Giant protrusion at the gastric fundus
May 28, 2023
Source: Cainiu Health
Dr. Shen Yonghua
Introduction
A large protrusion at the gastric fundus may be caused by gastric fundal varices, hypertrophy of gastric fundal muscles, food retention, gastrointestinal stromal tumor (GIST), or leiomyoma of the gastric fundus. Management should be tailored according to the specific cause. It is recommended to seek prompt medical attention at a hospital and receive treatment under the guidance of a physician. Dietarily, focus on soft, easily digestible foods and avoid coarse or hard foods.
A large bulge at the gastric fundus may be caused by gastric varices, hypertrophy of gastric muscular layer, food retention, gastrointestinal stromal tumor (GIST) of the gastric fundus, or leiomyoma of the gastric fundus. Management depends on the specific cause. It is recommended to seek timely medical evaluation and treatment under a doctor's guidance.
1. Gastric varices: Portal hypertension can obstruct venous return in the gastric fundus, leading to tortuous dilation of veins and resulting in a large bulge. Patients should rest adequately and avoid strenuous exercise and fatigue. The diet should consist mainly of soft, easily digestible foods. Avoid coarse or hard foods that could lacerate dilated veins and cause bleeding.
2. Hypertrophy of gastric muscular layer: This may be related to congenital individual development, where the muscular layer of the gastric fundus is thicker than normal, appearing as a large bulge during endoscopy. Usually, no special treatment is required; regular follow-up gastroscopies are sufficient to monitor changes in the bulge. Maintain regular eating habits, avoid overeating, and opt for smaller, more frequent meals to reduce gastric burden.
3. Food retention: If gastric emptying function is impaired, food may accumulate in the gastric fundus, causing a bulge-like appearance. This can be improved by adjusting dietary habits—such as chewing thoroughly, avoiding rapid or excessive eating—and increasing physical activity appropriately to enhance gastrointestinal motility.
4. Gastrointestinal stromal tumor (GIST) of the gastric fundus: A tumor originating from interstitial cells of Cajal in the stomach, presenting as a large bulge. Patients may also experience symptoms such as dysphagia, decreased appetite, nausea, and vomiting. Surgical resection is typically the main treatment approach. Procedures such as endoscopic mucosal resection or laparoscopic partial gastrectomy may be performed under medical supervision.
5. Leiomyoma of the gastric fundus: A benign tumor arising from smooth muscle cell hyperplasia in the stomach, which can also lead to a large bulge. Symptoms may include dull upper abdominal pain, bloating, and discomfort. Surgical removal is the primary treatment. Tumors can be excised via open surgery or laparoscopic surgery as directed by a physician.
In daily life, maintain a light diet and avoid spicy or irritating foods such as garlic, hot pot, and wasabi. Ensure adequate rest and avoid excessive fatigue to protect overall health.
