Stomach disease
Encyclopedia
The stomach is an important organ
in the body. It plays a vital role in digestion
of foods, releases various enzyme
s and also protects the lower intestine from harmful organisms. The stomach connects to the 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.
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.
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.
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.
. 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
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.
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.
is an inflammatory bowel disease
that can affect any part of the digestive tract, even the stomach although it's a rare presentation. It's main feature are inflammatory ulcers that can affect the total thickness of the stomach wall and can bleed but rarely perforate.
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.
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 steroid
al 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.
. 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.
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.
Organ (anatomy)
In biology, an organ is a collection of tissues joined in structural unit to serve a common function. Usually there is a main tissue and sporadic tissues . The main tissue is the one that is unique for the specific organ. For example, main tissue in the heart is the myocardium, while sporadic are...
in the body. It plays a vital role in digestion
Digestion
Digestion is the mechanical and chemical breakdown of food into smaller components that are more easily absorbed into a blood stream, for instance. Digestion is a form of catabolism: a breakdown of large food molecules to smaller ones....
of foods, releases various enzyme
Enzyme
Enzymes are proteins that catalyze chemical reactions. In enzymatic reactions, the molecules at the beginning of the process, called substrates, are converted into different molecules, called products. Almost all chemical reactions in a biological cell need enzymes in order to occur at rates...
s and also protects the lower intestine from harmful organisms. The stomach connects to the esophagus
Esophagus
The esophagus is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. During swallowing, food passes from the mouth through the pharynx into the esophagus and travels via peristalsis to the stomach...
above and to the small intestine
Small intestine
The small intestine is the part of the gastrointestinal tract following the stomach and followed by the large intestine, and is where much of the digestion and absorption of food takes place. In invertebrates such as worms, the terms "gastrointestinal tract" and "large intestine" are often used to...
below. It is intricately related to the pancreas
Pancreas
The pancreas is a gland organ in the digestive and endocrine system of vertebrates. It is both an endocrine gland producing several important hormones, including insulin, glucagon, and somatostatin, as well as a digestive organ, secreting pancreatic juice containing digestive enzymes that assist...
, spleen
Spleen
The spleen is an organ found in virtually all vertebrate animals with important roles in regard to red blood cells and the immune system. In humans, it is located in the left upper quadrant of the abdomen. It removes old red blood cells and holds a reserve of blood in case of hemorrhagic shock...
and liver
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...
. The stomach does vary in size but its J shape is constant. The stomach lies in the upper part of the abdomen
Abdomen
In vertebrates such as mammals the abdomen constitutes the part of the body between the thorax and pelvis. The region enclosed by the abdomen is termed the abdominal cavity...
just below the left rib cage
Rib cage
The rib cage is an arrangement of bones in the thorax of animals. It is formed by the vertebral column, ribs and sternum and encloses the heart and lungs....
.
Gastropathy is a general term used for stomach
Stomach
The stomach is a muscular, hollow, dilated part of the alimentary canal which functions as an important organ of the digestive tract in some animals, including vertebrates, echinoderms, insects , and molluscs. It is involved in the second phase of digestion, following mastication .The stomach is...
disease.
Examples including the name include:
- Portal hypertensive gastropathyPortal hypertensive gastropathyPortal hypertensive gastropathy refers to changes in the mucosa of the stomach in patients with portal hypertension; by far the most common cause of this is cirrhosis of the liver. These changes in the mucosa include friability of the mucosa and the presence of ectatic blood vessels at the surface...
- Ménétrier's diseaseMénétrier's diseaseMénétrier disease , a disorder in which the gastric mucosal folds are enlarged , making the surface of the stomach look a bit like the brain gyri...
, also known as "hyperplastic hypersecretory gastropathy"
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
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
. However, a large number of studies have indicated that most cases of stomach ulcers, gastritis
Gastritis
Gastritis is an inflammation of the lining of the stomach, and has many possible causes. The main acute causes are excessive alcohol consumption or prolonged use of nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen. Sometimes gastritis develops after major surgery, traumatic...
, and stomach cancer
Stomach cancer
Gastric cancer, commonly referred to as stomach cancer, can develop in any part of the stomach and may spread throughout the stomach and to other organs; particularly the esophagus, lungs, lymph nodes, and the liver...
are caused by Helicobacter pylori
Helicobacter pylori
Helicobacter pylori , previously named Campylobacter pyloridis, is a Gram-negative, microaerophilic bacterium found in the stomach. It was identified in 1982 by Barry Marshall and Robin Warren, who found that it was present in patients with chronic gastritis and gastric ulcers, conditions that were...
infection. One of the ways it is able to survive in the stomach involves its urease
Urease
Urease is an enzyme that catalyzes the hydrolysis of urea into carbon dioxide and ammonia. The reaction occurs as follows:In 1926, James Sumner showed that urease is a protein. Urease is found in bacteria, yeast, and several higher plants. The structure of urease was first solved by P.A...
enzymes which metabolize urea
Urea
Urea or carbamide is an organic compound with the chemical formula CO2. The molecule has two —NH2 groups joined by a carbonyl functional group....
(which is normally secreted into the stomach) to ammonia
Ammonia
Ammonia is a compound of nitrogen and hydrogen with the formula . It is a colourless gas with a characteristic pungent odour. Ammonia contributes significantly to the nutritional needs of terrestrial organisms by serving as a precursor to food and fertilizers. Ammonia, either directly or...
and carbon dioxide
Carbon dioxide
Carbon dioxide is a naturally occurring chemical compound composed of two oxygen atoms covalently bonded to a single carbon atom...
which neutralises gastric acid and thus prevents its digestion. In recent years, it has been discovered that other Helicobacter
Helicobacter
Helicobacter is a genus of Gram-negative bacteria possessing a characteristic helix shape. They were initially considered to be members of the Campylobacter genus, but since 1989 they have been grouped in their own genus...
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
Achlorhydria
Achlorhydria or hypochlorhydria refers to states where the production of gastric acid in the stomach is absent or low, respectively. It is associated with various other medical problems.-Signs and symptoms:...
respectively and are conditions which can have negative health impacts. Having high levels of gastric acid is called hyperchlorhydria
Hyperchlorhydria
Hyperchlorhydria refers to the state in the stomach where gastric acid levels are higher than the normal range. In humans, the normal pH is around 1 to 3, which varies throughout the day. The highest basal secretion levels are in the late evening . Hyperchlorhydria is usually defined as having a...
. 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.
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 painAbdominal pain
Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. Making a definitive diagnosis of the cause of abdominal pain can be difficult, because many diseases can result in this symptom. Abdominal pain is a common problem...
and indigestion
Dyspepsia
Dyspepsia , also known as upset stomach or indigestion, refers to a condition of impaired digestion. It is a medical condition characterized by chronic or recurrent pain in the upper abdomen, upper abdominal fullness and feeling full earlier than expected when eating...
. 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.
Gastritis
In the stomach there is a delicate balance between acidGastric acid
Gastric acid is a digestive fluid, formed in the stomach. It has a pH of 1 to 2 and is composed of hydrochloric acid , and large quantities of potassium chloride and sodium chloride...
and the wall lining which is protected by mucus
Mucus
In vertebrates, mucus is a slippery secretion produced by, and covering, mucous membranes. Mucous fluid is typically produced from mucous cells found in mucous glands. Mucous cells secrete products that are rich in glycoproteins and water. Mucous fluid may also originate from mixed glands, which...
. 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
Nausea
Nausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...
, vomiting and heartburn
Heartburn
Heartburn, also known as pyrosis or acid indigestion is a burning sensation in the chest, just behind the breastbone or in the epigastrium...
. 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
Hematemesis
Hematemesis or haematemesis is the vomiting of blood. The source is generally the upper gastrointestinal tract. Patients can easily confuse it with hemoptysis , although the latter is more common.-Signs:...
). 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
Peptic ulcer
A peptic ulcer, also known as PUD or peptic ulcer disease, is the most common ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. It is defined as mucosal erosions equal to or greater than 0.5 cm...
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.
Gastroparesis
Another very common long term problem which is now more appreciated is gastroparesisGastroparesis
Gastroparesis, also called delayed gastric emptying, is a medical condition consisting of a paresis of the stomach, resulting in food remaining in the stomach for a longer period of time than normal. Normally, the stomach contracts to move food down into the small intestine for digestion. The...
. Gastroparesis affects millions of individuals and is often never suspected and most patients have a delay in diagnosis. Basically in gastroparesis, the stomach motility
Motility
Motility is a biological term which refers to the ability to move spontaneously and actively, consuming energy in the process. Most animals are motile but the term applies to single-celled and simple multicellular organisms, as well as to some mechanisms of fluid flow in multicellular organs, in...
disappears and food remains stagnant in the stomach. The most common cause of gastroparesis is diabetes
Diabetes mellitus
Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...
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.
During digestion
Digestion
Digestion is the mechanical and chemical breakdown of food into smaller components that are more easily absorbed into a blood stream, for instance. Digestion is a form of catabolism: a breakdown of large food molecules to smaller ones....
, 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
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...
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.
Crohn's Disease
Crohn's DiseaseCrohn's disease
Crohn's disease, also known as regional enteritis, is a type of inflammatory bowel disease that may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms...
is an inflammatory bowel disease
Inflammatory bowel disease
In medicine, inflammatory bowel disease is a group of inflammatory conditions of the colon and small intestine. The major types of IBD are Crohn's disease and ulcerative colitis.-Classification:...
that can affect any part of the digestive tract, even the stomach although it's a rare presentation. It's main feature are inflammatory ulcers that can affect the total thickness of the stomach wall and can bleed but rarely perforate.
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 due to fluctuations in acidity level 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 infection with H.pylori, pernicious anemia, Menetriere's disease, and nitrogenous preservatives in food. .Causes and Treatment
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 steroid
Steroid
A steroid is a type of organic compound that contains a characteristic arrangement of four cycloalkane rings that are joined to each other. Examples of steroids include the dietary fat cholesterol, the sex hormones estradiol and testosterone, and the anti-inflammatory drug dexamethasone.The core...
al 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.
Endoscopy
There are many tools for investigating stomach problems. The most common is endoscopyEndoscopy
Endoscopy means looking inside and typically refers to looking inside the body for medical reasons using an endoscope , an instrument used to examine the interior of a hollow organ or cavity of the body. Unlike most other medical imaging devices, endoscopes are inserted directly into the organ...
. 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
Duodenum
The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms anterior intestine or proximal intestine may be used instead of duodenum...
. The procedure also allows the physician to obtain biopsy
Biopsy
A biopsy is a medical test involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically...
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 bariumBarium
Barium is a chemical element with the symbol Ba and atomic number 56. It is the fifth element in Group 2, a soft silvery metallic alkaline earth metal. Barium is never found in nature in its pure form due to its reactivity with air. Its oxide is historically known as baryta but it reacts with...
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.
External links
- http://digestive.niddk.nih.gov/ddiseases/topics/stomach.asp