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This is a vague problem that is functional in nature and usually not due to an underlying structural cause. Belching, distension and abdominal sounds often occur in association with abdominal or epigastric pain. Dietary factors are often important in reducing symptoms; because similar symptoms may be due to more serious conditions, it is important to have an accurate diagnosis. Numerous conditions are possible in this area, some of which are:- Cardiospasm: Dilation of the esophagus due to the gastroesophageal sphincter failing to open properly and allow food into the stomach.
- Gastroesophageal Reflux Disease (GERD): Incompetent cardiac sphincter, causing backward flow of acid from the stomach up into the esophagus.
- Gastric Mucosal Tears: Lacerations in the mucosa of the gastroesophageal junction, where the esophagus passes through the diaphragm, or in the lining of the lower esophagus. Generally caused by repeated vomiting or retching (repetitive contractions of the abdominal muscles), it can cause profuse hemorrhaging.
- Esophageal Stricture: Narrowing of the esophagus due to scar tissue, resulting in difficulty swallowing.
- Esophageal Obstruction: Blockage of the esophagus caused by tumors or other foreign bodies such as improperly chewed food (often large pieces of meat) impacted in the lower esophagus.
- Esophageal Varices: Enlarged veins in the lower esophagus are a common complication of liver cirrhosis. If these veins rupture, massive bleeding may result.
- Hiatal Hernia: Movement of the upper part of the stomach up into the chest cavity resulting in retention of acid and other stomach contents which can then easily reflux into the lower esophagus.
- Dumping Syndrome: Rapid gastric emptying caused by the lower end of the small intestine (jejunum) filling too quickly with undigested food from the stomach. Symptoms include nausea, vomiting, diarrhea, bloating, shortness of breath, weakness, and dizziness. Stomach surgery is the main cause.
- Hypochlorhydria and achlorhydria: Insufficient stomach acid to sterilize the stomach and start protein digestion.
- Menetrier’s Disease: A chronic condition with an unknown cause. Giant folds of tissue, possibly inflamed or containing ulcers, grow in the wall of the stomach and can interfere with the body’s absorption of some proteins.
- Whipple’s Disease: A malabsorption disease caused by bacteria. Although it can affect any system of the body, it usually attacks the small intestine. It interferes with the body’s ability to absorb certain nutrients, causing weight loss, irregular breakdown of carbohydrates and fats, resistance to insulin, and malfunctions of the immune system. The disease can be cured, but if not recognized, it is usually fatal.
- Zollinger-Ellison Syndrome: Another disease of unknown cause leading to gastrin-secreting tumors in the pancreas, which promote an extreme form of peptic ulcer disease in both the stomach and duodenum.
- Peptic Ulcer Disease (PUD): Over 20 million Americans will suffer from a peptic ulcer in their lifetime.
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