The stomach (see Figure 2) functions as a reservoir. It is a large, hollow organ and holds the food we eat. It secretes acid and some digestive enzymes that help begin the processes of digestion. It also acts as a churn to mix up food so that when the food is released through the valve at the end of the stomach (called the pylorus), it is in a liquid or semi-liquid form ready to be digested and absorbed by the small intestine.

STOMACH DISORDERS

Gastritis

The term "gastro" means stomach. When a word ends with "itits," it means "inflammation of." So the word gastritis means inflammation of the stomach. When we look into the stomach of a patient with gastritis, we see that it is very reddened and sometimes so inflamed that it can ooze a small amount of blood just by being touched. Gastritis is very common with the ingestion of substances that irritate the lining of the stomach. Examples of these are alcohol, medications containing aspirin, and anti-arthritis medications.

Gastroparesis

Gastro-paresis" means "Stomach-Paralysis." Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. The function of the stomach is abnormal but without any physical evidence of obstruction.

The most common symptoms are a full feeling after eating only a small amount, bloating, regurgitation, nausea and vomiting especially after eating. In some patients, symptoms can be quite non-specific, such as persistent heartburn, abdominal pain or poor glucose control in patients with diabetes.

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Peptic Ulcer Disease, Gastric Ulcer, Stomach Ulcer

One might ask, "with the stomach making so much acid, why doesn't it just digest itself?" The body has a number of defense mechanisms that protect the stomach from the acid it produces. Any agents or conditions that decrease these normal defense mechanisms can predispose the development of an ulcer in the stomach. Symptoms of a gastric ulcer may be indigestion, burning upper abdominal pain, or intolerance to certain foods. Some people complain of pain in the pit of their stomachs (the soft part of the stomach just below the breastbone) or slightly to the left. Classically, this pain is relieved by eating food; but, one or two hours later the pain returns. Others say eating makes the pain worse. If an ulcer is located near the valve at the end of the stomach (pylorus), it may interfere with the valves' function and prevent adequate emptying of the stomach contents into the small intestine. This may result in nausea and/or vomiting. Should the ulcer bleed, blood may be present in the material vomited or blood may pass in the stool (bowel movement). If a large amount of blood has been passed, it may be digested and the stool will appear black and sticky and have a bad odor. Persons who pass such a black stool should consult their physicians immediately!

Nonucler Dyspesia Syndrome

Dyspepsia is a condition that affects 25% of the population. It is defined in various ways as upper abdominal pain, burning, bloating, indigestion, or early fullness after eating, and is frequently associated with gas, belching, and bloating. What distinguishes the condition of nonulcer dyspepsia from other conditions that cause similar symptoms is the absence of identifiable pathology on diagnostic testing. For instance, testing done such as upper endoscopy, ultrasound imaging, laboratory testing, and CAT scan of the abdomen are all normal. This is a very common and frustrating problem for patients but unfortunately, few proven effective treatments exist. The cause of this condition is unknown, but several theories exist including an over production of gastric acid, failure of the stomach to relax appropriately (especially after eating), and an increased sensitivity of the digestive system to various stimuli such as air or temperature. Different approaches to treatment include use of acid suppressing medications, treatment of a bacteria that can inhabit the stomach (H. pylori), use of medications that can facilitate movement of food through the upper gastrointestinal tract and improve gastric relaxation (zelnorm), and use of medications that can alter the perception of pain (elavil). Some patients, despite our best efforts, never get full relief of their discomfort. Fortunately this condition is not life threatening but merely a nuisance. It is important to make sure that other conditions that can mimic nonulcer dyspepsia such as celiac sprue, gastroparesis, peptic ulcers, pancreatic disease, gallbladder disease, and possibly bacterial overgrowth are ruled out before assuming someone has nonulcer dyspepsia.

Gastric Cancer, Stomach Cancer

Cancer occurs when there is growth of abnormal cells which are no longer under control of the body. Unfortunately, cancers of the stomach usually grow silently, until they become rather large and are no longer curable by surgery. However, cancers can imitate stomach ulcers and that is why physicians who find stomach ulcers biopsy them to be sure that they are not malignant (cancer). The symptoms of gastric cancer are very similar to those of gastric ulcers and include pain in the pit of the stomach, nausea, sometimes vomiting (with or without the presence of blood), weight loss, and "early satiety," which is full sensation felt after eating only a small amount of food.

Diet

Because of the effectiveness of the medications currently available to treat ulcers, strict diets are usually not necessary. You should, however, do the following:

• Avoid ingestion of excessive alcoholic beverages.
• Stop smoking.
• Eliminate caffeinated beverages from your diet.
• Take nothing that contains aspirin or other over-the-counter medications that are known to irritate the stomach.
• Avoid certain foods that seem to upset your stomach until the ulcer heals.