The stomach is part of the digestive tract.

The food that is eaten is transported further into the stomach via the esophagus. In the stomach, the food is mixed with gastric juice (highly concentrated hydrochloric acid) and a protein-splitting enzyme pepsin, the pulp is brought to body temperature, mixed and released in portions to the duodenum and subsequently the small intestine.

The hydrochloric acid in the stomach not only has an important digestive function, but also provides effective protection and a barrier against viruses, bacteria and fungi.

gastritis

Symptoms and types of gastritis

The most common disease of the stomach is gastritis (inflammation of the stomach), which can occur either acutely with severe pain in the middle upper abdomen during or shortly after eating or chronically . In addition, nausea or vomiting can occur. A distinction is made between the following forms:

  • Type A: atrophic (autoimmune) gastritis
  • Type B: bacterial, Helicobacter pylori
  • Type C: chemically through certain drugs such as NSAIDs (classic pain medication), Gallereflux from the duodenum

Type A gastritis is rather rare and there are vitamin B12 deficiencies and the resulting anemia. Regular gastroscopy and blood count checks and substitution of vitamin B12 are useful. An increased risk of gastric cancer is associated with this type of gastritis.

Type B (60-85%) and C gastritids (10-30%) are the most common. The eradication therapy of the Helicobacter with a triple administration of antibiotics under gastric protection, a drug that reduces the release of gastric acid (PPI) and thus facilitates the healing of the gastric mucosa, is in any case with a Helicobacter pylori positive gastritis, with a gastric ulcer (ulcus ventriculi ) and also indicated for gastric cancer. It is known that a Helicobacter infection promotes the development of at least gastric ulcers, but also gastric carcinomas (stomach cancer). The success should be documented via a stool test 4-6 weeks after completion of the treatment. This check is important because the Helicobacter is a resistant germ. If symptoms recur later and Helicobacter is detected, it is important to know when choosing the antibiotics whether the germ was successfully treated during the last therapy or not. The infection rate with Helicobacter is very high in the Eastern European countries and figures up to almost 90% of the population are given. The risk of infection or renewed infection is therefore very high (saliva, stool). It is also important to test family members or people with whom you are intimate before your own therapy for Helicobacter and, if necessary, treat them, otherwise a "ping-pong effect" can occur. In the case of germs resistant to antibiotics, a culture of the Helicobacter and a resistance determination to various antibiotics should be carried out in order to select the suitable one to which the germ is sensitive.

Benign gastric tumors

Benign gastric tumors are usually hyperplastic polyps or glandular cysts (harmatoms). Other tumors exist, but are very rare.

Malignant diseases of the stomach

Gastric cancer

Malignant gastric tumors, such as gastric carcinoma, are generally not so common in the western world since the use of gastric drugs that reduce acid production, so-called PPIs (proton pump inhibitors such as Pantoloc, Nexium, etc.) and the eradication of Helicobacter. Another risk factor is nitrosamine.

Like most cancers, gastric cancer is completely asymptomatic in its early stages. As always, early detection is essential in order to be able to diagnose a possible tumor disease at the very beginning. The very best chance of recovery is at this stage. For this reason, preventive examinations (screening) are given special priority.

Symptoms

If the disease has persisted for a long time, gastritis-like symptoms (nausea, vomiting, epigastric pain, bloating, loss of appetite and disgust for meat) or bleeding, which can be detected in the stool with rapid tests or are even visible . Since the iron in the red blood pigment (hemoglobin) is reduced by the action of gastric acid on the blood, the stool turns black in most cases (melena) when the stomach bleeds.

Likewise, blood is the best emetic (emetic) and therefore vomiting larger amounts of blood in the stomach leads to blood vomiting.

Diagnostics

After a detailed survey of the medical history and the possible risk factors, the first method of choice to clarify a problem in the stomach is gastroscopy (gastroscopy). The esophagus, stomach and duodenum are examined in great detail with our state-of-the-art high definition (HD) devices. In addition to so-called chromoendoscopy, in which dyes are applied to the mucous membrane in order to emphasize the contrast between the individual structures and ultimately also between the tumor and normal mucous membrane, so-called NBI (narrow band imaging) are also available. Together with chromoendoscopy, an optimal diagnostic tool is created here to reveal even the smallest pathologies.

Don't worry - the gastroscopy is performed by me in a twilight sleep (gentle endoscopy, gastroscopy), just like the colonoscopy. The examination is completely painless and you overslept the entire procedure.

Depending on the illness, further examinations are then connected or a suitable therapy is prescribed.

I would be happy to advise you and, if necessary, perform a gastroscopy in twilight sleep (sedation) to clarify your symptoms. Then we will work together to create a therapy concept that is tailored to you .