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Does a J shaped stomach lead to delay in emptying?

Thursday, 14 July 2005
Answered by: Dr. Venk Mani
Consultant Physician,
Leigh Infirmary,
UK
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Q. I am 25 years old and suffering from delay in gastric emptying for the past five years. I have done all tests including CT, endoscopy, H. pylori, thyroid function etc. and all are normal. My barium test done shows delay due to J shaped stomach. I was informed that my stomach has become sluggish, that is why there is delay in emptying. Please advise.

A.  J shaped stomach is an accepted variation of normal anatomy of the stomach. However, this should not cause delay in gastric emptying. Delay in gastric emptying can occur in many people due to various factors in day to day life but it is always transient and does not persist. From your mail I notice that you are having regular symptoms. It occurs in chronic diabetes as a part of visceral neuropathy and I note that you do not suffer from diabetes. This makes me think about a rare condition called pseudo-obstruction. This is a very rare condition and usually affects the small intestines but can affect any part of the digestive tract, including the stomach. It can be secondary to certain drugs or primary which can be familial. It is said to be due to faulty innervation of the stomach which is congenital. Most of the symptoms are mild when the stomach is affected and invariably responds to Dompiridone. However if this does not help one would need a minor gastric surgery called gastro-entereostomy when the small intestine is connected to the stomach to drain the stomach. I have only had the opportunity of treating two patients, a father and son and both of them are well now. But please do not take it that you have this problem and I would suggest you to see an appropriate specialist before venturing on surgey.

A.  J shaped stomach is an accepted variation of normal anatomy of the stomach. However, this should not cause delay in gastric emptying. Delay in gastric emptying can occur in many people due to various factors in day to day life but it is always transient and does not persist. From your mail I notice that you are having regular symptoms. It occurs in chronic diabetes as a part of visceral neuropathy and I note that you do not suffer from diabetes. This makes me think about a rare condition called pseudo-obstruction. This is a very rare condition and usually affects the small intestines but can affect any part of the digestive tract, including the stomach. It can be secondary to certain drugs or primary which can be familial. It is said to be due to faulty innervation of the stomach which is congenital. Most of the symptoms are mild when the stomach is affected and invariably responds to Dompiridone. However if this does not help one would need a minor gastric surgery called gastro-entereostomy when the small intestine is connected to the stomach to drain the stomach. I have only had the opportunity of treating two patients, a father and son and both of them are well now. But please do not take it that you have this problem and I would suggest you to see an appropriate specialist before venturing on surgey.

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