| disease | Gastroptosis |
Gastroptosis refers to the condition where, when standing, the lower edge of the stomach reaches the pelvic cavity, and the lowest point of the lesser curvature of the stomach falls below the iliac crest line. This condition is often caused by insufficient diaphragmatic suspension, weakened and relaxed hepatogastric and phrenicogastric ligaments, decreased intra-abdominal pressure, and lax abdominal muscles, among other factors. Combined with body type or constitution, the stomach becomes extremely hypotonic and fishhook-shaped, which is the atonic stomach seen in gastroptosis.
bubble_chart Etiology
The diaphragm is positioned low, with insufficient diaphragmatic suspension, relaxation of the gastrophrenic and hepatogastric ligaments, decreased intra-abdominal pressure, and laxity of the abdominal muscles.
bubble_chart Clinical Manifestations
Grade I ptosis is generally asymptomatic. Those with significant ptosis may experience upper abdominal discomfort and bloating, which are more pronounced after meals, accompanied by nausea, belching, anorexia, constipation, and sometimes a deep dull pain in the abdomen. These symptoms often worsen after eating, standing, or exertion.
Long-term gastric ptosis often leads to symptoms such as weight loss, lack of strength, orthostatic syncope, hypotension, palpitation, insomnia, and headache.
The tenderness in the upper abdomen is not fixed and may change with body position. In some patients, a splashing sound below the umbilicus can be heard during palpation. A few cases with significant ptosis may also exhibit signs of liver, right kidney, or colon ptosis.
- Emaciation, lack of strength, gastric distension and discomfort, aggravated after eating, a sensation of something sagging in the abdomen that alleviates when lying flat. Abdominal pain lacks periodicity and rhythm, often accompanied by vomiting and belching. After a full meal, the lower umbilical region may appear raised while the upper abdomen appears sunken. A strong, stirred pulse can be palpated in the upper abdomen.
- Ultrasound examination: After filling the gastric cavity with water, ultrasound reveals the lower edge of the stomach descending into the pelvic cavity.
- X-ray barium meal examination: The most reliable diagnostic method for gastroparesis. The degree of gastroparesis is classified as grade I if the gastric lesser curvature notch is 1–5 cm below the iliac crest line, grade II for 6–10 cm, and grade III for more than 11 cm.
bubble_chart Treatment Measures
Western medicine treatment
For upper abdominal discomfort, dull pain, indigestion, etc., refer to the treatment of chronic gastritis.
For abdominal distension and fullness, or delayed gastric emptying, Domperidone 19mg can be provided three times a day, or Metoclopramide 5-10mg three times a day.
Try ATP treatment, intramuscular injection 20mg half an hour before breakfast and lunch, twice a day, for 25 days as one course, with a 5-day interval before the second course.
Place a gastric support if necessary.
Chinese medicine treatment
Ear acupuncture: Use a filiform needle handle to press on the "gastrointestinal area" of the ear to find a sensitive point, then apply pressure for 2-3 minutes at this point once daily.
Moxibustion: Apply moxibustion at acupoints such as Qihai (CV6), Guanyuan (CV4), Zusanli (ST36), and Weishu (BL21).
Qigong: Supine breathing method: The patient lies supine with the hips slightly elevated or the bed raised by 5 cm. Inhale first, then exhale, pause, and repeat. During inhalation, the tongue touches the upper palate while silently reciting the first word of a phrase; during exhalation, the tongue lowers while silently reciting the second word; during the pause, the tongue remains still while silently reciting the remaining words. The phrases can be "stomach rising" or "stomach body rising," etc.
Avoid overeating; it is advisable to eat small, frequent meals. Refrain from smoking and alcohol, and avoid greasy, sweet, or spicy stimulating foods. Instead, opt for easily digestible and nutritious foods. Do not engage in heavy physical labor or intense activities, especially after meals. Taking a walk after meals aids in the recovery of this condition. Maintain an optimistic mood, avoiding fits of anger or prolonged depression. Persist patiently with treatment, dietary adjustments, and rehabilitation exercises.
