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Gastropathy

Disease of Stomach


Presentation

  • RESULTS: Despite prophylactic acid suppressive therapy, upper GI bleeding findings were consistently present in high risk patients, 69.4% presenting hematemesis and 55.6% presenting coffee-ground gastric content.[ncbi.nlm.nih.gov]
  • Abstract A patient is described who had severe hyperplastic gastropathy as the presenting manifestation of systemic lupus erythematosus (SLE).[ncbi.nlm.nih.gov]
  • The most common presenting symptoms were vomiting and edema. Average symptoms' duration prior to admission was 3.2 weeks and mean albumin at presentation was 1.8 g/dl (range, 1.5-2.5 g/dl; normal values, 3.5-5 g/dl).[ncbi.nlm.nih.gov]
  • CONCLUSIONS: Bile reflux gastropathy is present in a significant proportion of patients with GERD and associated with disease severity.[ncbi.nlm.nih.gov]
  • Presentation was with weight loss and abdominal discomfort. There were endoscopic and radiological features of erosive gastritis. Radioactive chromium studies confirmed that the low serum albumin was associated with fecal protein loss.[ncbi.nlm.nih.gov]
Lymphadenopathy
  • Associated findings were hypertrophic gastric folds, hypoalbuminemia, hyperlipidemia, lymphadenopathy, edema, ascites and venous thrombosis.[ncbi.nlm.nih.gov]
Coarse Facial Features
  • Abstract Two brothers with pachydermoperiostosis, an autosomal dominant syndrome characterized by digital clubbing, periosteal new bone formation, coarse facial features with thick, furrowed, and oily skin, presented in their twenties with severe complicated[ncbi.nlm.nih.gov]
Vomiting
  • Two patients were treated with gastroenterostomy and vagotomy for intractable vomiting due to diabetic gastropathy.[ncbi.nlm.nih.gov]
  • If the bleeding is rapid and of adequate volume it may even result in vomiting of bright red blood (hematemesis).[en.wikipedia.org]
  • The patients, when seen, are usually in acute abdominal pain and vomiting or edema due to hypoproteinemia is present. Eosinophila was found in half of the recorded cases and the cause in these cases may be due to hypersensitivity.[ncbi.nlm.nih.gov]
  • The most common presenting symptoms were vomiting and edema. Average symptoms' duration prior to admission was 3.2 weeks and mean albumin at presentation was 1.8 g/dl (range, 1.5-2.5 g/dl; normal values, 3.5-5 g/dl).[ncbi.nlm.nih.gov]
  • These symptoms may include abdominal pain, nausea, heartburn and vomiting. Without proper medical attention, the pain can grow, becoming continuous, and there may be internal bleeding that can be seen in stools.[westmedical.com]
Nausea
  • However, since the symptoms are localized to this organ, the typical symptoms of stomach problems include nausea, vomiting, bloating, cramps, diarrhea and pain.[en.wikipedia.org]
  • We report the case of a 45-year-old man with HHGP who presented with nausea and anorexia. The patient had no underlying disease and was not on medication. Esophagogastroduodenoscopy and CT showed a thickening of the gastric folds in the stomach.[ncbi.nlm.nih.gov]
  • Some symptoms that can occur may include ulcerations on the stomach lining and recurrent nausea. Stomach bleeding may or may not be directly related to the condition.[wisegeekhealth.com]
  • These symptoms may include abdominal pain, nausea, heartburn and vomiting. Without proper medical attention, the pain can grow, becoming continuous, and there may be internal bleeding that can be seen in stools.[westmedical.com]
  • Koch KL, Bingaman S, Xu L, Stern RM, Muth E: Acute effects of acustimulation at Neiguan point on nausea and gastric myoelectrical activity in patients with chronic nausea. Gastroenterology 112(suppl):A763, 1997 Google Scholar 63.[link.springer.com]
Abdominal Pain
  • Remnant gastropathy due to bile reflux is a treatable cause of chronic abdominal pain in RYGB patients, and ursodiol should be considered for empiric treatment in RYGB patients with unexplained chronic abdominal pain.[ncbi.nlm.nih.gov]
  • The patient was relieved of anorexia, abdominal pain, and diarrhea.[ncbi.nlm.nih.gov]
  • Data from hospitals indicate that more than 25% of the population suffers from some type of chronic stomach disorder including abdominal pain and indigestion.[en.wikipedia.org]
  • The patients, when seen, are usually in acute abdominal pain and vomiting or edema due to hypoproteinemia is present. Eosinophila was found in half of the recorded cases and the cause in these cases may be due to hypersensitivity.[ncbi.nlm.nih.gov]
  • These symptoms may include abdominal pain, nausea, heartburn and vomiting. Without proper medical attention, the pain can grow, becoming continuous, and there may be internal bleeding that can be seen in stools.[westmedical.com]
Dyspepsia
  • Their father and one paternal uncle also had pachydermoperiostosis and a past history of ulcer dyspepsia. The mother, one sister, two maternal aunts, and one other paternal uncle were healthy.[ncbi.nlm.nih.gov]
  • METHODS: Biopsy specimens were obtained during upper gastrointestinal endoscopy from 167 subjects (125 Indonesians and 42 Japanese) with uninvestigated symptoms of dyspepsia.[ncbi.nlm.nih.gov]
  • Characteristically, patients with Ménétrièr's disease are older than 60 years of age and have epigastric pain, weight loss, nausea, diarrhea, and dyspepsia, with or without a history of peptic ulcer disease.[annals.org]
  • Hausken T, Berstad A: Wide gastric antrum in patients with non-ulcer dyspepsia. Effect of cisapride. Scand J Gastroenterol 27:427–432, 1992 Google Scholar 29.[link.springer.com]
  • However, there are many other stomach diseases that don't include the word "gastropathy" such as gastric or peptic ulcer disease, gastroparesis, and dyspepsia. Many stomach diseases are associated with infection.[en.wikipedia.org]
Epigastric Pain
  • A total gastrectomy was done for relief of persistent epigastric pain and correction of hypoproteinemia. Histologically the polyps consisted of hypertrophied mucosal glands with cystic dilatation deep to the glandular layer.[ncbi.nlm.nih.gov]
  • Characteristically, patients with Ménétrièr's disease are older than 60 years of age and have epigastric pain, weight loss, nausea, diarrhea, and dyspepsia, with or without a history of peptic ulcer disease.[annals.org]
  • Symptoms may include epigastric pain, a bloated feeling and nausea; these most often resolve within a week. After approximately two weeks the reaction evolves into an active chronic gastritis.[cmej.org.za]
  • pain secondary to NSAID use, and the MDs must recognize, diagnose, and determine the best course of action.[physio-pedia.com]
Aphthous Ulceration
  • BACKGROUND AND STUDY AIMS: Oral sodium phosphate (NaP) solution is widely used for colonoscopy bowel preparation and it may cause aphthous ulcers in the colon.[ncbi.nlm.nih.gov]

Workup

  • METHODS: All consecutive patients with RYGB and a diagnosis of chronic abdominal pain, and a negative diagnostic workup (including physical examination, routine laboratory work, cross-sectional imaging, and standard upper endoscopy), who underwent device-assisted[ncbi.nlm.nih.gov]
  • A complete laboratory workup evidenced normal complete blood cell count, blood urea nitrogen, creatinine, sodium, and potassium.[care.diabetesjournals.org]
  • An extensive workup, including ultrasonography (cases 1-4 and 9), computed tomographic (cases 1-4 and 6-9), and 2-[fluorine-18]fluoro-2-deoxy- d -glucose positron emission tomographic scans (cases 2, 4, 6, and 8); colonoscopy (cases 2, 4-6, and 9); and[bloodjournal.org]

Treatment

  • Remnant gastropathy due to bile reflux is a treatable cause of chronic abdominal pain in RYGB patients, and ursodiol should be considered for empiric treatment in RYGB patients with unexplained chronic abdominal pain.[ncbi.nlm.nih.gov]
  • Three previous case reports have noted a response of idiopathic hyperplastic gastropathy to systemic corticosteroid treatment, yet none of the presented patients had a systemic inflammatory disease.[ncbi.nlm.nih.gov]
  • Treatment with cimetidine for more than three years had little benefit when colonisation by H pylori was detected.[ncbi.nlm.nih.gov]
  • Since the course of this disease is not favorable with medical treatment, an operation should be done for patients with life threatening complications and intractable symptoms.[ncbi.nlm.nih.gov]
  • The 34-year-old patient had complete resolution of the disease without antiviral treatment. To our knowledge the present report is the first case of CMV-associated protein-losing hypertrophic gastropathy in an immunocompetent adult.[ncbi.nlm.nih.gov]

Prognosis

  • In adults, the natural course of the disease is marked by a chronic course and carries a bad prognosis.[ncbi.nlm.nih.gov]
  • Distinction from Menetrier's disease is emphasized as the condition is characterized by abrupt onset, short duration, eosinophila and good prognosis. The association with hypersensitivity as a possible etiology is more suggestive in this condition.[ncbi.nlm.nih.gov]
  • Portal hypertensive gastropathy: correlation with portal hypertension and prognosis in cirrhosis. Dig Dis Sci 2010;55:3561-3567. 20407828. 24. Pérez-Ayuso RM, Piqueé JM, Bosch J, Panés J, González A, Pérez R, et al.[e-cmh.org]
  • In contrast to H pylori gastritis, the surface epithelium lacked Ki67 expression and a downward elongation of the proliferative zone was noted. [27] Prognosis and Predictive Factors The finding of reactive gastropathy indicates the presence of an offending[emedicine.medscape.com]
  • See Answer Certain factors affect prognosis (chance of recovery) and treatment options.[medicinenet.com]

Etiology

  • Gov't MeSH terms Animals Animals, Newborn Cardiomyopathies/etiology Cardiomyopathies/metabolism Cardiomyopathies/pathology* Case-Control Studies Cells, Cultured Exome/genetics Female Gastritis, Hypertrophic/etiology Gastritis, Hypertrophic/metabolism[ncbi.nlm.nih.gov]
  • The association with hypersensitivity as a possible etiology is more suggestive in this condition. The radiographic changes will often provide the first clue to this condition and rapid reversal of the gastric changes is diagnostic.[ncbi.nlm.nih.gov]
  • Abstract Lymphomatoid gastropathy, which was first reported in 2010, is a rare NK-cell proliferation of cyCD3, CD4, CD5, CD8, CD56 phenotypes with unknown etiology.[ncbi.nlm.nih.gov]
  • There is Helicobacter pylori (HP) in most of the stomach pathologies as the etiologic agent. No matter if the factor is HP or other etiologic agents, the tissue gives similar responses.[ncbi.nlm.nih.gov]
  • Thus, the gastric immunotactoid deposits in this case appear to be an isolated finding of light chain deposition, of which the significance and etiology are unclear.[ncbi.nlm.nih.gov]

Epidemiology

  • BACKGROUND: The epidemiology of reactive gastropathy and its relationship with other conditions of the gastrointestinal tract associated with NSAID use have not been evaluated.[ncbi.nlm.nih.gov]
  • Epidemiology The main cause of PHG is liver cirrhosis. Even though about 65% of patients with portal hypertension develops PHG, it occurs greatly in patients with liver diseases.[news-medical.net]
  • Epidemiology General assocations: Increases with age. [2] Etologic factors - associated with: [3] Excess acid. Alcohol use (excessive). Bile (reflux). May be seen post-Bilroth II (distal gastrectomy). Drugs. [1] Iron (brown pigment on histology).[librepathology.org]
  • Epidemiology and course of acute upper gastrointestinal haemorrhage in four French geographical areas. Eur J Gastroenterol Hepatol 2000;12:175-181. 10741931. 5. Christensen E, Fauerholdt L, Schlichting P, Juhl E, Poulsen H, Tygstrup N.[e-cmh.org]
  • Epidemiology of infection. In: Mobley HLT, Mendz GL, Hazell SL, eds. Helicobacter pylori: Physiology and Genetics.Washington DC: ASM Press, 2001. Odze RD, Goldblum JR, eds.[cmej.org.za]
Sex distribution
Age distribution

Pathophysiology

  • Careful clinical and endoscopic follow-up is required for the diagnosis of lymphomatoid gastropathy, and additional case studies and molecular studies are warranted to further investigate the pathophysiology of this peculiar benign mimic of lymphoma.[ncbi.nlm.nih.gov]
  • Specific sections deal with Physiology and Pathophysiology, Clinical Presentation of Disease, Clinical Manifestations and Management (discussing the Mouth and Esophagus, The Stomach and Duodenum, The Intestine, and The Pancreas), Diagnosis of Gastrointestinal[books.google.com]
  • Unlike others on this topic, this text demonstrates how the endoscope incorporates pathophysiology, diagnostic, and treatment modalities into endoscopic practice.[books.google.com]
  • Preview Received: November 04, 1992 Published online: February 05, 2009 Number of Print Pages: 3 Number of Figures: 0 Number of Tables: 0 ISSN: 0012-2823 (Print) eISSN: 1421-9867 (Online) For additional information: Abstract In order to investigate some pathophysiological[karger.com]
  • As the pathophysiology of diabeticgastropathy is better understood, more specific andimproved treatments will evolve.[link.springer.com]

Prevention

  • Prevention of NSAID-related gastropathy is an important clinical issue, and therapeutic strategies for both the primary and secondary prevention of adverse events are continually evolving.[ncbi.nlm.nih.gov]
  • The distinct mechanisms of NSAID-induced injury in the stomach/proximal duodenum versus the more distal small intestine likely dictate distinct strategies for prevention. 2011 The Author.[ncbi.nlm.nih.gov]
  • Propranolol was equally effective in preventing recurrent bleeding from gastritis and esophageal varices.[acpjc.acponline.org]
  • If treatment with anticholinergic drugs and inhibitors of gastric acid secretion fails, total gastrectomy is the best solution, because it stops protein loss, eliminates hyperchlorhydria, prevents development of gastric carcinoma, and permits anastomotic[ncbi.nlm.nih.gov]
  • BACKGROUND: The 1999 ASHP (American Society of Health-System Pharmacists) recommendation regarding the prevention of stress-related mucosal disease and bleeding in critical care patients by using PPI and H2RA still holds.[ncbi.nlm.nih.gov]

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