Omission of the stomach: causes, symptoms, treatment, prevention

Under certain unfavorable conditions, the stomach can change the usual anatomical position, and then there is a partial or complete displacement downward - gastric emptying.

In a normal state, the human stomach is located in the left hypochondrium area of the peritoneum and partially in the epigastric region. It is covered with the peritoneum on all sides and is held by a system of ligaments consisting of a mesentery of the transverse colon and folds of the peritoneum (large epiploon). Between the folds of the peritoneum there is fatty tissue, which helps to fix the normal position of the stomach.

[1], [2], [3], [4], [5], [6], [7], [8], [9]

Causes of gastric emptying

Omission of the stomach (or gastroptosis) is considered a consequence of the weakening of the abdominal muscles, especially the deepest transverse muscle (transversus abdoninus), and excessive stretching of the stomach supporting ligaments. Why is this all happening?

Omission of the stomach, as well as the omission of other internal organs (splanchnoptosis) is congenital (constitutional) or acquired. Congenital depressions of the stomach are characteristic of the human asthenic somatotype, whose owners are characterized by thinness, long limbs and a weak muscular system. In the case of the stomach, there is an excessive stretching of the weak gastro-ovary ligament, which leads to the omission of the organ, a disturbance in its functioning and pain sensations.

The main causes of acquired gastric emptying: significant weight loss (weight loss), constant overstrain of the abdominal muscles (in heavy physical work or weightlifting), removal of a large tumor from the abdomen, and multiple pregnancy and childbirth (therefore, this disease is often diagnosed precisely women).

As doctors-gastroenterologists note, the consequences of gastric emptying are expressed in a partial violation of its functions - weakening of the motor and the difficulty of moving food into the intestines when the part of the stomach is bent. In addition, there may be incomplete closure of gastric sphincters, resulting in esophagus entering the stomach (which causes eructation). And if the pyloric sphincter is broken from the duodenum, bile may enter the stomach, which leads to heartburn and, in the long term, gastritis and peptic ulcer disease.

Often the consequence of gastric emptying - due to its downward pressure - is the omission of the large intestine and pelvic organs. With the lowering of the stomach and intestines (thick), there are complaints of constipation, flatulence and pain in the lower abdomen. The lowered intestine, in turn, presses on the bladder, the prostate (in men), the uterus and the ovaries (in women). So the chain of pathological processes caused by gastroptosis can lead to many diseases.

[10], [11], [12], [13], [14], [15]

Symptoms of gastric emptying

Depending on the level at which the stomach has moved downward relative to the normal anatomical position, three degrees of gastric emptying are accepted in clinical gastroenterology.

At the 1 st and 2 nd degree, the disease in most cases occurs without pronounced symptoms. Then how to determine gastric emptying? Suspicion should cause such signs as a feeling of discomfort, "raspiraniya" and severity in the stomach, pulling or aching pain in the upper abdominal cavity (especially after sudden movements or physical exertion). Pain of this nature and localization, as a rule, is short-lived.

If gastric emptying has reached the third degree, patients after eating feel pain in the epigastric region, often giving up to the heart. Moreover, in the horizontal position of the body (lying), the pain quickly subsides. In addition, with constitutional gastroptosis, the appetite decreases, there is an eructation, nausea, vomiting, and constipation and pain in the lumbar region.

Diagnosis of gastric emptying

The clinical picture of gastroptosis is similar to that of many gastrointestinal pathologies. Therefore, the diagnosis of gastric emptying requires a comprehensive examination.

After collecting an anamnesis, the doctor performs a polypositional physical examination of the abdomen, in which the initial position of the stomach in the abdominal cavity is determined by palpation in the supine position, and palpation in the standing position allows you to determine the incidence in the epigastric region and bulging in the abdominal region of the abdomen.

To establish the correct diagnosis of gastroptosis also used:

• X-ray examination of the esophagus and stomach with contrast agent,
• endoscopic examination of the gastrointestinal tract - esophagogastroduodenoscopy (EGDS),
• fibroesophagogastroduodenoscopy (PHEGS) of the esophagus, stomach and duodenum.

[16], [17], [18], [19], [20], [21]

Treatment of gastric emptying

The conventional treatment of gastric emptying in clinical practice is conservative. And the key place in the therapy of this disease is given to physical therapy and proper nutrition.

With significant pain, analgesics are prescribed, with constipation - laxatives. But surgical treatment of gastric emptying is extremely rare, because of the high probability of relapse of the disease. Operative correction of gastroptosis of 2 nd and 3 rd degree can be performed with complicating pathologies, for example, with the reverse movement of stomach contents through the lower esophageal sphincter into the esophagus (gastroesophageal reflux). During fundoplication - an operation to eliminate this pathology - the stomach is stitched to the diaphragm around the esophagus, fixing it to the abdominal wall, at the expense of the stomach is pulled up.

Exercises for lowering the stomach

The complex of specially selected exercises is aimed at increasing the muscle tone of the abdominal wall. In this complex of exercises with the lowering of the stomach there are no jumps or sharp tilts of the trunk - that is, movements that can cause displacement of organs.

Charging when the stomach is lowered by force is absolutely for all patients - regardless of age, since all exercises in the first months are performed only lying down.

So, the recumbent gymnastics with the lowering of the stomach. Starting position: lying on the back, legs straight, arms stretched along the trunk.

• Exercise # 1: after the deepest inspiration, you need to make the maximum possible exhalation, which requires "squeezing" the air with the tension of the abdominal press (repeat 10 times).
• Exercise number 2: alternately raising the straight legs (repeat 10 times).
• Exercise number 3: on inhalation one leg bends in the knee, at the exit the bent leg is pressed against the chest with both hands. Then the same is done by the other leg (repeating with each foot 5 times).
• Exercise 4: the same movement as in the previous exercise is performed by two bent legs simultaneously.
• Exercise number 5: both legs bend at the knees, the pelvis rises with the support of the body on the feet, elbows and the back of the head (repeat 5 times).
• Exercise number 6: both legs bend at the knees, rise and make movements that mimic cycling (repeat 10 times).
• Exercise number 7: the legs are straightened, the arms are stretched along the trunk - the raising of the upright hands (on inspiration) with the plant behind their head - "sipping"; on exhalation - return to the starting position (repeat 10 times).

After each exercise, you need to pause - for a rest. And after all the charging while lowering the stomach, you need to lie down for about a quarter of an hour, placing a pillow or roller of a rolled blanket under your feet.

It is recommended to do massage while lowering the stomach. To do this, the palm should be placed on the epigastric region to the left and produce light circular stroking of the abdomen - 10 circles clockwise, and then in the opposite direction. Circles with stroking, as in a spiral, you need to move closer to the navel, and then expand again.

With a significant gastroptosis, doctors recommend wearing a special bandage while lowering the stomach, which should be put on lying (in the morning, on an empty stomach) and removed only before bedtime.

[22], [23], [24], [25], [26], [27], [28]

Diet when stomach is down

Recommendation gastroenterologists with gastroptosis - during the day to eat 5-6 times in small portions: the food should not stay in the stomach for a long time and stretch it. It is advisable to eat at the same time to accustom your stomach to a "work schedule". Food should be easily assimilated, but at the same time it is high in calories.

In addition, everything eaten should contribute to the normal functioning of the entire gastrointestinal system, so in a diet with gastric emptying you need to include porridges (except manna and rice), vegetables (raw and stewed), lean meat (beef, veal), poultry and low-fat sea food fish, dairy products, fruit.

To deal with constipation, season salads and vinaigrettes with vegetable oil, drink kefir, eat 2-3 prunes a day. Give up white bread and yeast baked bread, replacing them with bread from wholemeal bread, diet breads or biscuits.

With palpable gastroptosis, doctors advise to lie down after each meal - at least an hour.

[29], [30], [31], [32], [33]

Treatment of gastric emptying by alternative means

With a decrease in appetite, which often accompanies gastric emptying, it is recommended to take infusion of one of the following medicinal plants: wormwood, bitter wormwood, centipedes, yarrow, dandelion root or chicory.

To prepare the infusion, a tablespoon of dry food is poured into a glass of boiling water, it is insisted for half an hour, filtered and taken one tablespoon 30-40 minutes before meals.

Normalize the production of gastric juice will help decoction from the leaves of plantain (3 tablespoons per 500 ml of boiling water). This broth is recommended to drink half an hour before a meal - half a cup.

With gastroptosis, herbalists are also advised to drink a decoction of rhizomes of the cinquefoil erect (Kalgan). A glass of boiled water is taken one tablespoon of crushed rhizomes, cooked for 20 minutes, filtered and taken four times a day on a tablespoon.

Treatment of gastric emptying by alternative means also provides clay applications. To do this, you need to prepare a steep mass of ordinary clay and water, roll the ball, roll the ball in the form of a flat cake (about the size of an ordinary plate and about 2 cm thick) and put on the stomach. On the stomach clay should be kept for at least three hours.

Prevention of gastric emptying

To effective methods of preventing gastric emptying, experts unanimously refer to mandatory physical education in childhood and adolescence, which contribute to strengthening the muscular system of the body.

Adults should, first, take into account the peculiarities of their constitutional type. Secondly, it is more to move - to walk, to swim, but not to overload the abdominal press by lifting weights or long jogging.

It is especially important for prevention of gastric emptying in women to try to strengthen the muscles of the anterior abdominal wall before pregnancy, and during pregnancy and after childbirth use special antenatal and postnatal bandages. They will help to avoid many problems, including gastroptosis and ovulation of the uterus.

Prognosis of gastric emptying

The omission of the stomach has a favorable prognosis, but it should be remembered that this pathology can manifest itself again and lead to diseases of other organs and systems of the body.