Dyskinesia of the stomach refers to the category of fairly common pathologies, detected in every third patient who has complaints about the work of the organs of the gastrointestinal tract.
This disease, which occurs in one of two types - hyperkinetic and hypokinetic - is affected mainly by children and young patients, as well as individuals with organic or functional lesions of the central nervous system.
Lubrication of clinical manifestations often causes frequent diagnostic errors, when dyskinesia of the stomach is taken by more serious diseases of the gastrointestinal tract, as well as the genitourinary and nervous system.
That is why the basis for setting such a diagnosis is a comprehensive diagnostic examination that allows to exclude any possible organic damage to the above organs and systems.
About the disease
Dyskinesia of the stomach is a disease that leads to functional disorders of its motor skills, often accompanied by a pronounced pain syndrome and a complex of dyspeptic disorders against the background of complete absence of any organic changes.
Depending on the type of violation of gastrointestinal dyskinesia, there is:
- hypertensive( characterized by increased contractile activity);
- hypotonic( accompanied by a decreased motor function);
- atonic.
According to another classification, considering pathology in terms of the prevailing clinical symptoms, dyskinesia of the stomach is usually attributed to one of three types:
- pain;
- dyspeptic;
- mixed.
Depending on the etiology of origin, stomach dyskinesias are divided into:
- exogenous, due to external factors;
- is endogenous, developing due to diseases of other internal organs and systems.
Causes of
Dyskinesia of the stomach can be both a major and secondary disease that occurs after a number of severe pathologies( eg, pneumonia and myocardial infarction).
Disturbance of gastric motility can occur as a result of:
- of improper nutrition( the decisive role is played by the irregularity of meals);
- habits are in the dry;
- too hasty ingestion of insufficiently chewed food( mechanical and enzymatic treatment of a food coma in the oral cavity with this variant of nutrition is insufficient);
- eating foods that are abundant in carbohydrates and containing insufficient amounts of proteins, minerals and vitamins;
- abuse of too sharp and greasy dishes;
- is an allergic reaction of the body to a variety of foods( most often it reacts to proteins contained in cow's milk, fish and chicken eggs).
Pathology can develop under the influence of all sorts of exogenous factors presented:
- by toxic effects of chemicals, nicotine, alcoholic beverages, irritating stomach receptors;
- excessively high temperature environment;
- by vibration and ionizing radiation;
- received burns.
Dyskinesia of endogenous etiology may result from:
- of viral hepatitis;
- cholecystitis( inflammation of the gallbladder);
- enteritis( inflammatory disease of the small intestine, accompanied by a violation of his work and dystrophic lesions of the mucous membranes);
- pancreatitis( inflammation of the pancreas);
- heart and blood vessel disease;
- rheumatism( systemic involvement of connective tissue: mostly vessels and cardiac muscle);
- hypertension( cardiovascular pathology provoking increased blood pressure, organic and functional changes in the kidneys, heart muscle and central nervous system).
Violation of gastric motility is often observed in any pathological processes leading to intoxication of the body. It is necessarily present when:
- purulent-inflammatory diseases of the lungs( with tuberculosis);
- pathology of the endocrine system( thyroid, pituitary and gonadal glands);
- kidney disease.
Disturbances of gastric motility can occur under the influence of diseases of the nervous system: neuropsychic stresses and severe organic lesions: encephalitis, strokes, intracerebral tumors.
Symptoms of stomach dyskinesia in adults and children
- The main clinical sign of gastric dyskinesia is the presence of abdominal pains that do not have a clearly expressed localization. The painful attacks that occur in the navel, then in the hypochondrium, in the epigastric region, can be both short-term( not more than a few minutes) and extremely long( exhausting the patient for several days and even weeks).
- Dyskinesia of the stomach, flowing through the hypertonic type , is accompanied by pain, similar to ulcerative.
- Patients with anti-hyperstatic contractions of the stomach muscles, leading to the ingestion of acidic stomach contents into the lumen of the esophagus, develop an eructation of sour and heartburn.
- Spasms of the pylorus of the stomach provokes the periodic occurrence of vomiting. A characteristic feature of this type of dyskinesia is pneumatosis - a condition accompanied by a high concentration of gases in the stomach, leading to the bursting of the stomach and the appearance of a constant loud belch.
- If the dyskinesia of the stomach develops according to the hypotonic type , characterized by a significant decrease in the motor activity of the stomach, as a result of stagnation of the food masses, a belch appears in the patient with a smell of rotten eggs and a feeling of squeezing in the epigastric region, as well as a marked protrusion in the hypochondrium.
- The disease, which developed against the background of the defeat of the central nervous system and the excitation of the emetic center, provokes the occurrence of sudden profuse vomiting( emetic masses have a greenish color), which does not bring relief to the sick person.
The intensity of the above clinical symptoms can be different. The absence of pronounced specificity is striking: such manifestations are typical for a huge number of diseases.
Among the characteristic signs of dyskinesia of the stomach can be attributed:
- the presence of the connection of its clinical manifestations with the impact of stress and mental trauma;
- expressed symptomatic of neurosis;
- the volatile nature of the complaints presented and the decrease in their number during the night;
- complete absence of organic lesions, confirmed by the results of histological and endoscopic studies.
For the clinical picture of dyskinesia of the stomach, which has different variants, the presence of:
- Pylorospasm( a condition characterized by spasmodic pyloric valve delimiting the stomach from the duodenum), provoking the emergence of an "acidic" eructation that hampers the evacuation of gastric contents and is the culprit of pain in the epigastric region.
- Cardiospasm( spastic contraction of the cardiac sphincter separating the stomach from the esophagus), which is the cause of difficulty swallowing and severe pain behind the sternum.
- Tetanii - convulsive contractions of the stomach, accompanied by the appearance of gastrocardial syndrome( a set of reflex changes in the work of the cardiovascular system that occur when irritating the esophageal and gastric receptors) and intense pain.
- Aerophagia is a complex of functional disorders that arise as a result of rapid ingestion of food along with a significant amount of air.
- Acute gastric dilatation - a condition caused by chronic overeating or a significant decrease in stomach tone in patients during the postoperative period.
Diagnostics
The main purpose of the diagnosis for dyskinesia of the stomach is to reveal the absence of organic lesions of the main digestive organ( despite a whole complex of characteristic clinical manifestations).
- The first step in the diagnosis is the consultation of a gastroenterologist. During the physical examination of the patient( by palpation of the abdomen) the doctor is convinced of the presence of painful manifestations. If the stomach is in an atonic state, the gastroenterologist can determine by using percussion how much the border of the affected organ is widened. During the consultation, the doctor can establish the alleged cause of the pathology( it may be due to the presence of concomitant diseases, neuropsychiatric changes, non-observance of diet, imbalance of rest and labor).
- In order to study electrical activity and rhythmicity of the gastric motility, resort to the procedure of electrogastrography. In the course of this electrophysiological study, with the help of special electrodes, biopotentials of gastric motility are recorded, and after deciphering the obtained data, the motor activity of the organ under investigation is assessed.
- The compulsory diagnostic procedures include performing esophagogastroduodenoscopy , a technique for endoscopic examination of organs located in the upper part of the digestive tract( on a segment containing the esophageal tube, stomach and duodenum).The study is performed on an empty stomach with a special probe( fibroendoscope), equipped with a miniature video camera, which displays the image on the screen. To suppress the gag reflex, the study is performed either under local anesthesia of the pharynx, or under general anesthesia. A characteristic endoscopic sign of dyskinesia of the stomach is the presence of thickened folds of the mucous membranes of this organ without any macroscopic changes. During the procedure, a specialist with special forceps necessarily performs a biopsy - takes tissue samples to perform a number of laboratory tests( histological and cytological).If the histology shows the absence of any changes in the obtained samples, the specialist will receive an undeniable confirmation of the presence of dyskinesia of the stomach.
- Enough informative is the procedure for fluoroscopic examination of the stomach. With its help you can determine the type of dyskinesia, the presence of gastroesophageal reflux, cardiospasm or pylorospasm.
Treatment and prognosis of dyskinesia of the stomach
Treatment of patients with stomach dyskinesia is usually performed on an outpatient basis. Hospitalization, necessary for conducting diagnostic studies, is subject only to patients with severe pain syndrome.
- Diet therapy is of great importance in the treatment of pathology. The patient's diet is carefully adjusted and subject to strict treatment. The volume of portions is also controlled.
- Medication therapy.
- To normalize the nervous regulation of gastric motility, the patient is prescribed a complex of psychotropic, neurotropic and sedative drugs.
- Dyskinesia, proceeding according to the hypertonic type, is treated with M-anticholinergics.
- Patients with hypotonic dyskinesia are treated with euphyllin and caffeine.
- The drug from atony of the stomach is the drug "Proserin".
- To restore the disturbed secretory function of the stomach, the patient is prescribed acidin-pepsin, natural gastric juice and preparations containing pancreatic enzymes.
- Good results are obtained using physiotherapy:
- mud applications;
- electrophoresis
- ozokeritotherapy;
- diathermy - the procedure of electrotherapy, consisting in heating by high-frequency currents of deep-seated tissues and organs;
- paraffin applications.
If mistakes were made in the selection of treatment tactics, or the sick person did not seek medical help for a long time, there is a sharp deterioration in the prognosis due to an increased risk of destructive changes in the gastric mucosa.
If adequate treatment was carried out in a timely manner( taking into account the necessary preventive measures), no recurrence of pathology occurs.
As a supportive therapy, doctors recommend periodically taking recreational treatment courses in sanatoria and health resorts, adhering to the norms of proper nutrition for life and observing the correct mode of work and rest.