Skip to content

Muscle Spasm And Muscle Cramps 

Photo by gastroscopy showing ulcer in the antrum area of the stomach.
Photo by gastroscopy showing ulcer in the antrum area of the stomach (lower area).

What Is A Gastric Ulcer?

G astric ulcer is a painful stomach disorder characterized by an open sore involving the mucosa lining and deeper muscle layer of the stomach.

Gastric ulcer is associated with lymphocytic gastritis which is inflammation of the mucosal lining of the stomach. The thick mucosal lining normally protects the stomach from the erosive action of stomach acid.

Q: How do ulcers develop?

A: Ulcers develop if  hydrochloric acid secreted by the gastric glands of the stomach for the purpose of digesting food damages the normally resistant mucosal walls of the stomach. In the reverse, ulcers may be accompanied by achlorhydria (insufficient acid production).

Damage occurs when there is a predisposing factor that alters the health of the mucosal lining. The most common cause is infection with a bacteria called h. pylori bacter, stress and chronic use of the pain relievers aspirin and non-steroidal drugs like ibuprofen.

Smoking tocacco and consuming alcohol aggravate an ulcer but do not cause it to develop.

The most common location for ulcer formation is along the stomach antrum which is the area of the stomach before the pylorus, the lower region that empties liquid stomach contents into the small intestine.

What Is A Gastric Ulcer In Celiac Disease and/or Gluten Sensitivity?

Chronic Fatigue / Lassitude / Tiredness

What Are Erosions In The Second Part Of The Duodenum?

E rosions in the second part of the duodenum typically are superficial excoriations (sores) in the mucosal lining that do not penetrate into the muscle layer as does an ulcer.

Of note, most erosions develop in the first part of the duodenum rather than the second part.

Q: Are duodenal erosions serious?

A: Yes duodenal erosions are serious and can be life-threatening for the following reasons:

  • Duodenal erosions may occur together with gastric erosions, therefore they can jointly induce massive bleeding.
  • Duodenal erosions may be associated with duodenal ulcer but hemorrhage originates from the erosion and the ulcer itself does not bleed.
  • Duodenal erosion in itself might induce bleeding. The intensity of bleeding, if there is no hemorrhage from other places, is not so severe, as the one originating from gastric erosions.1

What Are Erosions In The Second Part Of The Duodenum In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Preisich P, Farkas I, Konyár EJ. The role of duodenal erosions in the occurrence of upper gastrointestinal haemorrhage. Scand J Gastroenterol Suppl. 1989;167:36-8. [↩]

Chronic Fatigue Syndrome 

Intestinal Edema in an 11 Month Old Baby. Courtesy: Nature.com
Intestinal Edema of Duodenum in an 11 Month Old Baby. Courtesy: Nature.com

What Is Small Intestinal Edema?

S mall intestinal edema is characterized by fluid accumulation within the intestinal mucosa so that the intestinal wall appears thick and swollen.

Intestinal edema hampers peristalsis that can result in pain and gas build-up. Peristalsis is the normal rhythmic muscular wave-like action that moves residue along the gastrointestinal tract.

Q: What part of the small intestinal lining is swollen?

A: Any part of the small intestine may be affected. Some causes of edema include allergic reactions, enteropathies such as celiac disease, cow milk enteropthy, yeast infection, parasite infection, inflammatory bowel disease such as Crohn’s disease, and certain medications.

For example, the anti-hypertensive drugs known as Angiotension Converting Enzyme (ACE) inhibitors can cause intestinal angioedema and therefore the patient may present with gastrointestinal complaints.1

What Is Small Intestinal Edema In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. LoCascio E J,  Mahler  S A, and  Arnold TC. Intestinal Angioedema Misdiagnosed as Recurrent Episodes of Gastroenteritis. West J Emerg Med. Sep 2010; 11(4): 391–394. [↩]

Muscle Wasting 

Multiple Gastric Ulcerations. Courtesy Dr. Krum.
Multiple Gastric Ulcerations. Courtesy Dr. Krum.

What Are Multiple Gastric Ulcerations?

M ultiple gastric ulcerations denote a stomach disorder that involves damage to the superficial mucosa characterized by many sores of the stomach antrum that are marked by inflammation, necrosis (death of the affected cells) and sloughing of destroyed tissue.

Q: Where is the stomach antrum?

A: The antrum is the lower region of the stomach before the pylorus which is nearest the duodenum (first part of the small intestine). The stomach and duodenum are separated by the powerful pyloric sphincter.

The stomach antrum propels food in the stomach against the pylorus which resists passage of food until it is turned into chyme. Chyme is highly acidic liquified food that has been thoroughly mixed with stomach juices.

Gastric ulcerations are typically associated with widespread gastritis (inflammation), inflammatory involvement of acid producing cells, and atrophy of acid and pepsin producing cells.1

The primary causes of gastric ulcerations are H. pylori infection, use of Aspirin and non-steroidal drugs (NSAIDS), and stress.1

What Are Multiple Gastric Ulcerations In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Kathleen Mahan and Sylvia Escott-Stump, ed. Krause’s Food, Nutrition & Diet Therapy, 10th Edition. Philadelphia, PA. USA: W.B. Saunders Company, 2000. [↩] [↩]

Dermatomyositis

Obesity_001_[1]

What Is Unexplained Weight Gain?

U nexplained weight gain is characterized by increased body mass due to excess fat accumulation that is not desired by the individual.

A body mass index (BMI) of 25 to 30 signifies being overweight.

What Is Unexplained Weight Gain In Celiac Disease and/or Gluten Sensitivity?

Muscle Weakness 

Microscopic View of Gastric Biopsy Showing a Collagen Band Under the Surface Mucosal Cells. Courtesy Gastrolab.com
Microscopic View of Gastric Biopsy Showing a Collagen Band Stained Pink Under the Surface Mucosal Cells. Courtesy Gastrolab.com

What Is Collagenous Gastritis?

C ollagenous gastritis is a rarely reported stomach disorder characterized by the deposition of a subepithelial collagen band and accompanying inflammatory infiltrate in the stomach wall.

A subepithelial collagen band means that collagen, a tough fibrous protein, has abnormally accumulated under the surface layer of epithelial cells which form the mucosa lining the stomach.

The surface mucosa may remain intact and not show lymphocytosis and/or gastritis on endoscopic examination or it may become stripped off and bleed from entrapped capillaries. Biopsy is necessary to diagnose collagenous gastritis.1

Q: Why does collagen become deposited under the surface lining of the stomach?

A: It is thought that collagen deposition is preceded by inflammation and tissue damage. However, the natural history and pathogenesis of collagenous gastritis remain unclear.2

What Is Collagenous Gastritis In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Jain R, Chetty R. Collagenous gastritis. Int J Surg Pathol. 2010 Dec;18(6):534-6. doi: 10.1177/1066896908329588. Epub 2008 Dec 22. [↩]
  2. Leung ST, Chandan VS, Murray JA, Wu TT. Collagenous gastritis: histopathologic features and association with other gastrointestinal diseases. Am J Surg Pathol. 2009 May;33(5):788-98. doi: 10.1097/PAS.0b013e318196a67f. [↩]

Osteomalacic Myopathy

IMG_1007a stomach body normalWhat Is Lymphocytic Gastritis?

L ymphocytic gastritis is an inflammatory stomach disorder that is characterized by superficial inflammation of the stomach lining (mucosa) that mainly involves the gastric antrum in children.

Lymphocytic gastritis is defined by the recognition of more than 25 intraepithelial lymphocytes (IEL) per 100 surface epithelial cells lining the stomach wall.

Q: What are intraepithelial lymphocytes?

A: Intraepithelial lymphocytes in lymphocytic gastritis are a unique T-cell population  of white blood cells that are interspersed between epithelial cells in the mucosa.

What Is Lymphocytic Gastritis In Celiac Disease and/or Gluten Sensitivity?

Muscle Pain and Tenderness, Chronic 

Reproduction of a lithograph plate showing inside of the stomach from Gray's Anatomy. Courtesy Wikipedia Commons.
Reproduction of a lithograph plate showing inside of the stomach from Gray’s Anatomy. Courtesy Wikipedia Commons.

What Is Delayed Gastric Emptying?

D elayed gastric emptying is a stomach motility or movement disorder characterized by abnormally slow movement of gastric contents from the stomach through the pyloric sphincter into the duodenum, causing dyspepsia.

Q: What determines how fast the stomach empties?

A: How fast the stomach empties depends on the pressure of strong coordinated muscle contractions in the top region of the stomach propelling chyme against resistance at the pylorus (base region of the stomach).

Chyme is food that has been dissolved and thoroughly mixed with stomach secretions.

In the digestion of carbohydrate, protein and fat, protein leaves the stomach first (1 hour), then carbohydrates (1 1/2 to 2 hours), and fat takes longest to digest (2-4 hours). Plain water is able to pass through the pylorus within 5 minutes.

What Is Delayed Gastric Emptying In Celiac Disease and/or Gluten Sensitivity?

Weight Loss, Unexpected/ Inability To Gain Weight

unexpected weight loss celiac disease symptomWhat Is Unexpected Weight Loss?

Unexpected weight loss is unintentional loss of body mass composition or inability to gain weight marked by decreased serum proteins and increased stool fat.1

What Is Unexpected Weight Loss In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Krause’s Food, Nutrition, & Diet Therapy. 10th Edition. Kathleen Mahan, Sylvia Escott-Stump. 2000. W.B. Saunders Company. [↩]

Polymyositis

What Is Helicobacter Pylori (H. Pylori) Infection? H elicobacter pylori infection is a potentially deadly stomach disease characterized by chronic superficial inflammation and ulcerations in 100% of infected patients. This infection disrupts normal defense and…