CLINICAL NUTRITION

Clinical Nutrition 3(2+1)

Lesson 11:Diseases of the stomach and duodenum

Symptoms and Clinical Findings

• Epigastric pain, heart bum etc due to reflux of acid into oesophagus occurring as deep hunger contraction 1 to 3 hours after meals is often the chief complaint. The pain may be described as dull, piercing, burning or gnawing and is usually relieved by the taking food or alkalis.
• Discomfort and flatulence in upper part of abdomen. The basis for the pain may be the action of unneutralised hydrochloric acid on exposed nerve fibres at the site of the ulcer.
• Pain is also associated with hyper motility of the stomach or gastric distension following ingestion of large amounts of food or liquids.
• Low plasma protein levels are often present and delay rapid and complete healing of the ulcer.
• Weight loss and iron deficiency anaemia are common.
• The intake of iron, ascorbic acid, and B complex vitamin, particularly thiamine may be less than desirable because of self imposed limitation of green leafy vegetables and other good source of these nutrients .
• In some instances, haemorrhage is the first indication of an ulcer and requires surgical intervention. Other complications such as obstruction, perforation and carcinoma of the gastric ulcer are treated surgically.
• Bleeding ulcers can result in vomiting known as haematemesis (dark brown in color).
• There are spasms of pyloric canal and this may give rise to a feeling of sickness distension and prevent taking food