Stomach neurosis: signs, how to diagnose?

The complex and diverse activity of the digestive organs is innervated by a whole system of nerves, which, entering their walls, are intertwined in a dense network around the glands and smooth muscle tissue, consisting of layers of nerve cells that perceive and regulate the process of digestion of food. The stomach is provided with such very powerful plexuses, localized between bundles of smooth muscles and located directly under the mucous membrane. Neurosis of the stomach (gastroneurosis) is considered a violation of its work due to a disorder of innervation in the absence of organic pathology, both gastroenterological and brain.

The modern pace of life predisposes to nervous exhaustion, we encounter stressful situations much more often than our ancestors, who lived a more measured life. In addition, the wrong daily routine and diet - lack of sleep, snacks on the go, bad habits, a state of dissatisfaction, and we begin to worry about discomfort in the epigastric region, and regularly. The clinical picture is not specific and resembles many pathologies of the digestive tract. Therefore, you should not swallow analgesics, tablets and herbs "for the stomach." This is a reason to see a doctor, get examined and determine the cause of indigestion.

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Epidemiology

The prevalence of all types of neuroses is growing in both developed and developing countries, and this is due to cases with complex vegetative-visceral disorders (organic, including gastric neurosis). The frequency of occurrence of classical forms of the disease is decreasing. According to selective data, neuroses make up about a fifth of all neurological pathologies. The disease manifests itself during the period of highest vital activity, as a rule, after 30 years. According to research data, patients with an average age of approximately 36-37 years mainly come with complaints of symptoms corresponding to gastric and intestinal neurosis, the majority of them are female (65-70%). In women, diseases of neurotic etiology are more severe and much more often than in men, they end in disability.

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Causes gastric neurosis

In most cases, the development of gastroneurosis is based on psychological factors: frequent stress and depression, physical and mental overstrain, interpersonal conflicts, internal dissatisfaction, psychological trauma. This is, in the full sense, a disease of the nerves. This condition often fits into the clinical picture of neurasthenia, hysterical and obsessive-phobic neurosis.

Risk factors for the appearance of symptoms of gastroneurosis are overeating or, conversely, lack of appetite, poor eating habits (when a long period of hunger is followed by excessive consumption of food), alcohol abuse, drug addiction, smoking, and poisoning.

Individual personality traits also increase the risk of developing gastric neurosis. Hypochondriacs, suspicious people, and those who are overly sensitive to sensations from internal organs are very susceptible to this pathology. The likelihood of getting sick increases in individuals who have poor control over their emotions - frequent bouts of anger, envy, and jealousy are the triggers of the disease. At risk are hyper-responsible people who voluntarily perform many duties, have high self-esteem, and cannot cope with increased workload. Oddly enough, their antipodes, who are unwilling to make decisions and shirk problems, also risk getting sick with this type of neurosis.

Physiological factors that provoke gastric neurosis include diseases of the digestive organs, nervous system, mental disorders, viral and bacterial infections, and also – in some cases, gastric irritation and neurosis are caused by gynecological diseases – inflammation or neoplasms of the uterus and ovaries.

The causes of gastroneurosis seem to be clear. Like other neurotic conditions, it is caused by a combination of provoking factors. Genetic predisposition, constitutional features, traumatic childhood experiences, and poor adaptability to unfavorable life situations play a major role in the development of neuroses.

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Pathogenesis

Personal accentuations and individual psycho-emotional characteristics are of decisive importance in the modern interpretation of the pathogenesis of organic neurosis of any clinical type. The impetus for its development is usually an internal personal conflict with the possibility of a multidirectional resolution, not always corresponding to the moral values of the individual. This causes prolonged excitation of nervous activity with sharply emphasized emotionality of experiences. The individual then finds himself in a stressful situation. Dyspeptic symptoms of stress have been felt to one degree or another by almost everyone - a feeling of a lump in the throat, nausea, vomiting, diarrhea, lack of appetite, etc. Various studies have proven the direct relationship of stress factors to the digestive process. Their constant action slows down the digestion process and dyspepsia develops. Neuroses are often accompanied by gastroenterological symptoms.

The pathogenesis of this nervous disorder has been studied quite well, although there are still "blank spots" in the question of choosing a symptom complex that determines specific gastroenterological signs of neurosis. The main role of the provoking factor is given to the individual psychophysiological properties of the patient's personality. The mechanism of development of gastroneurosis also takes into account the pathophysiological features of the patient's digestive system, congenital or acquired as a result of diseases, intoxications and injuries suffered during life, which are supported by an unresolved emotional conflict and, at the same time, can lead to the formation of persistent dysfunctions of internal organs.

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Symptoms gastric neurosis

Gastroenterological symptoms are classified into two types: gastric and intestinal. However, each of the neuroses in its pure form is extremely rare, much more often mixed forms are observed - neurosis of the stomach and intestines. Moreover, as a rule, symptoms of gastric neurosis appear first, and intestinal colic, constipation or loose stools (intestinal symptoms) join them a little later. Quite often, such a very sensitive form as gastralgia is encountered. Sometimes stomach pain on a nervous basis is the only symptom from the gastrointestinal tract. Some researchers even considered it separately, as an independent type of neurosis, however, modern neurology considers it as a clinical organic symptom of damage to the nervous system.

The first signs of gastroneurosis can be different, there can be several of them, from those listed below, there can be one:

• nausea, habitual vomiting and/or heaviness in the stomach after eating, sometimes lasting for a long time;
• sudden attacks of hunger, reminiscent of a "hunger ulcer";
• severe heartburn;
• sour belching;
• stomach colic, flatulence;
• lack of appetite, even smells cause nausea up to vomiting of bile;
• discomfort, pain in the epigastrium
• a feeling of fullness or, conversely, emptiness in the stomach
• ineffectiveness of traditional gastroenterological therapy.

The symptom complex usually includes neurological signs - anxiety, restlessness, irritability, panic attacks, obsessive fears, insomnia, sudden awakenings in the middle of the night from nightmares, difficulty falling asleep, headache, dizziness, unstable blood pressure. Symptoms of cardiac neurosis may join - tachycardia, arrhythmia, heaviness or pain in the chest area, as well as frequent urge to urinate. Recently, mixed symptoms have become much more common. Organic neuroses are characterized by increased manifestations in the evening. They are usually reversible, lasting an average of six months, the symptoms pass as the psychoemotional conflict is resolved. Although there are protracted courses that last for years and lead to irreversible morphofunctional disorders.

Gastric neurosis often develops with an ulcer, and it can also be provoked by another organic disease of the stomach and organs located close to it. Particularly dangerous are neoplasms that are asymptomatic at first and manifest themselves with neurotic symptoms. However, organic disorders are differentiated from neuroses, in which they are not detected. Thanks to modern diagnostic methods, the incidence of gastroneuroses has significantly decreased, since many of their cases turned out to be a consequence of organic pathologies, primarily, an ulcer of the antral part of the stomach and / or duodenum manifests itself in this way. And disturbances in the regulation of gastric function in peptic ulcer disease, although accompanied by neurotic symptoms, are not a neurosis.

It is possible to distinguish such types of gastroneurosis as secretory, motor and sensory. However, they do not occur in pure form, usually all functions are disrupted at once, and therefore modern medicine does not consider it appropriate to focus on this.

There are many clinical types of gastrointestinal disorders without organic lesions. The so-called gastroneuroses are the most common among them. They are also called: functional, non-ulcer or neurogenic gastric dyspepsia, pseudo-ulcer syndrome, irritable stomach syndrome, etc. The interpretation is quite broad, however, experts warn that identifying functional pathologies of the stomach only with neurotic ones is incorrect. In fact, the term "functional" is much broader than "neurotic", not every disorder of gastric functions is a manifestation of neurosis.

The classification of neuroses is also not approved in general, however, neurology distinguishes the following types: hysterical, obsessive states (obsessive-phobic) and neurasthenia. They are usually accompanied by gastroenterological symptoms, which differ somewhat depending on the type of neurosis, and this may be of interest.

Thus, patients with hysterical neurosis have more pronounced symptoms, accompanied by a vivid demonstration of trouble in the gastrointestinal tract, a desire to “have a diagnosis”, often express a desire to undergo surgery and sometimes even achieve this, although they have no need for surgical treatment.

The obsessive-phobic type of neurosis is characterized by emphasized adherence to a dietary regimen and eating habits, physical processing of dyspeptic complaints, and persistent searches for a cancerous tumor in oneself.

Neurasthenics, on the contrary, try to make sure that they do not have serious organic pathologies, and they do this by undergoing an endless number of examinations both on an outpatient basis and in a hospital.

In gastroenterology, such a symptom as neurotic vomiting is also distinguished by types: hysterical and habitual. The first is a symptom of stressful situations, is a way of emotional expression and has a demonstrative nature, the second often occurs in a state of rest and is interpreted as an expression of suppressed emotions. Neurotic vomiting is also distinguished, induced, for example, by observing a loved one who had stomach cancer, and is an involuntary imitation. Symptoms of psychogenic vomiting are distinguished by their "ease" of execution - the absence of preliminary painful attacks of nausea, are not accompanied by pallor, sweating, salivation. As a rule, they do not lead to noticeable weight loss. Although there are exceptions. In severe hysteria, dehydration, demineralization, and other metabolic disorders may occur as a result of repeated vomiting.

In gastralgia, the most common form of gastroneurosis, there is a direct interdependence between emotional stress and the appearance of signs of functional gastric disorder - pain, burning, heaviness, nausea, as well as the absence of any connection between clinical manifestations and the nature of nutrition. The stomach in this case is the "organ of self-expression".

The main manifestation of gastroneurosis can be aerophagia - a demonstratively loud, scream-like belching as a result of swallowing more air than usual during eating. It is more often manifested in hysterical neurosis, often accompanied in addition by cardiological symptoms.

Aversion to food, lack of appetite or outright gluttony can also be an expression of a neurotic disorder. Both types can be accompanied by vomiting (in bulimia - after eating, in anorexia - at the sight of food, often demonstrative (hysterical)).

Another typical prevailing symptom of gastroneurosis is excruciating heartburn, which is not helped by either diet or gastroenterological drugs.

Neuroses of any kind develop through several stages of development. At the beginning, the connection between the nervous disorder and its cause is usually clearly visible, over time this connection weakens and disappears completely without treatment. Neurotic reactions continue, based on the mental image of the primary impact. Sometimes resolution occurs on its own as emotions and the significance of the primary cause fade. In other cases, emotional loops are formed, the person becomes fixated on the mental image. A prolonged course leads to personal neuroticism - pathologically altered qualities are built into the psychological structure of the individual.

The first stage is a neurogenic reaction, short-lived, which either quickly passes by itself or is replaced by the second stage - asthenia, in the vast majority of cases (approximately 90%) accompanied by depression. This stage is still self-reversible, however, if the situation is not resolved, then neurosis develops as a disease (the third stage). At this stage, recovery is still possible, in rare cases even without treatment, but more often asthenia develops and neuroticism of the personality occurs.

The consequences and complications of this disease, which in general does not pose a mortal threat, may still be not very pleasant. The long course and progression of the disease can lead to chronic neurosis, morphological changes in the organs appear, caused by endless diagnostic procedures and taking gastroenterological drugs that turned out to be ineffective. Patients, before coming to the attention of neurologists and psychotherapists, were examined many times and had piles of documentation on hand about this. Some patients were even operated on. Surgical interventions carried out on patients based on their persistent complaints are usually not just useless, but also harmful.

With a long-term course of the disease, a person stops adequately perceiving reality, he is constantly in a bad mood, concomitant diseases worsen, immunity decreases. Chronic neurosis has a detrimental effect on relations with the outside world, long-term neurotization can lead to mental disorders.

Diagnostics gastric neurosis

Gastroenterological symptoms of neurosis are non-specific. They are inherent in many diseases of the gastrointestinal tract, so the diagnosis is made by excluding organic pathologies. For this, the patient takes tests and undergoes a comprehensive gastroenterological examination. Instrumental diagnostics necessarily include fibrogastroduodenoscopy, other research methods may be prescribed - ultrasound, radiography. Differential diagnostics are carried out with peptic ulcer disease, gastritis, neoplasms, diseases of organs located in close proximity to the stomach.

When organic pathologies are not detected, the question of neurosis is raised. The patient is transferred to the hands of a neurologist and psychotherapist, who, having studied the patient's anamnesis and lifestyle, will begin to correct his psycho-emotional state.

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Prevention

Prevention of neurotic disorders is a complex task, however, quite feasible. Its main goal is to normalize the rhythm and lifestyle, provide yourself with conditions that allow you to relax and relieve emotional stress, and cope with negative emotions if they arise.

It is very important to maintain an acceptable work and rest regime: it is essential to take annual leave, not work on weekends, get enough sleep, and try to spend more time with loved ones and close ones.

A huge role is played by proper nutrition, giving up bad habits and an active lifestyle - walks in the fresh air, feasible physical activity, hardening activities increase our resistance to stress.

You need to try to avoid conflict situations, but not delay resolving them if they do arise.

Use everything – autogenic training, yoga, other practices that cultivate a positive attitude in us. If you feel that you can’t cope, you can always seek help from a psychotherapist.

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Forecast

Gastroneurosis is a reversible psychogenic disorder. It is not a fatal disease, although it can significantly spoil the patient's quality of life. The sooner it is detected, diagnosed, and the patient is provided with professional help and treatment, the easier it will be to overcome the disease. Prolonged chronic neurosis can negatively affect the functioning of many body systems.

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