Stomach complaints
What are stomach complaints?
Stomach complaints are problems in the upper abdomen due to irritation or inflammation in the stomach lining or reflux symptoms (heartburn). Heartburn (reflux) is discussed as a separate condition below.
Irritation of the lining of the stomach may have various causes, including excessive eating, or food that is too greasy or very spicy. Large amounts of coffee or alcohol stimulate the production of stomach acid that irritates the lining of the stomach. Some medicines, and painkillers (NSAIDs) in particular, can damage the lining of the stomach. Smoking can also have the same effect. Stress can play a role in stomach complaints.
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An inflammation of the lining of the stomach (gastritis) is usually caused by a type of bacteria known as Helicobacter pylori. It may cause the inflammation of the lining of the stomach, although it does not always do so.
A stomach ulcer (ulcer ventriculi) or a duodenal ulcer (ulcus duoudeni) is almost always caused by Helicobacter pylori, which is probably transmitted from human to human by mouth or by hands infected with faeces. Poor sanitary conditions therefore exacerbate the risk.
What are the associated complaints?
Many people suffer occasionally from their stomach. This feeling may be unpleasant but it is not necessarily harmful and it usually resolves spontaneously. Not everyone with Helicobacter pylori in their stomach will develop symptoms. However, severe irritation, the inflammation of the stomach lining or a stomach ulcer will be accompanied by stomach ache, flatulence, a bloated feeling and nausea. The symptoms will often manifest themselves at the same time.
People with intellectual disabilities sometimes find it impossible to communicate pain, a bloated feeling or nausea. The people around them may then notice only a change in behaviour.
How common are stomach complaints in the general population?
Stomach complaints are common in general practice. Stomach-ache is seen in 1.9% of people in general practice annually.
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The following diagnoses are made in people with stomach complaints who are referred for gastroscopy:
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- 20 to 25% have gastro-oesophageal reflux disease or oesophagitis (stomach acid that rises and burns in the oesophagus or inflammation of the oesophagus);
- 5% have an ulcer; in the last 20 years, the number of new cases of stomach and duodenal ulcers has fallen sharply;
- functional stomach complaints (in other words, complaints but no abnormalities) are seen in 60 to 70%;
- carcinomas (malignant tumours) of the stomach and oesophagus are rare (less than 1% of the referred patients).
The presence of the Helicobacter pylori in the stomach increases with age. The prevalence rate in adults and young adults is 16%, rising to 48% in older people.
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How common are stomach complaints in people with intellectual disabilities?
It is not known how often stomach complaints occur in people with intellectual disabilities.
Helicobacter pylori is very common. A prevalence rate of 50% has already been found in children with intellectual disabilities who do not live in an institution.
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The prevalence rate was found to be 82.8% in Dutch adults living in an institution.
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Predictive factors for Helicobacter pylori were: living in an institution for a longer period of time, an IQ of less than 50, regurgitation and upper abdominal complaints.
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In addition, people with intellectual disabilities are more likely to see Helicobacter pylori return a number of years after being treated.
Older studies found a prevalence rate of 5.4% for ulcers in the lining of the stomach and/or duodenum.
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The prevalence rate has probably fallen since the increase in the administration of medication to protect the stomach in people with intellectual disabilities.
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206Numans ME, de Wit N, Dirven J, Heemstra-Borst C, Hurenkamp G, Scheele M, Burgers J, Geijer R, de Jongh E. NHG-Standaard Maagklachten (tweede herziening). Huisarts Wet 2013; 56 (1): 26-35
Numans ME, de Wit N, Dirven J, Heemstra-Borst C, Hurenkamp G, Scheele M, Burgers J, Geijer R, de Jongh E. NHG-Standaard Maagklachten (tweede herziening). Huisarts Wet 2013; 56 (1): 26-35
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206Numans ME, de Wit N, Dirven J, Heemstra-Borst C, Hurenkamp G, Scheele M, Burgers J, Geijer R, de Jongh E. NHG-Standaard Maagklachten (tweede herziening). Huisarts Wet 2013; 56 (1): 26-35
Numans ME, de Wit N, Dirven J, Heemstra-Borst C, Hurenkamp G, Scheele M, Burgers J, Geijer R, de Jongh E. NHG-Standaard Maagklachten (tweede herziening). Huisarts Wet 2013; 56 (1): 26-35
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206Numans ME, de Wit N, Dirven J, Heemstra-Borst C, Hurenkamp G, Scheele M, Burgers J, Geijer R, de Jongh E. NHG-Standaard Maagklachten (tweede herziening). Huisarts Wet 2013; 56 (1): 26-35
Numans ME, de Wit N, Dirven J, Heemstra-Borst C, Hurenkamp G, Scheele M, Burgers J, Geijer R, de Jongh E. NHG-Standaard Maagklachten (tweede herziening). Huisarts Wet 2013; 56 (1): 26-35
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207Van Blankenstein M, van Vuuren AJ, Looman CW, Ouwendijk M, Kuipers EJ. The prevalence of Helicobacter pylori infection in the Netherlands. Scand J Gastroenterol. 2013 Jul;48(7):794-800
Van Blankenstein M, van Vuuren AJ, Looman CW, Ouwendijk M, Kuipers EJ. The prevalence of Helicobacter pylori infection in the Netherlands. Scand J Gastroenterol. 2013 Jul;48(7):794-800
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519Luzza F, Concolino D, Imeneo M, Pascuzzi A, Pietragalla E, Pallone F, Strisciuglio P. High seroprevalence of Helicobacter pylori infection in non-institutionalised children with mental retardation. Clin Microbiol Infect. 2004 Jul;10(7):670-3
Luzza F, Concolino D, Imeneo M, Pascuzzi A, Pietragalla E, Pallone F, Strisciuglio P. High seroprevalence of Helicobacter pylori infection in non-institutionalised children with mental retardation. Clin Microbiol Infect. 2004 Jul;10(7):670-3
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208Böhmer CJ, Klinkenberg-Knol EC, Kuipers EJ, Niezen-de Boer MC, Schreuder H, Schuckink-Kool F, Meuwissen SG. The prevalence of Helicobacter pylori infection among inhabitants and healthy employees of institutes for the intellectually disabled. Am J Gastroenterol. 1997 Jun;92(6):1000-4.
Böhmer CJ, Klinkenberg-Knol EC, Kuipers EJ, Niezen-de Boer MC, Schreuder H, Schuckink-Kool F, Meuwissen SG. The prevalence of Helicobacter pylori infection among inhabitants and healthy employees of institutes for the intellectually disabled. Am J Gastroenterol. 1997 Jun;92(6):1000-4.
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208Böhmer CJ, Klinkenberg-Knol EC, Kuipers EJ, Niezen-de Boer MC, Schreuder H, Schuckink-Kool F, Meuwissen SG. The prevalence of Helicobacter pylori infection among inhabitants and healthy employees of institutes for the intellectually disabled. Am J Gastroenterol. 1997 Jun;92(6):1000-4.
Böhmer CJ, Klinkenberg-Knol EC, Kuipers EJ, Niezen-de Boer MC, Schreuder H, Schuckink-Kool F, Meuwissen SG. The prevalence of Helicobacter pylori infection among inhabitants and healthy employees of institutes for the intellectually disabled. Am J Gastroenterol. 1997 Jun;92(6):1000-4.
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521Kim M, Learman L, Nada N, Thompson K. The prevalence of peptic ulcer in an institution for the mentally retarded. J Ment Defic Res. 1981 Jun;25(Pt 2):105-11
Kim M, Learman L, Nada N, Thompson K. The prevalence of peptic ulcer in an institution for the mentally retarded. J Ment Defic Res. 1981 Jun;25(Pt 2):105-11
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520Wallace RA, Schluter PJ, Webb PM. Recurrence of Helicobacter pylori infection in adults with intellectual disability. Intern Med J. 2004 Mar;34(3):132-3
Wallace RA, Schluter PJ, Webb PM. Recurrence of Helicobacter pylori infection in adults with intellectual disability. Intern Med J. 2004 Mar;34(3):132-3