Atony of the stomach

One of the important functions of the stomach - peristalsis - is provided by alternating the muscle contractions of the organ wall. Thanks to these movements there is a mixing and crushing of food, the contact of food lumps with enzymes and other components of gastric juice involved in digestion increases, the contents move to the pyloric section towards the sphincter and is pushed into the intestine.

To perform this work, the muscle fibers must maintain tone, the ability to respond to reflex and neuro-humoral signals. Atony of the stomach is a serious disorder of the contractile capacity of the muscle layer and the nervous regulation of the process.

Unlike hypotension, in which there is a partial and inconsistent decrease in peristalsis, muscle relaxation is stable, represents a more neglected digestion problem for humans.

Anatomy and physiology of gastric motility

Muscular is one of the four layers that make up the wall of the stomach. It, in turn, is divided into 3 shells of muscle fibers with different directions: in the innermost, they go along an oblique line, in the middle - they are circular( reaches the maximum thickness in the area of ​​the sphincter), outside - longitudinally relative to the main axis of the stomach.

A certain alternation of contractions of multidirectional fibers creates peristaltic movements of the stomach wall

The nerve plexus lying between the layers( Auerbachovo) "maintains" the tone of the muscle fibers. It is it that receives signals from the nervous system( central part and spinal cord) through the vagus nerves and from the branches of the nearest celiac plexus.

Two vagus nerves( left and right) divide the zones of innervation between themselves, pass along the anterior and posterior surface of the stomach, connect with the branches of the solar plexus, liver, esophagus.
The greatest number of motor signals goes along the left trunk and small curvature of the stomach. This branch is called the nerve of Latare.

We draw attention to the details, since surgical intervention on the stomach, surgeons try to keep this branch. This is also important in the operation of vagotomy( dissection of the trunk of vagus nerves), which is carried out for different indications, but always take into account the level of the incision.

Swallowed food enters the stomach from the esophagus in small portions. Here it is delayed for different periods depending on the composition: broths and juices - for 20 minutes, meat( for example, pork) for 6 hours. Due to the peristalsis of the muscular layer, a chyme is formed - a mushy content, progressing gradually towards the doorman.

To relax the closed sphincter, it is necessary to achieve a certain level of acidity of the gastric juice. In this period, wave-like contractions of the muscles of the stomach appear. They push the contents into the duodenum to continue the digestion process. When gastric emptying is suspended production of gastric juice.

Such a complex process is controlled by the vegetative department of the nervous system. He is not controlled by the will of man. All work of the gastrointestinal tract is performed on the basis of internal regulation. Precisely to establish, with what the occurrence of atony of the stomach is connected is impossible, as it is difficult to reveal the true mechanism of peristalsis lesion. The same problem determines the complexity of treatment of pathology.

The wandering nerves belong to the autonomic nervous system

The main causes of

It is believed that the disease can cause any factors affecting the regulation processes from the central nervous system, the spinal cord, the local stomach network. In other words, any defeat of the nervous system can provoke a gastric atony.

The starting factor can be:

• severe infectious diseases with severe intoxication( especially characteristic of typhoid fever, botulism);
• excessive stressful situations;
• suffered myocardial infarction, peritonitis, croupous pneumonia;
• trauma to the spine and brain.

The atony of the stomach is revealed in patients on the background:

• of frequent excessive overeating( overstretch of the walls of the stomach);
• exposure to toxic substances( toxins) in food poisoning;
• depletion of the body;
• thrombosis feeding the arterial vessels of the stomach;
• endocrine pathology, hormonal imbalance;
• damage to nerve trunks during stomach surgery;
• congenital changes in the form of pustules and lengthening of the organ.

How are the signs of pathology manifested?

Symptoms of atony of the stomach can grow rapidly and rapidly deteriorate the patient's condition or develop gradually. Distinguish between the mild and severe course of the disease. In the case of mild forms, patients complain of a prolonged heaviness in the stomach after eating, epigastric pain in a bursting temper, eructation with acidic contents.

There is hiccough, poor appetite, bad breath, atonic constipation without a sense of relief after defecation. Perhaps in this stage the atony of the stomach does not reach its maximum, but is delayed in the form of hypotension.

Usually deterioration occurs after eating fatty foods and dishes, drinking large amounts of water

In severe cases, the symptoms are caused by chronic gastric obstruction. The patient is concerned about: the

• has a constant sense of overflow, even if a lot of time has passed after eating;
• spreading intense pain in the epigastric region;
• not passing hiccup;
• belching long-eaten food;
• profuse vomiting;
• feeling nauseous.

Diagnostics of

Hardware methods help to identify atony of the stomach, but to determine the cause and purpose of optimal treatment the attending physician will prescribe a comprehensive examination.

Important point - the patient is difficult to prepare for research. Even with special fasting, it is difficult to achieve a state of complete emptying of the stomach and intestines. Therefore, often with fibrogastroscopy, vomiting occurs. After cleansing, the doctor sees a stretched stomach in the absence of signs of inflammation or stagnant phenomena with irritation of the mucosa.

X-ray examination with reception of contrast material( barium suspension) allows to detect an enlarged cavity of the stomach, elongated form, "fall" and accumulation of barium in the area of ​​the pylorus. The images are taken in different projections in order to exclude as precisely as possible the mechanical obstruction in the form of a tumor.

Treatment Requirements

Treatment for atony of the stomach requires a comprehensive approach. Through inquiry and inspection, it is often possible to find out the main reasons. To eliminate them will require a change in the mode of life, habits, special physical exercises, diet, the implementation of recommendations of specialists: gastroenterologist, therapist, neurologist, psychiatrist.

Surgical treatment is practically not applied. To help the patient by washing the stomach with a probe is not difficult. The problem is the normalization of the natural way of digestion, the support of other organs and systems.

Scheme of therapy is selected for each patient individually

Diet

The patient is assigned table number 2 according to Pevzner. It includes mandatory compliance with the conditions:

• frequent meals( 7-10 times a day) in small portions;
• the exception of all fried, spicy, smoked and going only to cooked meals;
• preference for liquid and semi-liquid food;
• addictive to drink drinks in small sips;
• the need for breaks between eating solid and liquid foods;
• exclusion of dishes with contrasting temperatures.

For all restrictions, the patient should receive a sufficient amount of vitamins and protein. To stimulate peristalsis are shown: rye bread, sour-milk products, prunes, honey. Protein is compensated by dishes from low-fat boiled meat, chicken, fish, buckwheat porridge, porridge, milk soups. You can include eggs in the diet.

Therapeutic physical training

Physical exercises are aimed at strengthening the abdominal muscles. In this way, restoration of the lost innervation of the stomach is achieved. Increased muscle tone is promoted by:

• "bicycles" with the lowering of the legs as low as possible to the floor;
• leg lifts in a lying position to an angle of 90 degrees and a slow lowering;
• throwing your feet behind your head;
• execution of "birch" on the shoulder blades;
• static standing in the bar on the hands for a minute;
• flies forward, backwards and to the sides;
• twisting the spine forward with the feet pressed to the floor.

Patients are advised to consult about medical gymnastics with a specialist and perform it on a daily basis. At the same time advised to master the course of breathing exercises, swim in the pool, walk more. After classes in the morning, a contrast shower is shown. It helps strengthen the nervous system.

The most effective classes are in the

groups. With easy atony, the use of a gastric bandage has a good effect. He is put on while lying down. They wear all day. The dense tissue supports the abdominal wall and increases the tone of the muscle tissue. To purchase you need to know your size, consult your doctor.

Treatment with medicines

When atony of the stomach, the following drugs are used:

• improving gastric motility( Motilium, Proserin);
• stimulating the process of restoration of impaired innervation( Solcoseryl);
• vitamins - especially group B, are necessary to provide nerve regulation;
• antiemetics;
• containing calcium and potassium necessary for muscle fibers.

Patients with general asthenia and severe weight loss are prescribed anabolic hormones, immunomodulators, intravenously injected protein solutions. Some experts advocate course treatment with insulin subcutaneously. In any case, therapy requires an individual approach. Self-selection is not possible.

Folk methods

Folk tips help to strengthen the peristalsis of the stomach. To do this, decoctions of such plants are suitable: chamomile, dandelion root, rose hips, oregano, leaves of mother-and-stepmother, yarrow.

Brew them as tea, drink before meals for half an hour.

In the absence of treatment, the most frequent complications of atony of the stomach are gastritis with the possible transition to peptic ulcer, acute gastric rupture, intestinal atony. It should be remembered that any stagnation causes a risk of developing tumors.

Prognosis and prophylaxis of

If pathology is under the control of a physician and the patient is aware of their problem, then one has to make efforts and gradually cope with it, achieving persistent periods of remission.

But with the connivance of a person, reluctance to follow the advice of a doctor, follow the regime, the disease progresses, causing complications.

Prevention is the constant fulfillment of the requirements of diet, exercise, holding courses of therapy, taking vitamins, changing their attitude to stressful situations. Human inaction only worsens the prognosis and contributes to the accumulation of various diseases.