Lazy stomach syndrome

Lazy stomach syndrome (syn.: gastroparesis, or gastric paralysis) is a slow emptying of the stomach due to pathological conditions that disrupt the motor-evacuation function of the stomach. The pathology can also cause serious digestive problems and lead to symptoms such as nausea, vomiting, malnutrition and blood sugar imbalance. This is a chronic disease with frequently recurring symptoms over a long period of time. There is no effective treatment to date. Symptoms can be alleviated with a therapeutic diet or medications.

Epidemiology

Manifestations of lazy stomach syndrome are considered the most common reason for visiting a gastroenterologist. Data from a study conducted in Europe, North America, and Australia showed that the overall prevalence of dyspepsia symptoms among the population is within 7-41%, which is approximately 25% on average.

Most data show that only every 2-4th person with symptoms of functional dyspepsia goes to see a doctor. Such patients make up approximately 2-5% of all patients who come to see a general practitioner. If we talk about visiting gastroenterologists, then 20-40% of patients come with the problem of lazy stomach syndrome. About a third of patients go directly to a gastroenterologist, and the rest visit doctors of other specialties (such as psychiatrists, homeopaths, nutritionists, and acupuncturists).

Comparison of the prevalence of the disease among men and women has rather ambiguous indicators. But in general, the prevailing opinion now is that this indicator is approximately the same for women and men, unlike other functional disorders (for example, IBS, functional constipation, functional abdominal pain syndrome, etc.), which women suffer from more.

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Causes lazy stomach syndrome

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

Other reasons:

• Anorexia or bulimia.
• Gastric surgeries affecting the vagus nerve.
• Viral infections (there are several reports of viral etiology of GERD).
• Diseases of the nervous system such as Parkinson's disease, stroke, and brain injury.
• Hypothyroidism and other metabolic disorders.
• Systemic sclerosis.
• Amyloidosis and scleroderma.
• Adrenal problems.
• Peptic ulcer and tumors in the stomach.

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Risk factors

Risk factors for the development of the disease may also include poor nutrition (eating fatty foods, overeating). In addition, bad habits such as smoking (it slows down the rate of digestion of food) have a negative effect on the stomach. Another risk factor for the development of stomach disorders may be certain medications (anticholinergics). A lazy stomach often develops against the background of diabetes, thyroid pathologies, and chemotherapy.

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Pathogenesis

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

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

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

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Symptoms lazy stomach syndrome

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

Other symptoms:

• Premature feeling of fullness after eating.
• Hypoglycemia or hyperglycemia (if the patient suffers from diabetes).
• Unexplained weight loss.
• Loss of appetite.
• Stomach cramps.
• Gastroesophageal reflux.

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Forms

Doctors distinguish 2 types of functional dyspepsia:

• An ulcer-like type of disease that manifests itself as frequent pain in the stomach area;
• The uncomfortable type, which manifests itself as discomfort and a feeling of heaviness in the stomach. It is also often accompanied by nausea and a feeling of fullness in the stomach.

Complications and consequences

Due to the lazy stomach syndrome, the patient's lifestyle changes, he has to stick to a diet. Since many patients experience symptoms of the disease after eating, they prefer to skip some of them. In addition, patients often associate the occurrence of dyspepsia symptoms with eating certain foods, which is why they unreasonably remove them from their daily diet. Most often, milk is excluded from consumption. The consequence of this can be the appearance of osteoporosis, which occurs as a result of an inadequate amount of calcium entering the body.

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Diagnostics lazy stomach syndrome

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

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Tests

During the examination to diagnose lazy stomach syndrome, various tests are also performed.

Biochemical and clinical blood tests are performed. This is required to exclude the presence of organic diseases.

A stool test is performed to detect possible hidden blood, to rule out bleeding in the stomach and intestines. A general stool test can assess how food is digested and identify signs of inflammatory processes or parasitic invasion (giardiasis) of the gastrointestinal tract.

Analysis to detect the presence of H.pylori infection. Among the diagnostic methods, the PCR procedure for examining feces and the urea breath test are distinguished. In the first case, feces must be submitted for analysis. In the second case, two samples of air exhaled by the patient are examined (before taking a special drink and half an hour after).

Instrumental diagnostics

To determine the possible causes of lazy stomach syndrome, instrumental diagnostics may be prescribed:

The procedure of endoscopic examination of the digestive organs (FGDS). During this examination, a flexible thin fiber-optic tube called an endoscope is inserted into the patient's esophagus (and then into the stomach and duodenum). 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 gastrointestinal tract from the inside (this will help to identify ulcers, inflammation, and neoplasms). In this case, tissue samples from the duodenum and stomach (they are called biopsies) can also be taken, which are examined in the laboratory.

X-ray procedures. Contrast esophagography (an X-ray procedure that uses barium to examine the esophagus) may be used to examine the esophagus and look for possible lesions. This procedure can reveal the presence of an ulcer in the stomach.

Ultrasound of the abdominal cavity - this method helps to determine the signs of pancreatic diseases, as well as the presence and location of neoplasms. In addition, ultrasound can detect the presence of stones in the gallbladder.

Differential diagnosis

Differential diagnostics of functional dyspepsia is carried out simultaneously with diagnostics of other pathologies of the gastrointestinal tract. These may be ulcers, chronic gastritis, pancreatitis and cholecystitis, as well as stomach cancer.

Treatment lazy stomach syndrome

To treat lazy stomach syndrome, you should eat more often, but in small portions - this will help avoid worsening the symptoms of the disease, because in this case, food will be better absorbed by the stomach, without lingering in it. You should also avoid those products that irritate the gastric mucosa - you need to limit the consumption of smoked foods, spices, marinades, sauces. Avoid foods high in fat, which slow down the digestion process (bacon, sausages, salami, cheeses and pork ribs).

In some cases, antibacterial treatment may be prescribed - if a Helicobacter infection was detected during the examination. It would also be useful to consult a neuropsychiatrist - he can detect nervous disorders that influenced the development of the stomach disorder.

Medicines

Medicines are prescribed to treat the disease. Antisecretory drugs and atacids (including Omeprazole and Maalox) can be used. In case of symptoms of heaviness in the stomach, medications are prescribed that stabilize its motor function - such as Motilium.

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

Side effects of the drug include:

• Gastrointestinal organs: constipation and diarrhea, flatulence, vomiting with nausea, abdominal pain;
• Organs of the nervous system: if the patient has a concomitant severe somatic disease, dizziness, pain, and depression or, conversely, agitation may occur; if there is severe liver disease, encephalopathy is possible.
• Musculoskeletal system: myasthenia or arthralgia, as well as myalgia, are sometimes observed.
• Hematopoietic organs: sometimes thrombocytopenia or leukopenia, pancytopenia and agranulocytosis are possible.
• Skin: sometimes itching, skin rash; exudative erythema (various forms), photosensitivity, and alopecia may occur.
• Allergies: fever, hives, possible angioedema, anaphylactic shock or interstitial nephritis.

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

Side effects of Maalox - long-term use can cause the body to develop phosphorus deficiency. The drug is contraindicated in cases of severe kidney problems.

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

Side effects of Motilium:

• Endocrine system: gynecomastia and amenorrhea; hyperprolactinemia is sometimes observed, sometimes leading to galactorrhea.
• CNS: occasionally, extrapyramidal disorders occur in children (their symptoms resolve after stopping the medication).
• Digestion: rare disturbances in the functioning of the gastrointestinal tract, sometimes transient spastic contractions may be observed in the intestines.
• Allergies: skin rashes, hives.

Contraindications:

• If there is obstruction of the so-called mechanical etiology or perforation of the gastrointestinal tract;
• In case of prolactinoma (a pituitary tumor that secretes prolactin);
• Bleeding in the intestines or stomach;
• Hypersensitivity to domperidone or other components of the drug;
• Concomitant administration with ketoconazole (oral form).

Other medications that may be prescribed to treat lazy stomach syndrome include cholinergic drugs, erythromycin, metoclopramide.

Vitamins

Gastrointestinal diseases often cause the development of pyridoxine deficiency in the body. This can cause nausea and vomiting, metabolic disorders, nervous disorders, and the inner stomach lining will become vulnerable.

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

The body needs vitamin B12 no less, since its deficiency can cause megaloblastic anemia.

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

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

Vitamin A has an antioxidant and protective effect on the gastric mucosa. This vitamin is found in butter and vegetable oil, cereals, bread, and sour cream with kefir.

Physiotherapy treatment

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

Physiotherapeutic treatment should promote the restoration of the secretory and motor-evacuation functions of the stomach (in this case, secreto-stimulating and vegetative-correcting methods of therapy are used). Thanks to sedative procedures, the patient's asthenodepressive state is relieved. The immunomodulatory method allows activating the mechanisms that form the body's non-specific immune response.

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

Vegetative-corrective processes include electrosleep therapy and transcranial electroanalgesia.

Sedative treatment methods: pine or nitrogen baths, galvanization procedure of the collar area.

Immunomodulatory procedures: high-frequency magnetic therapy with an effect on the thymus, as well as low-frequency CMV therapy with an effect on the umbilical region.

Traditional and herbal medicine

Fruits such as prunes (pitted), raisins, dates, dried apples, figs, and dried apricots are useful for treating the stomach. You can make a mixture from them that helps treat functional dyspepsia. All ingredients should be taken in equal quantities (0.5 cups each). Next, they should be washed, held in boiling water, and then put through a meat grinder to create a homogeneous fruit mass, to which crushed nuts, flax seeds (ground), and honey (all ingredients also 0.5 cups each) are added, and then mixed. The mixture should be stored in the refrigerator and taken 1 teaspoon in the morning 30 minutes before breakfast, and 30 minutes before bed.

Traditional medicine using flax seeds. The tincture is prepared as follows. Pour 2 teaspoons of seeds with a glass of boiled cold water and leave to infuse overnight. In the morning, add scalded raisins, 1 tablespoon of honey, and 1 medium carrot (grate it first) to the tincture. Drink 1 tablespoon twice a day (on an empty stomach).

Another recipe: leave 2 tablespoons of seeds in 0.5 cups of boiled cold water overnight. In the morning, add 1 tablespoon of honey, yogurt, and fruit juice. Drink 0.5 cups in the morning on an empty stomach.

Treatment with chamomile - a collection made from calendula, chamomile, and St. John's wort helps the stomach work. You need an equal amount of all the ingredients, which you need to mix, then take 1 tbsp. of the mixture and pour boiling water over it (1 glass). Infuse for about half an hour. You need to drink four times a day, ¼ glass.

There is also chamomile tea. It is prepared in the following way: 2 teaspoons of chopped chamomile flowers are poured into 1 glass of boiling water, infused for half an hour, and then drunk instead of tea. To make the effect better, you can add St. John's wort or mint. The same drink can be prepared using sage instead of chamomile. This tincture can also be added to green tea. The drink should be consumed warm.

Prevention

To avoid lazy stomach syndrome, you should take the following preventive measures:

• Include foods high in fiber into your daily diet - eat cereals, fruits and vegetables every day.
• Limit your consumption of fatty and heavy foods – 50g of fat is considered a normal daily dose. You should also avoid overeating.
• Do not eat before bedtime, so as not to harm the organs responsible for digestion. Dinner should be no later than 2-3 hours before bedtime. To make the stomach function more productively, chew food thoroughly.
• Arrange fasting days for yourself – once a week, do not eat heavy and fatty foods for a whole day so that your digestive system can “rest”.
• You should drink more water, as it can prevent constipation and improve intestinal peristalsis. Drink a glass of clean, plain water in the morning to stimulate the stomach.
• Exercise regularly, do not avoid physical activity and simply try to move more. Frequent walks, climbing/descending stairs, dancing, participating in sports games - all this helps prevent the occurrence of lazy stomach syndrome.
• Since alcohol and nicotine impair the functioning of the stomach, you should give up bad habits.
• Avoid nervous shocks and stress.

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Forecast

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

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