Lazy Stomach Syndrome

Syndrome of lazy stomach (syn: gastroparesis, or gastric paralysis) - delayed emptying of the stomach due to pathological conditions, disrupting the motor-evacuation function of the stomach. Pathology can also cause serious digestive problems and lead to symptoms such as nausea, vomiting, malnutrition and violation of blood sugar levels. It is a chronic disease with frequently recurring symptoms for a long time. To date, there is no effective treatment. Symptoms can be weakened by a therapeutic diet or medication.

Epidemiology

Manifestations of the lazy stomach syndrome are considered the most common reason for going to the gastroenterologist. Data from a study in Europe, S.Amerike, and Australia, showed that among the general population, the incidence of dyspepsia is between 7 and 41%, an average of about 25%.

Most of the data show that only 2-4 people with symptoms of functional dyspepsia apply to the doctor. Such patients make up about 2-5% of all patients who come to consult a general practitioner. If we talk about the appeal to specialists-gastroenterologists, here with the problem of lazy stomach syndrome comes 20-40% of patients. About a third of patients go directly to the gastroenterologist, and the rest attend doctors of other specialties (such as psychiatrists, homeopaths, nutritional specialists, and acupuncturists).

Comparison of the prevalence of the disease among men and women is quite ambiguous. But in general, the prevailing opinion now is that this indicator in women and men is approximately the same, unlike other functional disorders (eg, IBS, functional constipation, functional abdominal pain syndrome, etc.), which affect women more.

[1], [2], [3]

Causes of the lazy stomach syndrome

This syndrome is also called functional dyspepsia, because with her stomach does not work at the necessary rhythm. All the existing causes of the lazy stomach syndrome by gastroenterologists have not been fully studied yet, but it should be noted that they unanimously believe that stress and nervous disorders affect the functioning of the stomach. Because of this, experienced doctors usually prescribe patients and sedatives in addition to essential medicines.

Other reasons:

• Anorexia or bulimia.
• Operations on the stomach affecting the vagus nerve.
• Viral infections (there are several reports of the viral etiology of GERD).
• Diseases of the nervous system, such as Parkinson's disease, stroke, and brain trauma.
• Hypothyroidism and other metabolic disorders.
• Systemic sclerosis.
• Amyloidosis and scleroderma.
• Problems with the adrenal glands.
• Peptic ulcer and tumors in the stomach.

[4], [5]

Risk factors

Risk factors for the development of the disease can also be malnutrition (eating fatty foods, overeating). In addition, the stomach has a negative influence and bad habits, such as smoking (it slows down the rate of digestion of food). Another risk factor for the development of disorders of the functioning of the stomach may be some drugs taken (anticholinergics). A lazy stomach often develops against a background of diabetes, with pathologies of the thyroid gland, chemotherapy.

[6], [7]

Pathogenesis

Among the pathogenetic links of functional dyspepsia are disorders of gastroduodenal motility and disturbance of hydrochloric acid secretion.

The acid-peptic factor plays a rather ambiguous role in the development of the disease. The average indices of stimulated, as well as basal secretion of hydrochloric acid in most patients remain within normal limits. But in those who have a ulcerative variant of dyspepsia, this indicator is able to approach the level of secretion observed in patients with duodenal ulcer. There is an assumption that, probably, patients with functional dyspepsia have a high sensitivity of the duodenum and gastric mucosa to hydrochloric acid.

In diabetes mellitus, the development of lazy stomach syndrome is caused by damage to nerves and muscles in the stomach due to a constant high blood glucose level.

[8], [9]

Symptoms of the lazy stomach syndrome

The first signs of the syndrome appear immediately after eating. There are pain and feelings of discomfort in the epigastric region. Also in some cases, bloating, severe heartburn, a feeling of fullness of the stomach. Sometimes there is vomiting of undigested food.

Other symptoms:

• Premature feeling of satiety after eating.
• Hypoglycemia or hyperglycemia (if the patient suffers from diabetes).
• Unexplained weight loss.
• Loss of appetite.
• Spasms in the abdomen.
• Gastroesophageal Reflux.

[10], [11]

Forms

Doctors distinguish 2 types of functional dyspepsia:

• Yazvennopodobny type of the disease, which manifests itself frequent pain in the stomach;
• Discomfortable type, which manifests itself in the form of discomfort and a feeling of heaviness in the stomach. Also, nausea and overcrowding are common.

Complications and consequences

Because of the lazy stomach syndrome, the patient's lifestyle changes, he has to follow a diet. Since many patients show signs of the disease after eating, they prefer to skip some of them. In addition, patients often associate the appearance of signs of dyspepsia with the consumption of certain foods, because of what they unreasonably remove them from the daily diet. Most often, milk is excluded from use. The consequence of this may be the appearance of osteoporosis, which occurs as a result of an inadequate amount of calcium entering the body.

[12]

Diagnostics of the lazy stomach syndrome

Functional dyspepsia is diagnosed if there are no problems with the digestive tract, in particular, with the esophagus, stomach and duodenum. Diagnose lazy stomach syndrome if the disease is permanent or its symptoms are repeated regularly - discomfort or pain in the upper abdomen lasts at least 12 weeks per year.

[13]

Analyzes

During the examination, various analyzes are performed in the diagnosis of the lazy stomach syndrome.

Biochemical as well as clinical blood tests are performed. This is required to eliminate the presence of organic diseases.

Stool analysis is performed to identify possible latent blood to exclude bleeding in the stomach and intestines. Due to the general analysis of stool, it is possible to evaluate how food is digested and to reveal signs of inflammatory processes or parasitic invasion (giardiasis) of the gastrointestinal tract.

Analysis for the detection of H. Pylori infection. Among the diagnostic methods, a procedure for PCR for the study of stool and a urease respiratory test are distinguished. In the first case, feces are needed for analysis. In the second, two samples of exhaled air are examined (before taking a special drink and after half an hour after it).

Instrumental diagnostics

To determine the possible causes of lazy stomach syndrome, instrumental diagnostics can be assigned:

The procedure of endoscopic examination of the digestive system (FGDS). In the process of this study, the patient is injected into the esophagus (and further into the stomach and the duodenum) a flexible thin fiber-optic tube called the endoscope. It has a micro-camera and a small light source at the end. This procedure is necessary in order to examine the surface of the intestine from the inside (this will help to identify ulcers, inflammatory process, as well as neoplasms). In this case, samples of tissue from the duodenum and stomach (they are called biopsy specimens) can also be taken, which are studied laboratory.

X-ray procedures. To examine the esophagus and find possible lesions, contrast esophagography can be used (this is an x-ray examination of the esophagus with barium suspension). This method can detect the presence of ulcers in the stomach.

Ultrasound of the abdominal cavity - this technique helps to identify signs of pancreatic disease, as well as the presence and location of tumors. In addition, ultrasound can detect the presence of gallstones.

Differential diagnosis

Differential diagnosis of functional dyspepsia is carried out simultaneously with the diagnosis of other pathologies of the digestive tract. It can be ulcers, chronic gastritis, pancreatitis and cholecystitis, as well as stomach cancer.

Treatment of the lazy stomach syndrome

For the treatment of lazy stomach syndrome, you should eat more often, but with small portions - this will avoid the worsening of the symptoms of the disease, because in this case the food will be better absorbed by the stomach, not lazing in it. Also, it is necessary to abandon those products that irritate the gastric mucosa - it is necessary to limit the consumption of smoked products, spices, marinades, sauces. Avoid foods high in fat that slow down the digestion process (bacon, sausages, salami, cheese and pork ribs).

In some cases, antibacterial treatment may be prescribed - if a heliobacter infection was detected during the examination. It will be useful to consult a psychoneurologist too - he can detect nervous disorders that have affected the development of a disturbance in the functioning of the stomach.

Medications

Medicines are prescribed for the treatment of the disease. Antisecretory drugs and atacides (among them Omeprazole and Maalox) can be used. In the case of manifestations of symptoms of severity in the stomach prescribed medications that stabilize its motor function - such as Motilium.

Omeprazole - capsules are taken in the morning before meals, without chewing. The medicine must be taken with water. Contraindications to use: during pregnancy and during lactation, small children, with high sensitivity to the composition of the medication. It is not recommended to appoint in renal or hepatic insufficiency.

Among the side effects of the drug:

• Gastrointestinal organs: constipation and diarrhea, flatulence, vomiting with nausea, pain in the abdomen;
• NA organs: if the patient has a concomitant severe medical illness, dizziness, pain, and the onset of depression or vice versa may occur; if there is a serious liver disease, encephalopathy is possible.
• Musculoskeletal: sometimes myasthenia gravis or arthralgia, as well as myalgia.
• Organs of hematopoiesis: sometimes thrombocytopenia or leukopenia, pancytopegia is possible, as well as agranulocytosis.
• Skin: sometimes itching, a rash on the skin; Exudative erythema (of various forms), photosensitivity, and also alopecia can be observed.
• Allergies: fever, the appearance of urticaria, possible angioedema, the appearance of anaphylactic shock or interstitial nephritis.

Maalox usually needs to be taken 1-1.5 hours after eating or when pain occurs. It is necessary to drink 1-2 tablets. (chew or keep in your mouth until they dissolve). In the form of a suspension, the drug is prescribed in the amount of 15 ml (1 packet or 1 tablespoon).

Side effects of Maalox - long-term use can cause the development of phosphorus deficiency in the body. The drug is contraindicated in the presence of severe problems in the work of the kidneys.

Motilium in chronic dyspeptic conditions is prescribed 10 mg before meals (15-30 minutes) three times a day.

Side Motilium:

• Endocrine system: gynecomastia and amenorrhea; sometimes there is hyperprolactinaemia, which at times leads to the appearance of galactorrhea.
• CNS: Occasionally, children develop extrapyramidal disorders (their symptoms stop after stopping the medication).
• Digestion: rare abnormalities in the work of the gastrointestinal tract, sometimes in the intestines can be observed transient spastic contractions.
• Allergies: rashes on the skin, hives.

Contraindications:

• If there is an obstruction of the so-called mechanical etiology or perforation of the gastrointestinal tract;
• With prolactinoma (secreting the appearance of prolactin tumor of the pituitary gland);
• Bleeding in the intestine or stomach;
• Hypersensitivity to domperidone or other components of the drug;
• Simultaneous reception with ketoconazole (oral form).

Other drugs that can be prescribed for the treatment of lazy stomach syndrome are cholinergic drugs, erythromycin, metoclopramide.

Vitamins

Diseases of the gastrointestinal tract often cause the development of a deficiency in the body of pyridoxine. Because of this, there may be nausea with vomiting, a metabolic disorder, nervous disorders, and the inner gastric membrane becomes vulnerable.

Pyridoxine (vitamin B6) is found in foods such as beans, peas and grain bread.

Not less the body needs vitamin B12, since its deficiency can cause megaloblastic anemia.

Vitamin PP (or niacin) stabilizes the amount of secreted gastric juice and allows you to get rid of diarrhea. This vitamin is abundant in meat, various porridges, and also fish.

Folic acid, necessary to eliminate the inflammatory process in the gastric mucosa, can be obtained from liver, spinach, and cabbage.

Thanks to vitamin A, there is an antioxidant and protective effect on the gastric mucosa. This vitamin is found in butter and vegetable oil, cereals, bread, as well as sour cream with yogurt.

Physiotherapeutic treatment

Since diseases of the gastroduodenal region can cause various disorders of regulatory systems, it is necessary to include, in addition to medications, physical therapy procedures in the course of treatment of dyspepsia.

Physiotherapeutic treatment should promote the recovery of secretory, as well as motor evacuation functions of the stomach (in this case, secretion-stimulating and vegetative-correcting methods of therapy are used). Thanks to sedative procedures, the asthenodepressive state of the patient is stopped. Immunomodulating method allows to activate mechanisms that form the nonspecific immune response of the organism.

The secretion-stimulating procedures include treatment with mineral waters (hydrocarbonate-chloride and sodium-calcium).

Vegeto-correcting processes include electro-therapy, as well as transcranial electroanalgesia.

Sedative treatment methods: coniferous or nitrogen baths, galvanization procedure for the collar area.

Immunomodulatory procedures: high-frequency magnetotherapy with impact on the thymus, as well as low-frequency CMV-therapy with exposure to the umbilicar region.

Alternative treatment and herbal treatment

Useful for treating the stomach will be fruits such as prunes (pitted), raisins, dates, dried apples, figs, dried apricots. Of these, you can prepare a mixture that helps to treat functional dyspepsia. All ingredients must be taken in equal quantities (0.5 cups each). Then they need to be washed, held in boiling water, and then passed through a meat grinder to create a homogeneous fruit mass, into which crushed nuts, flax seeds (ground), and honey (all 0.5-cups) are added, and then are mixed. The mixture should be stored in the refrigerator and take 1 tsp. In the morning for 30 minutes. Before breakfast, and also for 30 minutes. Before bedtime.

Alternative treatment with flax seeds. The tincture is made as follows. A glass of boiled cold water is poured into 2 tsp. Seeds and leave to insist on the night. In the morning in the tincture you need to add scalded raisins, 1 tbsp. Honey, and also 1 medium carrot (pre-rub it). You need to drink 1 st.lozh. Twice a day (on an empty stomach).

Another recipe - in 0,5 stack. Boiled cold water leave at night 2 tbsp. Seeds. In the morning, add 1 tbsp. Honey, yogurt, and also fruit juice. Use in the morning on an empty stomach in an amount of 0.5 glasses.

Treatment using chamomile - a collection made from marigold, chamomile, and also St. John's wort helps the work of the stomach. You need an equal amount of all the ingredients that you need to mix, then take 1 tbsp. Mixture and pour it with boiling water (1 glass). Insist for about half an hour. Drink four times a day for ¼ cup.

There is also chamomile tea. It is prepared in this way: 2 tsp. Chopped chamomile flowers pour 1 stack. Boiling water, insist for half an hour, after which they drink instead of tea. To make the effect better, you can add St. John's wort or mint to it. The same beverage can be prepared using sage instead of chamomile. This tincture can be added to green tea. Use the drink should be warm.

Prevention

In order to avoid the syndrome of a lazy stomach, it is necessary to carry out such preventive measures:

• Enter in your daily diet foods that contain a lot of fiber - daily use cereals, fruits and vegetables.
• Limit yourself in the use of fatty and heavy foods - 50g of fats are considered a normal daily dose. Also, do not overeat.
• Do not eat before going to bed so as not to harm the organs responsible for digestion. Dinner should be no later than 2-3 hours before bedtime. To stomach function more productively, chew food carefully.
• Arrange for yourself the days of unloading - once a week all day do not eat heavy and fatty foods, so that the digestive system can "rest."
• It is necessary to drink more water, since it is able to prevent constipation, and also improves intestinal peristalsis. Drink in the morning a glass of pure plain water to stimulate the work of the stomach.
• Regularly perform charging, do not avoid physical exertion and just try to move more. Frequent walking tours, climbing / descending stairs, dancing, participating in sports games - all this helps to prevent the occurrence of lazy stomach syndrome.
• Since alcohol and nicotine worsen the functioning of the stomach, one should give up bad habits.
• Avoid nervous shocks and stress.

[14], [15]

Forecast

A year after the start of treatment, lazy stomach syndrome occurs in 30-50% of patients. Also in 30% of cases, a spontaneous cure occurs. But at the same time, it should be noted that a relapse after the end of the course of treatment can happen with a high degree of probability.

[16], [17]