Gastric Disease
Gastroparesis
This is a condition where muscles in the stomach do not move food properly for it to be digested. It can be characterized by the following:
- Early satiety, or “feeling full”
- Bloating
- Nausea
- Vomiting
- Loss of appetiteUnintentional weight loss
There are several tests that may be used to diagnose gastroparesis. The first category is a gastric emptying test, which evaluates how quickly your stomach empties. One is scintigraphy. In this test, you eat a light meal with a very small amount of radioactivity and then a scanner is used to see the rate and which the radioactivity (and thus the food) leaves the stomach. There are also breath tests; in these you consume a food and then samples of your breath are collected to see how much trace amount of that food shows up in your breath; this also shows how fast your stomach is emptied.
Another option is an upper GI endoscopy, which is where a small camera on the end of a flexible tube is placed in the esophagus to see the esophagus and the beginning of the small intestine. Or an ultrasound can be used to see if the problems you’re having are associated with the gallbladder or kidneys.
There are several medicines that help stomach muscles work, with varying side effects and likelihood of working. There are also medicines that can be used to control nausea and vomiting. In severe gastroparesis, sometimes a feeding tube is used.
Gastric Antral Vascular Ectasia (GAVE)
Gastric Antral Vascular Ectasia (GAVE) is a condition that affects the stomach. It is sometimes called “watermelon stomach” because the stomach lining has red stripes that look like the outside of a watermelon. It is when blood vessels near the surface of the stomach lining have become widened, weaker, and prone to bleeding.
Doctors are not sure exactly why this occurs, nor how many people with scleroderma have GAVE. Not everyone is tested for it. GAVE is more common in people with early diffuse scleroderma and people who have RNA polymerase III antibodies, but it can happen to anyone with scleroderma.
It often presents with no symptoms in the stomach. Instead, GAVE can cause slow bleeding in the stomach which over time, can lead to anemia and its symptoms.
You may notice:
- Feeling very tired
- Feeling weak
- Feeling dizzy
- Shortness of breath
Most people do not see blood in their stool because the bleeding happens very slowly.
Your doctor can look inside your stomach with a test called an upper endoscopy (EGD). During this test, a small camera is passed through your mouth into your stomach. A biopsy is usually not needed.
GAVE is often treated during the endoscopy. The most common treatment is called argon plasma coagulation (APC). This treatment uses heat to seal the small blood vessels that are bleeding.
If GAVE has caused anemia, your doctor may also recommend:
- Iron pills
- Iron given through an IV
- A blood transfusion if the anemia is severe