Gastroptosis is characterized by abnormal downward displacement of the stomach. It may be part of a wider spectrum called visceroptosis.
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Epidemiology
There is paucity of literature about the actual prevalence of the condition. It is more common in females.
Clinical presentation
It has nonspecific non-life threatening symptoms. Most patients will have abdominal discomfort, nausea, vomiting and belching after taking meals. On examination, they may lack body fat. Often affected patients will be labeled as functional as there is absence of any organic cause..
Interestingly, one Japanese study found that it was protective against dyspepsia in older population and also not associated with emaciation 2.
Pathology
It is believed to be due to emaciation and relaxation of the abdominal wall muscles as well as reduction of abdominal fats, especially from lesser omentum, gastrohepatic and gastrocolic ligaments 3.
Previously, there were two theories regarding its etiology. The first was Glenard's theory, which stated that it was due to nutritional diseases causing atrophy and prolapse of bowel loops. While another theory, Stiller's theory, favored universal asthenia, characterized by degeneration.
Radiographic features
Fluoroscopy with barium swallow
It is diagnosed by barium swallow and is defined as the downward displacement of the stomach with the greater curve of the stomach partly projecting below the level of the iliac crests, in upright position. The cardiac end stays at its normal location 3.
Additional findings:
- elongated stomach
- delayed gastric emptying in upright position
- stomach ascent in lying position with commencement of normal gastric emptying
Treatment and prognosis
In the beginning of the 19th century, its treatment was surgical. However, the only indication for an operative procedure is when there is actual obstruction, which is rare 4,5.
As it is uncertain that gastroptosis itself leads to gastrointestinal symptoms, nowadays, its treatment is symptomatic with prokinetics, abdominal strengthening exercises or wearing abdominal bandages.
History and etymology
It is also called Glenard disease, named after French physician Frantz Glenard (1848-1920), who published his thesis on visceroptosis in 1833.