Gastroptosis - is the omission of the stomach. Most often this disease occurs in women after 30 years. There are gastroptosis
congenital or caused by constitutionally asthenic physique acquired.
Acquired ptosis of the stomach occurs with the weakening of muscles of the anterior abdominal wall. In this case the anterior abdominal wall muscles cease to press and fix the stomach and the whole burden of keeping the stomach falls on his ligaments. Ligaments gradually stretch - there is ptosis of the stomach - gastroptosis. The weakening of the abdominal wall muscle occurs at a sharp weight loss, when the size of the stomach is reduced, and the muscles remain for some time in the stretched state and cease to perform its function. The same condition can occur after pregnancy, after the removal of the tumor, or fluid in the abdominal cavity.
There are three degrees of ptosis of the stomach:
with first-degree gastroptosis lower bound of the stomach is 2 cm above the line between the iliac crest (pectinate line)
in the second degree - the lower limit of the stomach the same as the pectinate line with third-degree lower edge of the stomach is below pectinate line.
The first and second degree prolapse of the stomach is usually not clinically apparent. Only some patients may be a feeling of heaviness in the stomach or aching pain in the upper abdomen. Sometimes the pain occur when running, jumping. In this case the stomach ligaments are stretched. Such pain usually pass quickly.
In the third degree prolapse pain occur more frequently after a meal, but decreased in the supine position, as the ligaments supporting the stomach in this position are no longer tense.
The patient is usually poor appetite and frequent nausea. Some patients complain of pain in the heart. Patients with constitutional omission of the stomach are usually associated prolapse of the intestine or kidney, which is accompanied by constipation and pain in the lumbar region. Often such patients are placing a lot of complaints of neurotic character. On examination, the patient can be detected pendulous abdomen. Sometimes it is possible to probe through the anterior abdominal wall of the stomach and the lower surface of the gatekeeper (the place of transition of the stomach into the duodenum).
With fluoroscopic study with contrast barium find stretched, elongated stomach, lowering the boundaries of the stomach, congestion in the stomach of a contrast agent. In addition, the detected decrease in gastric motor activity - hypotension. In the study of the functional activity of gastric juice is often determined by reducing the number of hydrochloric acid, or even its absence (achlorhydria).
The main method of treatment is gastroptosis physiotherapy aimed at strengthening the abdominal muscles. In the third degree gastroptosis appointed a special set of exercises under the guidance of an instructor in physical therapy.
Applied physiotherapy, massage the abdomen, underwater shower-massage. All patients were recommended diet with frequent fractional power. Food should not be rough and difficult to digest. Sometimes wearing a therapeutic bandage is assigned.
Surgical treatments are rarely gastroptosis due to frequent relapses gastroptosis after surgical treatment.