Dilatation of the stomach is a much more common and serious affection
than prolapse of the stomach, although usually the two are associated.
Prolapse, or ptosis, of the stomach means simply a downward
displacement of the organ. This is apt to take place in those cases
where all of the abdominal organs have gravitated. There is invariably
some dilatation of the organ as well.
Weakness of the abdominal walls and of the supports of the stomach
constitute the principal =causes= of the prolapse. Spinal deviations
that impinge or obstruct the nerve strands (or obstruct the blood and
lymph supply to these strands) to the supporting stomach tissues is
the most frequent cause of the ailment. General debilitating diseases,
as anemia, cancer, etc., are indirect causes of weakened organs with
consequent displacements.
In dilatation of the stomach the condition may be either acute or
chronic. The former is found where immense amounts of food or drink
have been introduced.
One of the principal causes of chronic dilatation is some obstruction
to the opening from the stomach into the intestine, so that the stomach
contents do not pass readily into the bowel. This leads to chronic
disturbances of the stomach walls, and the food remaining in the
stomach somewhat indefinitely weights down and stretches the walls
of the stomach. The obstruction may be a tumor, or some stricture or
adhesion from scar tissue resulting from ulceration or inflammation.
The treatment of these cases comes within the province of surgical
interference rather than other methods.
The second important cause of chronic dilatation is muscular weakness
of the walls from poor nerve supply. This is a common cause and
osteopathy is very successful in curing these cases. The splanchnic
nerves are below normal, usually from a slight lateral or posterior
spinal curvature. The nerve force to the walls of the stomach not
being normal causes atony of the muscles and dilatation results. This
nervo-muscular atony, also, results from a chronic catarrh, or from a
general nutritional disorder as tuberculosis or anemia. The treatment
of the former would imply direct correction of nerve and blood supply
with attention to diet; the latter can be cured only through relieving
the nutritional disorder of which the stomach condition is a symptom.
Dilatation of the stomach is most common in people of middle age or
older. The disease is usually easily diagnosed. The symptoms may
not be indicative of the trouble beyond showing that the stomach is
disturbed. Indigestion, uneasiness, and nausea are common. Vomiting
of large quantities of material from the stomach is likely to occur.
The patient is generally emaciated, the skin is dry, the bowels
constipated, and the urine scanty.
The =diagnosis=, as a rule, is not hard to make. Through the media
of inspection, palpation and percussion, the careful osteopath will
have little trouble to determine the size of the stomach. Kemp’s[45]
distinction between gastroptosia and dilatation of the stomach is as
follows: “In dilatation the lesser curvature retains its relation
to the diaphragm. The distance between the lesser and the greater
curvature is increased, but the lesser curvature still maintains its
relation to the diaphragm, with the exception that the pyloric end may
extend farther over and somewhat farther down.” Another instructive
point relative to diagnosis the above authors make is the importance
of the splashing sound. Owing to the fact that the stomach in health
closes concentrically about its contents and thus adapts itself to the
volume of ingesta, no splashing sound can be elicited. Three different
degrees of relaxation are diagnosticated as follows: “Splashing sound,
which can be elicited only during the normal period of digestion, means
simple atony; splashing sound produced after the legitimate time of
digestion has expired means motor insufficiency; and splashing sound
produced in the morning, after the night’s fasting, before liquid
or food has been introduced, may mean stagnation, dilatation of the
stomach, as understood by most writers.” (For a more complete outline
see Dilatation of the Stomach. The object of this section is to present
an outline of prolapsed organs as a whole, and to refer especially to
the effectiveness of osteopathic treatment in this condition).
This is a disease where osteopathy has been particularly successful in
not only relieving distressing symptoms, but in actually curing the
disorder. This refers to the nervo-muscular atony type, for where there
is obstruction due to stricture or tumor of the pylorus, resulting in
stomach dilatation, the treatment, from the very nature of things, must
be largely surgical. Stomachs that have been dilated and prolapsed
several inches have been entirely restored to function and organic
integrity. To =cure= these cases is a matter of stimulating nerve
control and blood supply to the stomach tissues, and, often of greater
importance, removing spinal impingements to the stomach nerve fibers,
thus allowing nature to fully assert herself. In reality, outside of
so-termed surgical cases and other cases where the stomach dilatation
is merely a symptom of general nutritional disorder, the primary
treatment, by far, is the spinal one. Treatment over the stomach
is a decidedly beneficial treatment; it aids materially in toning
both abdominal and stomach muscles; still this is mostly a secondary
treatment.
Dieting is essential. Careful dieting lessens the tendency to catarrhal
inflammation and reduces the work of the stomach to a minimum. Still,
nourishing food is necessary and the dieting can easily be carried to
an extreme. Liquids should not be taken freely. Fatty and starchy foods
should be eliminated. Give the patient food at short intervals. Various
nutritious meats are excellent.
In dilatation, and also general abdominal relaxation, daily abdominal
treatments may be indicated. If the relaxation is pronounced, keeping
the patient in bed with thorough spinal treatment two or three times a
week, daily abdominal treatment, having the patient exercise abdominal
parietes by drawing the walls in and up, upper thoracic breathing,
and frequent feeding will accomplish comparatively quick results. The
progress of each case depends very materially upon the general health,
the physical status of other tissues, constitution, inheritance,
environment, age, etc. Some cases will yield in two or three months,
others will require two or three years in order to obtain the greatest
possible benefit.