Gastric outlet obstruction refers to a condition in which the exit to the stomach leading into the small intestine is blocked. This often causes someone to become full quickly because there isn't anywhere for the food to go. Vomiting can occur as a result, and in severe cases, malnutrition. There are various causes for gastric outlet obstruction, both benign and malignant, and treatment will depend on which underlying cause is to blame.
Benign gastric outlet obstruction may be caused by conditions like peptic ulcers. This condition is generally treatable, although it can be very painful. Symptoms may include abdominal pain or burning relating to the ulcer and a feeling of fullness, bloating, and vomiting due to the resulting obstruction. Treatment may include the use of expanding devices which open up the outlet to the small intestine. Expansion can be done by using balloons or self-dilating stents. In many cases the only treatment needed will include suctioning of fluids from the stomach along with injections of electrolytes and other fluids which may be needed.
Malignant causes of gastric outlet obstruction are related to various types of stomach cancer. In this case a tumor is often blocking the outlet. Surgery will likely be needed to remove the tumor, and further treatment for remaining cancer will also generally be performed. This may include radiation and chemotherapy. While surgery can usually remove the obstruction, the underlying cancer may not always be curable.
In some cases an infection, such as tuberculosis, may be to blame for gastric outlet obstruction. This can be treated with both expanding devices as well as antibiotics to kill the underlying infection. Some infectious diseases are harder to treat than others, so symptoms will likely be alleviated before the infection is gone to make the patient more comfortable.
Diagnosis is generally made through performing X-rays and by checking fluid levels. Further tests may be needed to determine the underlying cause. Once the diagnosis as been made and a cause has been discovered, treatment can begin to correct the condition and alleviate symptoms. In some severe circumstances, treatment of the underlying cause may not be feasible before symptoms have been managed. Cancer, for example, must be treated over a long period of time. The blockage must be removed so that ongoing treatment can begin.
Some patients may have recurring problems with gastric outlet obstruction, primarily those with peptic ulcer disease. Continued monitoring and treatments may be necessary to keep the condition from causing weight loss, malnutrition, and damage to the esophagus caused by frequent vomiting. In some very severe cases, surgery may be needed in a nonmalignant case to open the passageway to the intestine or create a new one.
