Stomach (Gastroduodenal) Disorders

The stomach is a “J” shaped canal which is continuous with the esophagus above and the duodenum below. Its function include storing large quantities of recently ingested food, initiating the digestive process and releasing its contents in a controlled fashion into the duodenum which has a smaller capacity.The duodenum is the first part of the small intestine. It is continuous with the stomach above and the jejunum (middle section of the small intestine) below. The liver and the pancreas are connected to duodenum through the bile duct and the pancreatic duct respectively, which open into a common channel to enter the duodenum. Most of the digestion of food takes place in the duodenum.

Gastroduodenal disorders fall into two types:

  • Organic
  • Functional

The gastroduodenal disorder symptoms are mostly nonspecific. The gastroduodenal disorder symptoms include:

  • upper abdominal pain
  • nausea
  • vomiting
  • abdominal bloating

The gastroduodenal disorder diagnosis and treatment depends on whether the disorder is functional or organic. The most common gastroduodenal disorders include the following:

Functional Dyspepsia. Functional dyspepsia refers to persistent or recurrent dyspepsia who have undergone tests including endoscopy and have not been found to have an obvious specific cause for their symptoms. Dyspepsia is defined as pain or discomfort coming from the upper abdomen.

Additional symptoms for the functional dyspepsia gastroduodenal disorder may include:

  • Fullness of stomach
  • Feeling full after a small quantity of food

Belching Disorder. During eating and drinking some amount of air is swallowed, which is belched out and this is considered a normal phenomenon. Belching is considered a disorder only when it is troublesome. Belching may accompany gastroesophageal reflux disease (GERD) and dyspepsia.

Nausea and Vomiting Disorders. Nausea is the unpleasant sensation of impending vomiting, felt in the upper abdomen and throat. Vomiting is forceful expulsion of stomach or intestinal contents through the mouth associated with contraction of abdominal and chest muscles.

This disorder group includes:

  • chronic idiopathic nausea
  • functional vomiting
  • cyclic vomiting syndrome

A patient is said to be suffering from chronic idiopathic nausea if they have bothersome nausea occurring several times a week for a period of three months, and tests done for metabolic diseases and endoscopy do not reveal anything.Functional vomiting is defined as:

  • The patient on average has at least one episode of vomiting a week
  • The patient does not suffer from eating disorder or any major psychiatric illness
  • The vomiting is not self included
  • There is no chronic cannabinoid use
  • There is no abnormalities in the central nervous system
  • Tests for metabolic diseases do not reveal anything

Cyclic vomiting syndrome is defined as follows:

  • Stereotypical episodes of vomiting with acute onset
  • Vomiting episodes last for less than one week
  • No nausea and vomiting between episodes

Rumination Syndrome. Rumination syndrome is a disorder characterized by repeated regurgitation of recently ingested food, which is followed by chewing and swallowing of the food again. It can occur in both males and females of all ages. Rumination starts within minutes of beginning a meal. Nausea or retching are not present. An episode may last for 1 to 2 hours. The food that is regurgitated is partially digested.

Gastritis and Gastropathies. Gastrtis is a condition characterized by inflammation of the inner lining of the stomach. The various symptoms of this gastroduodenal disorder are similar to the previous disorders with:

  • pain in the upper abdomen
  • nausea
  • vomiting

However, in like the previous disorders, the vomiting often contains blood.

Gastropathies are disorders characterized by erosions and other defects of the inner lining of the stomach without inflammation being present. Also absent are the symptoms of upper abdominal pain, nausea and vomiting.

The causes of gastritis and gastropathies may include:

  • infections
  • Granulomatous disease (such as Crohn’s disease)
  • distinctive forms (such as eosinophilic gastritis)
  • non-steroidal anti-inflammatory disease
  • alcohol abuse
  • cocaine abuse
  • stress
  • bile reflux
  • Zollinger Ellison Syndrome

Peptic Ulcers. Peptic ulcer is a common gastroduodenal disorder that affects individuals all around the world. An ulcer is a defect in the inner lining of the gastrointestinal tract. The two most common types of ulcers are:

  • gastric
  • duodenal

The two most common causes of peptic ulcers are Helicobacter pylori infection and intake of non-steroidal anti-inflammatory drugs, which are used to kill pain. Other causes of peptic ulcers may include – medications used for chemotherapy, medications used for osteoporosis, or conditions like Zollinger Ellison Syndrome.