of foods that cause problems and avoid them. [11]

Endoscopy

There are many tools for investigating stomach problems. The most common is endoscopy. This procedure is performed as an outpatient and utilizes a small flexible camera. The procedure does require intravenous sedation and takes about 30-45 minutes; the endoscope is inserted via the mouth and can visualize the entire swallowing tube, stomach and duodenum. The procedure also allows the physician to obtain biopsy samples. In many cases of bleeding, the surgeon can use the endoscope to treat the source of bleeding with laser, clips or other injectable drugs.

X rays

Other radiological studies frequently used to asses patients with chronic stomach problems include a barium swallow, where a dye is consumed and pictures of the esophagus and stomach are obtained every few minutes. Other tests include a 24 hour pH study, Ct scans or MRI.

References

  1. ^ Gastropathy at Dorland's Medical Dictionary
  2. ^ Chronic Stomach Information Retrieved on 2010-01-20
  3. ^ Stomach Health HealthLine. Retrieved on 2010-01-20
  4. ^ What is a stomach ulcer Mama's Health. Retrieved on 2010-01-20
  5. ^ Stomach and duodenal ulcers Gastro. Retrieved on 2010-01-20
  6. ^ Diarrhea Causes, Symptoms, Diagnosis, and Treatment on MedicineNet.com. Retrieved on 2010-01-27
  7. ^ Stomach Trouble Information you need to know. Retrieved on 2010-01-20
  8. ^ Lactose intolerance from MayoClinic. Retrieved on 2010-01-27
  9. ^ Crohn's Disease: Inflammatory Bowel Diseases (IBD) Merck Manual Home Edition. Retrieved on 2010-01-20
  10. ^ Stomach Cancer MedicineNet. Retrieved on 2010-01-20
  11. ^ Stomach Disorders MedLine Plus. Retrieved on 2010-01-20

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