Gastric emphysema (GE) is a rare, but serious condition that affects the stomach. Compared with other types of emphysema that affect the gastrointestinal (GI) tract, it’s estimated that 9% of all cases impact the stomach area.
Rather than being a disease itself,
Read on to learn more about what GE entails, including possible causes, symptoms, and treatment options that you can discuss with a doctor.
When you hear the word “emphysema,” you may think of a lung condition that’s one of the main subtypes of chronic obstructive pulmonary disease (COPD). This type of emphysema refers to problems with the air sacs in your lungs, which can make it hard to breathe.
Like regular emphysema, GE also involves problems with air. But unlike the involvement of the lungs’ air sacs, GE has to do with the abnormal presence of air inside the stomach wall.
While air may appear in any part of the GI tract, such as the rectum or the esophagus, the stomach is considered the least likely site to be affected. The exact causes continue to be researched, but it’s thought that GE may be a sign of another underlying medical condition.
Gastric emphysema vs. gastric pneumatosis
Both GE and gastric pneumatosis describe abnormal air in the stomach. GE describes trapped air in the gastric (stomach) wall, while pneumatosis describes trapped gasses more generally. Some experts also consider GE as a type of gastric pneumatosis.
GE may be asymptomatic, meaning it has no symptoms. In such cases, it may be found incidentally during diagnostic testing for another health condition.
When GE does cause symptoms, it may include GI-related symptoms, such as:
- upper abdominal pain
- blood in vomit (occasionally)
Such symptoms may be related to a number of GI conditions. So, if you experience unexplained GI symptoms, it’s important to contact a doctor right away.
Self-diagnosis may be dangerous, especially since GE can sometimes be confused with a more serious, and potentially fatal condition called emphysematous gastritis (EG). Unlike GE, EG is thought to be caused by gas-producing bacteria that may lead to infections and related complications, such as sepsis and shock.
It’s also important to note that vomiting, while a symptom of GE, has also been found to be a cause of GE when it’s especially severe and prolonged. One such case report discusses GE in a woman who experienced nausea and severe vomiting for 3 days and was treated with intravenous (IV) fluids after GE diagnosis.
While the exact cause of GE is widely debated, researchers believe it’s a result of physical, mucosal, or bacteria-related damage to the stomach wall.
Possible related causes of GE may include:
- cancer and related treatments, such as chemotherapy drugs
- high doses of steroid treatments
- damage to gastric mucosa from certain surgeries, such as bile duct stenting
- frequent and severe vomiting, which may also damage stomach mucosa
- alcohol misuse
For example, one case study describes a woman who was diagnosed with GE after previously undergoing chemotherapy treatments for neuroendocrine pancreatic cancer.
Your symptoms and overall medical history will help determine which diagnostic tools a doctor may use.
GE is typically diagnosed with a computed tomography (CT) scan of the abdominal area. This helps your doctor see whether there are pockets of gasses, including air, in the stomach wall. The involvement of systemic toxicity could indicate EG instead.
While a CT scan is considered standard in diagnosing gastric pneumatosis, a doctor may consider other tests, including:
- a physical exam
- blood tests
- urine tests
- chest X-rays
- electrocardiogram (ECG)
Treatment of GE is highly individual. Some cases require extensive therapies, while others may resolve on their own spontaneously without any treatment.
GE may be initially treated with a process called gastric decompression to help release trapped air and gasses. This involves a nasogastric tube, which is placed in your nose and goes down to the stomach. Research suggests that this treatment method improves symptoms within 72 hours.
Other treatments may depend on the underlying cause. For example, if GE is thought to be caused using certain drugs, a doctor may recommend different medications to treat your condition to prevent further GI problems.
IV fluids may also be administered in the case of dehydration, especially if a lot of fluids were lost due to vomiting. In some cases, bowel rest, proton pump inhibitors, and antibiotics may also be considered.
GE itself is benign and considered curable when detected early.
However, the overall outlook depends on the underlying cause of GE and its related treatment response. Some research suggests that GE could have a mortality rate of up to 50% depending on the cause and whether it receives prompt treatment.
GE refers to the presence of air within the stomach wall. This is an abnormal, yet rare occurrence that’s most often attributed to an underlying condition that damages the stomach mucosa. While GE alone is benign, the underlying cause could sometimes be life threatening.
The only way to diagnose GE is with a CT scan from a doctor. They will also use other clues to make their diagnosis, including imaging tests, blood tests, your medical history, and a review of symptoms you may be experiencing.
Treatment for GE depends on the underlying cause but may include a combination of rest, IV fluids, and medications.
It’s important to see a doctor right away if you’re experiencing any unusual GI symptoms so you can get an accurate — and potentially life-saving — diagnosis.