Gastroptosis
Introduction
Introduction to gastric sagging Gastroptosis refers to the lower edge of the stomach reaching the pelvic cavity when standing. The lowest point of the small curved curve of the stomach falls below the sputum line, which is called gastric ptosis. The occurrence of this disease is mostly due to insufficient suspension force of the diaphragm, liver and stomach, stomach and stomach. The ligament function is reduced and relaxed, the intra-abdominal pressure is lowered, and the abdominal muscles are relaxed. In addition to the body shape or physical constitution, the stomach is extremely low-profile fish structure, which is the tension-free stomach seen by the stomach drooping. This disease is part of the visceral sagging, more common in the long and weak body type, long-term sick and weak, menstruation, multiple abdominal surgery with incisional hernia and long-term bed rest. Mild gastroptosis is asymptomatic, moderate to severe gastrointestinal motility, dyspepsia. Because of the various symptoms of sagging stomach, the patient suffers from excessive stress for a long time, resulting in insomnia, headache, dizziness, dullness, depression and other neuropsychiatric symptoms, as well as hypotension, palpitations and standing fainting. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: anemia, headache, insomnia
Cause
Cause of gastroptosis
According to the opinions of ancient and modern doctors, the causes of gastroptosis are divided into two categories: congenital and acquired. Congenital factors are weak endowments, physical deficiencies, and the day after tomorrow can be summarized as eating disorders, chronic illness or overproduction, and seven emotions. Its disease position is in the spleen and stomach, and the main pathogenesis can be summarized as the word virtual and sputum, and the main path is virtual.
Qi (yang) virtual (20%):
Or because of the loss of the spleen, the spleen is spleen, the spleen is stagnation, the health is lost, the muscles are not strong, the stomach stagnation loses the sag, or the factors are yin deficiency, the tea is more than the drink, the spleen In the middle of the coke, the water is stagnant, and the stagnation is turned into sip, the blood and blood are not born, and the fascia is dying and drooping.
Blood stasis (25%):
More due to qi deficiency for a long time, blood transport is weak, or long-term illness into the network, blood circulation is impassable, and become bloody. Blood stasis is one of the most important diseases in recent years. Some people have systematically investigated 67 patients with gastroptosis, and found that 44.8% of them have bloody tongue and 35.8% of them have blood stasis. In addition, fiberoptic gastroscope has also been found to have bloody mucosal congestion or pale mucosa, veins revealed by blood stasis. Clinically, it has also been confirmed that the method of activating the blood and removing blood stasis can significantly improve the curative effect.
Yin deficiency (25%):
Multi-factor yang deficiency, or long-term disease and more prolific breeding and yin blood, five qi qi sputum, causing stomach yin deficiency, stomach veins lost in sputum, slow and not received, causing stomach sag.
(two) pathogenesis
Due to the difference in etiology, primary disease and physical condition, the degree of muscle weakness is low, the degree of ligament relaxation is different, the degree of sag is different, and the clinical manifestations are different. For example, those with weakness are often accompanied by sagging organs. The tissue ligaments of the suspended organs and fixed organs are all low tension, while those with chronic wasting diseases or long-term movements are often caused by decreased abdominal muscle tension, insufficient suspension force of the diaphragm and relaxation of the stomach and liver ligaments, often not combined. The whole body is drooping.
Prevention
Gastroptosis prevention
1, eat less meals
Because the digestive function of patients with gastric ptosis is weakened, too much food will enter the stomach, which will inevitably stay in the stomach and cause indigestion. Therefore, the first requirement of diet conditioning is that the amount of each meal should be less, but the number can be increased, 4-6 meals a day is appropriate.
2, chewing slowly
The gastric wall tension of patients with gastric ptosis is reduced, chewing slowly to facilitate digestion and absorption, and to enhance gastric motility and promote emptying speed, and relieve abdominal discomfort.
3, the food is soft
The food you eat should be soft, light and easy to digest. The staple food should be soft rice, such as noodles to be boiled soft; non-staple food should be chopped and fried, eat less raw vegetables. However, it should be noted that the fish must not be over-cooked, because the fish is the most tender and digestible when it is half-baked, and has the least burden on the stomach.
4, nutritional balance
Most of the patients with gastroptosis are weak in physical strength and muscle strength. In addition, the digestion and absorption are not good, and it is easy to cause imbalance in the body's nutrition. Therefore, it is more fatigued and less energetic than normal people. Therefore, patients should pay attention to the balance of dietary nutrition on the basis of a small number of meals, and the ratio of sugar, fat and protein is appropriate. The proportion of fat is lower.
5, reduce the stimulus
Irritating foods such as pepper, ginger, excessive alcohol, coffee, cola and strong tea can aggravate the symptoms of acid reflux and heartburn in patients with gastroptosis, affecting the improvement of the disease. Therefore, these foods should be eaten as little as possible, with limited restrictions. . Drinking a small amount of fruit wine and light tea is beneficial to slow down the occurrence and development of gastric ptosis.
6, prevent constipation
More fruits and vegetables are mixed in the daily diet, because fruits and vegetables contain more vitamins and cellulose, especially the latter can promote gastrointestinal motility, so that the stool becomes soft and smooth, preventing constipation. For example, drink a cup of light salt water in the morning or drink honey sesame oil before going to bed to relieve and eliminate constipation.
7, suitable for both movements and statics
Stomach ptosis patients actively participate in physical exercise can help prevent the progression of gastric sag, and can also increase gastric tension, stomach motility, and improve symptoms due to physical strength and muscle strength.
In short, should develop good eating habits, regular quantitative, for the body thinner, should increase nutrition. Should actively participate in physical exercise, such as walking, practicing Qigong, playing Tai Chi. To prevent the disease, you must also maintain optimism. It is also possible to use a simple and easy-to-learn fitness method. If you have chronic digestive diseases, you should actively and thoroughly treat them to reduce the incidence of the disease.
Complication
Gastroptosis complications Complications, anemia, headache, insomnia
Patients with longer course of disease, due to psychological and mental factors or anemia, weight loss and other factors, patients often have dizziness, headache, insomnia, palpitations, fatigue and other symptoms, a few even have symptoms of depression, severe cases accompanied by liver, spleen, kidney Sagging, such as the transverse colon, is called visceral drooping.
Symptom
Gastroptosis symptoms Common symptoms Abdominal distension, abdominal pain, constipation, palpitations, depression, dyspepsia, liver ptosis, gastrointestinal motility, low blood pressure, dizziness
Mild gastroptosis is asymptomatic, moderate to severe gastrointestinal motility, dyspepsia.
1, abdominal distension and upper abdominal discomfort: patients have more self-reported abdominal fullness, heavy feeling, pressure.
2, abdominal pain: mostly persistent pain, often occurs after meals, related to food intake, the greater the amount of food intake, the longer the pain, and the pain is also heavy, while the pain is related to activities, postprandial activities often make the pain worse .
3, nausea, vomiting: often occurs after a meal activity, especially when eating too much is more likely to occur, this is because 1 time into a larger amount of food, increased the traction of the stomach wall ligament and pain, followed by nausea and vomiting.
4, constipation: constipation is mostly intractable, the main reason may be due to the simultaneous sagging of the transverse colon, so that the colonic hepatic curvature and spleen curvature is acute, and the slow passage.
5, neuropsychiatric symptoms: due to a variety of symptoms of gastroptosis long-term torture of patients, making their mental burden too heavy, resulting in insomnia, headache, dizziness, dullness, depression and other neuropsychiatric symptoms, but also low blood pressure, palpitations and standing Fainting and other performances.
6, physical examination: visible elongated body type, upper abdominal tenderness point is not fixed due to vertical position changes, sometimes with impact palpation, or when the patient quickly changes position, you can hear the sound of the umbilical lower water, the upper abdomen is easy to take the initiative Pulse pulsation, often accompanied by signs of liver ptosis, renal ptosis and colonic drooping.
Examine
Gastroptosis examination
1, X-ray examination: gastrointestinal barium meal imaging can be seen:
(1) The corpuscle is obviously downward and displaced to the left, and the severe one is almost entirely on the left side of the midline of the spine.
(2) The lowest point of the small curve of the stomach is below the line.
(3) The tension-free stomach has a vertical body in the stomach, the body is wider than the bottom, the antrum is below the level of the pylorus, the peristalsis is weak, the tension is reduced, and the meal is retained. There is still 1/4 to 1/3 after 6 hours. Residual in the stomach.
(4) The duodenum ampulla is towed and elongated, and its upper corner is sharp. The second part of the duodenum is often located behind the pyloric tube, that is, it is shifted to the left.
(5) The third segment of the duodenum may be duodenal stagnation due to compression of the mesenteric artery.
2. Ultrasonic examination of drinking water: After drinking water, the lower edge of the stomach is detected and moved into the pelvic cavity.
Diagnosis
Gastroptosis diagnosis and differentiation
diagnosis
According to the patient's medical history and clinical manifestations and drinking water ultrasound test, the X-ray examination is easier to confirm. The degree of gastric ptosis is generally moderate with a small curved notch lower than the two-line connection level of 1 to 5 cm, and severely above 11 cm.
Differential diagnosis
1. Identification with acute gastric dilatation: acute gastric dilatation often occurs in trauma, several hours to one or two days after anesthesia and surgery, or shortly after a meal. The patient feels abdominal fullness or persistent pain, followed by vomiting, mainly Stomach contents, small amount, but frequent episodes, although spit and bloating does not decrease, patients can quickly appear water and electrolyte disorders, and even shock, X-ray abdominal plain film can be seen enlarged stomach saturated dense food residue shadow, take a small amount of tincture Visible dilated stomach type, asking for a history can help identify.
2, gastric retention: functional gastric retention due to lack of gastric tension, in addition, stomach or other abdominal surgery caused by gastric dysmotility, central nervous system diseases, diabetic neuropathy, and vagus nerve cutting Causes the disease, uremia, acidosis, hypokalemia, hyponatremia, systemic or intra-abdominal infection, severe pain, severe anemia, and the use of antipsychotics and anticholinergic drugs can also cause the disease, vomiting The main manifestations of this disease can occur day and night. The vomit is often a food, usually does not contain bile. The upper abdomen is full of swelling and pain. If there is vomiting and eating, the abdomen has a water sound when it is fasting. Gastric retention, after 4 hours of eating, can still be removed from the stomach or extracted from the stomach cavity can be confirmed, when the gastrointestinal barium meal examination, the tincture remains 50% after 4h, or after 6h still not empty, both Support for the disease.
3, the disease should be differentiated from peptic ulcer, chronic gastritis, chronic hepatitis, gastric neurosis, chronic cholecystitis, gastric cancer, gastric dilatation, pyloric obstruction and other diseases.
