3. Gastric hypersecretion syndrome

REASONS: Duodenal ulcer, chronic gastritis with hypersecretion, Zollinger-Ellison syndrome,

chronic pancreatitis.

SYMPTOMS:

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1. Heartburn, belching, vomiting, acidic, appetite maintained or increased, spastic constipation.

2. The possibility of pain in the pyloroduodenal zone, often later.

3. Radiologically in the pyloroduodenal department: functional (spasm), organic (―ulcerative niche‖, deformation, perigastritis, periduodenitis).

4. Laboratory data - gastric secretion: hypersecretion of hydrochloric acid and (or) pepsin (in the inter-digestive period or in response to stimulation).

5. Daily PH-metry allows you to verify the diagnosis.

4. Gastric hyposecretion syndrome

REASONS: Cancer of the stomach, chronic gastritis with decreased secretory function of the

stomach, involutional changes.

SYMPTOMS:

1. A feeling of heaviness in the epigastric region, sometimes aching, dull pains, nausea after eating, belching rotten, appetite reduced, tendency to diarrhea (urges to "bottom" immediately after eating) without pain, flatulence.

2. Radiologically - compacted folds of the gastric mucosa.

3. EFGDS - signs of chronic gastritis, atrophy of the fundus glands of an early degree.

4. Laboratory - reduced amount of hydrochloric acid and pepsin. PH-metrics even in response to maximum stimulation with histamine, up to achlorhydria (absence of hydrochloric acid) and achilia (absence of hydrochloric acid and pepsin).

5. Blood - possible anemia of B-12 folate deficiency.

6. Feces decorated or mushy, dark brown, a lot of undigested muscle fibers, undigested fiber, a little starch.

5. Syndrome of gastric evacuation

REASONS: peptic ulcer of the duodenum, complicated by pyloric stenosis, tumor of the pyloric

stomach and head of the pancreas.

SYMPTOMS:

1. Constant or paroxysmal pains (pylorospasms) in the epigastric region, aggravated by evening and at the height of digestion, sour belching, with the smell of ―rotten eggs‖, profuse vomiting with the remnants of food eaten ―the day before‖ and not bringing relief, constipation, alternating diarrhea.

2. With decompensated stenosis, the patient is depleted, sometimes peristalsis and antiperistalsis of the stomach are visible in the epigastrium. With severe stenosis, there is a large curvature of the stomach below the navel; late splashing noise is often determined - a positive symptom of Vasilenko.

3. Radiological - the evacuation of the contrast mass from the stomach to the duodenum is slow, but quickly occurs after exposure to atropine, (compensated stenosis), does not change after pharmacological treatment with decompensated stenosis, gastric tetany syndrome (chlorohydropenic) develops.

4. EFGDS - narrowing of the output section of the stomach

5. An increase in the remainder of an empty stomach (more than 200 ml)

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Pic 4.2 Pyloric stenosis (enlarged stomach in the pelvis)