Stomach disease

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Classification according to ICD-10
K25 Gastric ulcer
K29 Gastritis and duodenitis
K30 dyspepsia
K31 Other diseases of the stomach and duodenum
C16 Malignant neoplasm of the stomach
ICD-10 online (WHO version 2019)

The stomach as the place where food is pre-digested can be affected by various diseases. It is claimed that over 50% of the population will develop stomach ailments at least once in their lifetime .

List of diseases of the stomach

in animals

Investigation methods

The most productive method of examining the stomach is gastroscopy (gastroscopy). During the gastroscopy, an HU test is often taken to detect a Helicobacter colonization. In addition, targeted biopsies for histological examination are easily possible. The x-ray examination of the stomach, which was carried out before the advent of gastroscopy, is no longer performed routinely today because it produces very uncertain results. The ultrasound examination of the stomach is easily possible, but only rarely provides useful results, such as a gastric outlet stenosis or a noticeable irregular wall thickening. With the ultrasound, the gastric exit is quite good, other parts such as B. the cardia hardly assessable. A computed tomography of the stomach is useful also in exceptional cases. For the determination of Helicobacter bacteria is increasingly a breath test carried out.

Reflux disease

Almost every second German knows heartburn . If the symptoms only occur occasionally, there is usually no need to worry too much.

Sometimes, however, heartburn can hide "reflux disease". Based on its English name ( Gastro Esophageal Reflux Disease ), it is often called GERD . The constant "reflux" (backflow) of acidic gastric juice into the esophagus corrodes its sensitive mucous membrane, leads to esophagitis and can promote esophageal cancer . For the treatment of reflux disease, the regular intake of drugs from the group of proton pump inhibitors is now considered the standard .

Alternatively, the disease is treated surgically: in a so-called Nissen fundoplication , a cuff formed from the stomach wall is placed around the lower area of ​​the esophagus. This operation is now performed in a minimally invasive manner with relatively few risks and complications ( laparoscopic fundoplication ).

Inflammation of the lining of the stomach (gastritis)

A distinction is made between two types of gastritis according to the time course: acute and chronic gastritis. Chronic gastritis persists for years and does not cause any discomfort to the patient. A chronic inflammatory process leads to changes in the mucous membrane, and therefore changes in the work of the stomach. Acute gastritis can be sudden and severe. You experience nausea, vomiting, a feeling of fullness, and general weakness and loss of appetite. The appearance of bad breath can be noticeable. Proton pump inhibitors can also be used to treat this disease .

Peptic ulcer (stomach ulcer)

Ulcer in the lining of the stomach that can penetrate the entire wall of the stomach and cause stomach perforation or bleeding. An ulcer is caused by the attack of stomach acid on the z. B. gastric mucosa previously damaged by a Helicobacter pylori infection. The treatment of the uncomplicated ulcer is now the so-called eradication therapy . The bleeding ulcers are usually treated with gastroscopy . Only complicated ulcers, or ulcers that break through the stomach wall, need to be treated with surgery.

Gastric outlet obstruction
Gastric outlet obstruction

Gastric cancer

Certain dietary habits, chronic gastritis, cigarette smoke and alcohol consumption have been identified as risk factors for gastric cancer, one of the most common types of cancer in humans. The risk of developing stomach cancer is increased with hereditary stress (which is probably related to the hereditary transmission of the bacterium Helicobacter pylori ) - there is a 3.7 times higher risk for first-degree relatives. People with blood group A are more often affected. The cause is unknown. The treatment of gastric cancer is currently mainly surgical, for example by means of gastrectomy .

Alcohol complications

As a result of alcoholism , changes in the lining of the stomach, called portal gastropathy, occur. Changes in the gastric veins occur as a result of the liver changes. They enlarge and are called "fundic varices" (see gastric fundus). The therapy here is abstinence from alcohol, administration of beta blockers and sclerotherapy with Histoacryl adhesive.

Benign tumors

The most common benign changes are so-called corpus gland cysts and hyperplastic polyps . However, above a certain size, these tumors have to be removed endoscopically . At the moment, the recommendation is to remove all masses over 2 cm in diameter, as one can never be sure whether malignant tissue might not have developed in the large tumors.

Rare findings

All findings not described above are summarized under rare findings. Angiodysplasias are an example . It is a group of abnormalities of the vessels in the stomach that can occur in the context of congenital ( Osler's disease ) or acquired diseases ( renal insufficiency ).

See also

literature

  • Bettina Ruehe (Ed.): Basics Gastroenterology . Elsevier, Urban & Fischer, 2005, ISBN 3-437-42146-8 , pp. 26-27 and 28-29 .
  • Hans Adolf Kühn: The diseases of the stomach and duodenum. In: Ludwig Heilmeyer (ed.): Textbook of internal medicine. Springer-Verlag, Berlin / Göttingen / Heidelberg 1955; 2nd edition, ibid. 1961, pp. 767-804.