Gastric prolapse: causes, symptoms, treatment, prevention

Under certain unfavorable conditions, the stomach can change its usual anatomical position, and then its partial or complete displacement downwards occurs - prolapse of the stomach (gastroptosis).

In a normal state, the human stomach is located in the left hypochondrium of the peritoneum and partially in the epigastric region. It is covered by the peritoneum on all sides and is held in place by a system of ligaments consisting of the mesentery of the transverse colon and the folds of the peritoneum (the greater omentum). Between the folds of the peritoneum there is fatty tissue, which helps to fix the normal position of the stomach.

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Causes of gastric prolapse

Gastric prolapse (or gastroptosis) is thought to be a result of weakening of the abdominal muscles, especially the deepest transverse muscle (transversus abdoninus), as well as overstretching of the ligaments that support the stomach. Why does this happen?

Prolapse of the stomach, like prolapse of other internal organs (splanchnoptosis), can be congenital (constitutional) or acquired. Congenital prolapse of the stomach is typical for the asthenic somatotype of a person, whose owners are distinguished by thinness, long limbs and a weak muscular system. In the case of the stomach, there is excessive stretching of the weak gastrocolic ligament, which leads to prolapse of the organ, disruption of its functioning and pain.

The main causes of acquired gastric prolapse are: significant weight loss (weight loss), constant overexertion of the abdominal muscles (during heavy physical labor or weightlifting), removal of a large tumor from the abdominal cavity, as well as multiple pregnancies and births (which is why this disease is often diagnosed in women).

As noted by gastroenterologists, the consequences of gastric prolapse are expressed in a partial disruption of its functions - weakening of motility and difficulty in moving food into the intestines when some part of the stomach is bent. In addition, incomplete closure of the gastric sphincters may be observed, as a result of which air enters the stomach from the esophagus (which causes belching). And if the pyloric sphincter is disrupted, bile may enter the stomach from the duodenum, which leads to heartburn and, in the long term, to gastritis and gastric ulcer.

Often, the consequence of the prolapse of the stomach - due to its downward pressure - is the prolapse of the large intestine and pelvic organs. When the stomach and intestines (large) prolapse, there are complaints of constant constipation, flatulence and pain in the lower abdomen. The prolapsed intestine, in turn, presses on the bladder, prostate (in men), uterus and ovaries (in women). So the chain of pathological processes caused by gastroptosis can lead to many diseases.

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Symptoms of gastric prolapse

Depending on the level to which the stomach has shifted downwards relative to the normal anatomical position, three degrees of gastric prolapse are accepted in clinical gastroenterology.

At the 1st and 2nd degree, the disease in most cases proceeds without pronounced symptoms. Then how to determine gastric prolapse? Suspicion should be aroused by such signs as a feeling of discomfort, "bursting" and heaviness in the stomach area, pulling or aching pain in the upper abdominal cavity (especially after sudden movements or physical exertion). Pains of this nature and localization, as a rule, are short-lived.

If the prolapse of the stomach has reached the 3rd degree, then after eating, patients feel a nagging pain in the epigastric region, often radiating to the heart area. Moreover, in a horizontal position of the body (lying down), the pain quickly subsides. In addition, with constitutional gastroptosis, appetite decreases, belching, nausea, vomiting, as well as constipation and pain in the lumbar region occur.

Diagnosis of gastric prolapse

The clinical picture of gastroptosis resembles the symptoms of many gastrointestinal pathologies. Therefore, diagnosis of gastric prolapse requires a comprehensive examination.

After collecting the anamnesis, the doctor conducts a multi-position physical examination of the abdomen, in which the initial position of the stomach in the abdominal cavity is determined by palpation in the supine position, and palpation in the standing position allows one to determine depressions in the epigastric region and bulges in the suprapubic zone of the abdomen.

To make a correct diagnosis of gastroptosis, the following are also used:

• X-ray examination of the esophagus and stomach with a contrast agent,
• endoscopic examination of the gastrointestinal tract - esophagogastroduodenoscopy (EGDS),
• fibroesophagogastroduodenoscopy (FEGDS) of the esophagus, stomach and duodenum.

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Treatment of gastric prolapse

The treatment of gastric prolapse generally accepted in clinical practice is conservative. And the key place in the therapy of this disease is given to therapeutic physical training and a proper nutrition system.

In case of significant pain, analgesics are prescribed, in case of constipation - laxatives. But surgical treatment of gastric prolapse is resorted to extremely rarely due to the high probability of relapse of the disease. Surgical correction of gastroptosis of the 2nd and 3rd degree can be performed in case of pathologies that complicate it, for example, in case of reverse movement of the stomach contents through the lower esophageal sphincter into the esophagus (gastroesophageal reflux). During fundoplication - an operation to eliminate this pathology - the stomach is sutured to the diaphragm around the esophageal opening with fixation to the abdominal wall, due to which the stomach is pulled up.

Exercises for prolapsed stomach

A set of specially selected exercises is aimed at increasing the muscle tone of the abdominal wall. In this set of exercises for stomach prolapse, there are no jumps or sharp bends of the body - that is, movements that can cause displacement of organs.

Exercises for prolapsed stomach are possible for absolutely all patients, regardless of age, since all exercises in the first months are performed only lying down.

So, lying gymnastics for prolapsed stomach. Starting position: lying on your back, legs straight, arms extended along the body.

• Exercise No. 1: after taking the deepest possible breath, you need to exhale as deeply as possible, which will require “squeezing out” the air by tensing your abdominal muscles (repeat 10 times).
• Exercise #2: Alternating straight leg raises (repeat 10 times).
• Exercise #3: On inhalation, bend one leg at the knee, on exhalation, press the bent leg to the chest with both hands. Then do the same with the other leg (repeat 5 times with each leg).
• Exercise No. 4: the same movements as in the previous exercise are performed with both bent legs at the same time.
• Exercise No. 5: both legs bend at the knees, the pelvis is raised with the body supported by the feet, elbows and the back of the head (repeat 5 times).
• Exercise No. 6: both legs are bent at the knees, raised and movements are made that imitate riding a bicycle (repeat 10 times).
• Exercise No. 7: legs straight, arms extended along the body - raise straight arms upwards (while inhaling) and place them behind the head - "stretching"; while exhaling - return to the starting position (repeat 10 times).

After each exercise, you need to take a break - to rest. And after all the exercises, when the stomach is lowered, you need to lie down for about a quarter of an hour, placing a pillow or a bolster made from a rolled-up blanket under your feet.

It is recommended to do a massage when the stomach is lowered. To do this, place your palm on the left side of the epigastric region and make light circular strokes of the abdomen - 10 circles clockwise, and then in the opposite direction. When stroking, the circles, like a spiral, should be brought closer to the navel, and then expanded again.

In case of significant gastroptosis, doctors recommend wearing a special bandage for prolapsed stomach, which should be put on while lying down (in the morning, on an empty stomach) and removed only before going to bed.

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Diet for prolapsed stomach

Gastroenterologists recommend for gastroptosis - eat 5-6 times a day in small portions: food should not stay in the stomach for a long time and stretch it. It is advisable to eat at the same time to accustom your stomach to the "work schedule". Food should be easily digestible, but at the same time high in calories.

In addition, everything eaten should contribute to the normal functioning of the entire gastrointestinal system, so the diet for prolapsed stomach should include porridge (except semolina and rice), vegetables (raw and stewed), lean meat (beef, veal), poultry and lean sea fish, fermented milk products, and fruits.

To combat constipation, season salads and vinaigrettes with vegetable oil, drink kefir, eat 2-3 prunes daily. Give up white bread and yeast pastries, replacing them with wholemeal bread, diet bread or biscuits.

If gastroptosis is noticeable, doctors advise lying down after each meal – for at least an hour.

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Treatment of gastric prolapse with folk remedies

In case of loss of appetite, which often accompanies gastric prolapse, it is recommended to take an infusion of one of the following medicinal plants: wormwood, calamus, centaury, yarrow, dandelion root or chicory.

To prepare the infusion, pour a tablespoon of the dry mixture with a glass of boiling water, leave for half an hour, strain and take one tablespoon 30-40 minutes before meals.

A decoction of plantain leaves (3 tablespoons per 500 ml of boiling water) will help normalize the production of gastric juice. It is recommended to drink this decoction half an hour before meals - half a glass.

For gastroptosis, herbalists also recommend drinking a decoction of the rhizomes of the erect cinquefoil (galangal). Take one tablespoon of crushed rhizomes per glass of boiling water, boil for 20 minutes, strain and take one tablespoon four times a day.

Treatment of gastric prolapse with folk remedies also includes clay applications. To do this, you need to prepare a thick mass of regular clay and water, roll it into a ball, knead the ball into a flat cake (the size of a regular plate and about 2 cm thick) and put it on your stomach. The clay should be kept on your stomach for at least three hours.

Prevention of gastric prolapse

Experts unanimously consider mandatory physical exercise in childhood and adolescence to be an effective method of preventing gastric prolapse, as it helps strengthen the body's muscular system.

Adults should, firstly, take into account the peculiarities of their constitutional type. Secondly, move more - walk, swim, but do not overload the abdominal muscles by lifting weights or long runs.

It is especially important to try to strengthen the muscles of the anterior abdominal wall before pregnancy and to use special prenatal and postnatal bandages during pregnancy and after childbirth to prevent stomach prolapse in women. They will help to avoid many problems, including gastroptosis and uterine prolapse.

Prognosis of gastric prolapse

Gastric prolapse has a favorable prognosis, but it should be remembered that this pathology can recur and lead to diseases of other organs and systems of the body.