Gastric retention

　　Functional gastric retention is often caused by hypotonia of the stomach (gastric atony). In addition, gastric motility disorders caused by abdominal surgery, central nervous system diseases, neuropathy caused by diabetes, vagotomy, and other factors can also lead to this condition. Uremia, acidosis, hypokalemia, hypocalcemia, systemic or intra-abdominal infection, severe pain, severe anemia, and the use of antipsychotic drugs and anticholinergic drugs can also cause this condition.

　　In addition to its clinical manifestations, gastric retention can also cause other diseases. This condition can present with varying degrees of anemia, hypoalbuminemia, electrolyte and acid-base imbalance, and pre-renal azotemia, among others.

　　If there is vomiting of indigestible food and there is a tympanic sound in the abdomen when fasting, it indicates gastric retention. After eating for 4 hours, food can be aspirated from the stomach through a gastric tube to confirm the diagnosis.

　　During gastrointestinal barium meal examination, if the barium still remains in 50% of the stomach 4 hours later, or has not been evacuated 6 hours later, it is indicative of this condition. Attention should be paid to the differentiation between organic and functional gastric retention, where the former has increased gastric peristalsis and the latter has decreased gastric tone and reduced peristalsis.

　　1. Vomiting is the main symptom of this disease, which can occur at any time of the day, from once to several times a day. The vomitus is often indigestible food, usually without bile, and upper abdominal distension and pain are also common. Abdominal pain can be dull, cramping, or burning pain. Symptoms can temporarily improve after vomiting, and acute patients may experience dehydration and electrolyte metabolic disorders; chronic patients may have malnutrition and weight loss. Severe or long-term vomiting can cause alkalosis due to the loss of a large amount of gastric acid and potassium ions, leading to cramps in the hands and feet.

　　2. Physical examination may show signs of dehydration, distension of the upper abdomen, tenderness in the upper and middle abdomen with tympany, and the presence of a gastric shape with an enhanced left-to-right gastric peristalsis wave, which often suggests obstruction at the gastric outlet; if only the gastric shape is seen without peristalsis waves, it suggests hypotonia of the stomach.

　　When starting to eat, it is advisable to provide a small amount of congee, lotus root starch, and other light, fluid foods, limited to 30-60 milliliters per time. If there is no discomfort, it can be gradually increased to 150 milliliters. Foods with particles and those that produce gas, such as milk, are not suitable for consumption. Eating should be in small portions and frequent meals, focusing on easily digestible fluid foods. Pay attention to avoiding raw, cold, sour, spicy, and greasy foods, and do not overeat or drink. Pay attention to a light diet, avoid刺激性 foods, reduce greasiness, and increase water intake.

　　1. Blood test:It can be seen that there are varying degrees of anemia, hypoproteinemia, hypokalemia, hypocalcemia, and blood gas analysis suggests acid-base imbalance. Some patients may have increased blood urea nitrogen.

　　2. Gastrointestinal X-ray examination:Under X-ray, barium still remains 50% after 4 hours, or has not been excreted after 6 hours.

　　3. Ultrasound:Gastrointestinal ultrasound can detect a cystic and solid mass in the upper abdomen or left upper abdomen, that is, the stomach shape, with anechoic area inside, floating light spots and light clusters, moving to the lower position of gravity with the body position, and the mass will also shrink after the lower gastric tube is aspirated.

　　4. Gastroscopy:Under gastroscopy, a large amount of retained material can be seen.

　　5. Gastric tube absorption:The gastric tube can suck out the food intake 4 hours ago.

　　1. Eat less fried foods:Because these foods are not easy to digest, they will increase the burden on the digestive tract, and eating more will cause indigestion, and will also increase blood lipids, which is not good for health.

　　2. Eat less preserved foods:These foods contain a lot of salt and certain carcinogens, which are not suitable for eating in large quantities.

　　3. Eat less cold and spicy foods:Cold and spicy foods have a strong stimulating effect on the mucous membrane of the digestive tract, which is easy to cause diarrhea or inflammation of the digestive tract.

　　4. Regular diet:Research shows that regular meals, with fixed time and quantity, can form a conditioned reflex, which is beneficial to the secretion of digestive glands and more conducive to digestion.

　　1. General treatment, provide low-fiber diet, supplement vitamins and trace elements.

　　2. Correct water, electrolyte and acid-base imbalance.

　　3. Symptomatic treatment, administration of gastrointestinal motility-promoting drugs (Metoclopramide, Domperidone).

　　4. Traditional Chinese medicine treatment, mainly to strengthen the spleen and stomach, supplemented by physical exercise and diet adjustment, to benefit Qi and enhance Yang, nourish Yin and replenish the film, Qi-boosting and spleen-strengthening drugs, such as, Cimicifuga, Flos Chrysanthemi, Syzygium aromaticum, Amomum villosum, Platycodon grandiflorus, Hericium erinaceus, Asparagus cochinchinensis, etc. effective Chinese medicine.