Gastropathy: Types, Causes, Symptoms, Treatment, Diagnosis

Gastropathy, in simple terms, is referred to any type of stomach disease. Some of the examples of Gastropathy include: Portal hypertensive gastropathy, peptic ulcer disease, Ménétrier’s disease, gastric ulcer disease, dyspepsia and gastroparesis. Stomach diseases need not have the term “Gastropathy” in it. The stomach is one of the vital organs of human body and plays an important part where it helps in digestion, production of enzymes and shielding the intestines from foreign bodies. There are various types of disorders and diseases, which can affect the stomach and interrupt with its normal function. These diseases and disorders of stomach are classified as “Gastropathy.”

One of the common causes for gastropathy is acid irritation, which causes an erosive type of gastropathy, including ulcer disease or gastritis. The cause of gastropathy can be diagnosed upon endoscopy; however, in some cases a biopsy needs to be done to find out what type of gastropathy it is and what its cause is.

There are many different types of gastropathy. Many related gastropathy conditions can be distinctive diseases, such as hyperplastic gastropathy and portal hypertensive gastropathy which produces different kind of symptoms. Ménétrier’s disease is a complex condition which affects the lining of the stomach and produces debilitating symptoms in the patient. Erythematous gastropathy (non-bleeding) is another type of gastropathy which is treated with medications. As stomach disease appears in different forms, there are different types of chronic illnesses, which are related to stomach and can be classified as gastropathy. Any disease or disorder which causes inflammation, pain, bleeding in the stomach or any type of digestive problems can be placed under the category of gastropathy. Examples include Crohn’s disease, which produces gastric symptoms of which some may include stomach lining ulcerations and recurrent nausea. Bleeding in the stomach may or may not be directly related to Crohn’s disease.

Abrasions and sores similar to ulcers will develop in patients who have erythematous type of gastropathy. Inflammation can occur in these ulcers resulting in mild discomfort or severe pain. In some cases, bleeding may occur. This may be treated with medication or surgery if necessary.

There are several causes for hypertrophic gastropathy, such as stress and genetic disposition. Common symptoms include pain and inflammation along with production of excessive mucus in the stomach lining. Nausea and vomiting also commonly occur. Surgery is needed in cases where there is an obstruction.

Diabetic gastropathy is a condition, which is related to stomach and affects diabetic patients producing symptoms, which are localized in the gastrointestinal tract from malabsorption of insulin. Diabetic gastropathy can also cause nausea and vomiting. Symptoms of diabetic gastropathy can be controlled by changing diet and by regulating the glucose levels in the body.

The cause of erosive gastropathy is medications, which damage the stomach lining resulting in eroded tissue or lesions producing a painful burning sensation. In severe cases of erosive gastropathy, patient may also have stomach bleeding. Treatment comprises of stopping the medications which are causing the damage to the stomach lining.

Many of the gastropathy conditions are associated with infection. It is thought that increased acidic environment of the stomach helps in keeping the stomach protected from infection, but according to recent studies it has shown that many cases of gastritis, stomach ulcers, and stomach cancer occur due to Helicobacter pylori infection.
Hypochlorhydria is a condition where there is production of very little gastric acid. Achlorhydria is a condition where there is no gastric acid. Both these conditions can contribute to gastropathy. Hyperchlorhydria is a condition where there is increased level of gastric acid which can potentially cause stomach ulcers.

There are various types of chronic conditions which affect the stomach and commonly produce symptoms, such as nausea, vomiting, cramps, bloating, pain and diarrhea.

There different causes and risk factors which contribute to stomach disorders and gastropathy, some of which are:

• Eating spicy and/or acidic food can cause gastropathy.
• Smoking is known to cause gastropathy or different types of stomach disorder.
• Genetic predisposition.
• Tobacco.
• Excessive tea and coffee intake.
• Infections.
• Sleep deprivation.
• Other medical conditions.
• Stress.
• Excessive alcoholic consumption can also cause gastropathy.
• Using certain medications, which harm the lining of the stomach.

• Stomach cramps.
• Bloating can be a sign or symptom of gastropathy.
• Stomach pain.
• GERD/acidity.
• Nausea.
• Vomiting.
• Flatulence can also be a symptom of gastropathy.
• Diarrhea.
• Constipation.
• Blood in the stool.

Diarrhea: The undigested food travels to the colon and large intestine in a liquid form where the water gets absorbed by these organs thus turning the food into a more solid form. Different bacteria or viruses cause increase in the quantity of liquid, which is secreted and that moves very fast through the digestive tract before the water can be absorbed properly. This leads to diarrhea. Diarrhea is of two types: Acute diarrhea which can last for a few days to a week. Chronic diarrhea, which can be present for many days or for even longer duration for up to a few weeks. Differential diagnosis helps in determining the cause of diarrhea.

Gastritis: In our stomach, there is a balance maintained between the stomach acid and stomach wall lining which is managed by protecting mucus. Any type of disruption in this mucus causes increase in the stomach acid leading to gastritis and symptoms including abdominal pain, heartburn, nausea and vomiting. If treatment is not started, then there is increase in the pain which can become unrelenting along with internal bleeding which can be seen in stools. If the acid level is not in control, then the patient can also have blood loss, or there can be an appearance of a hole in the stomach. If there is blood in the stool, then it is important that the patient seeks immediate medical attention.

Crohn’s Disease: This is an inflammatory bowel disease, which can affect any part of the digestive tract, including the stomach. Symptoms include inflammatory ulcers, which change the wall of the stomach causing bleeding. Symptoms of Crohn’s disease include stomach pain, weight loss and diarrhea. Prompt medical attention should be sought to prevent further complications.

Gastroparesis: Millions of Americans are affected by Gastroparesis; however, this condition often goes undiagnosed. In gastroparesis, the natural movement of the stomach is disturbed and no longer occurs due to which the food is not able to properly move towards the intestines for complete digestion. The most common cause of gastroparesis is diabetes. Other causes include some type of blockage, stroke or certain cancers. Symptoms of gastroparesis include nausea, abdominal pain, vomiting and loss of appetite.

Cancers: Stomach cancer is rare and usually occurs because of changes in the acidity level. Patient may present with indistinctive symptoms of abdominal fullness, pain and weight loss. The exact cause of stomach cancer is unknown, but some of the risk factors include Helicobacter pylori infection, Ménétrier’s disease, pernicious anemia and nitrogen preservatives in food.

Endoscopy is one of the common and one of the many investigations which are done for diagnosis of gastropathy or stomach problems. Endoscopy is performed on an outpatient basis and involves the use of a small, flexible camera. Intravenous sedation is required after which the endoscope is inserted through the mouth so that the stomach and duodenum can be visualized. Biopsy samples can be taken during this procedure if required. If there is stomach bleeding, then the endoscope can be used for treating the source of bleeding using clips, laser or other injectable drugs.

Radiological studies, such as barium swallow x-rays, CT scan and MRI scan can be done to assess any chronic gastropathy. A dye is consumed and pictures are taken of the stomach and esophagus every few minutes.

Other investigations include a 24-hour pH study.

Treatment of gastropathy depends on the type of gastropathy and the cause of gastropathy. Smoking is known to cause different types of stomach disorders. Tobacco also stimulates the production of acid and hinders the production of the protective mucus. All this causes development of ulcers in most of the smokers. Excessive alcohol consumption can also lead to stomach problems i.e. gastropathy including gastritis, stomach ulcer and in some cases stomach cancer. Thus, it is important to cut down or quit smoking and drinking alcohol to prevent gastropathy.

Certain medications, such as non-steroidal anti-inflammatory drugs like aspirin which are given to relieve pain and inflammation are also one of the common causes of chronic gastropathy. These medicines damage the stomach lining and lead to ulcers. Narcotics are other type of medications, which can disturb the emptying of the stomach and lead to nausea, bloating and vomiting. Stopping these medications will relieve whatever gastropathy the patient has.

In case of diabetic gastropathy, following a good diet and maintaining proper sugar levels will give relief to the patient.

Treatment of chronic stomach problems or gastropathy comprises of lifestyle modifications. Following a healthy diet comprising of vegetables and fruits is important. The consumption of lean meat and fatty foods should be limited. A diary should be maintained of foods which cause stomach problems so that they can be avoided.

There are many characteristics or facets to gastropathy. If gastropathy is suspected, then it is imperative that the patient get a proper diagnosis and treatment done immediately.