Visceroptosis: Symptoms, Diagnosis, and Treatment

Introduction

You may be surprised to learn about visceroptosis, a condition in which the organs inside your abdomen can sink downward. Depending on the severity and compression of abdominal internal organs and the sharp curvature of blood vessels, nerves, and ducts, this can cause various gastrointestinal symptoms.

Visceroptosis can occur if the muscles and ligaments in your belly are weak, if someone has bad posture, or just because of getting older. Let’s find out more about the different types of visceroptosis, how doctors find it, and what can be done to help!

What Is Visceroptosis?

Visceroptosis is a condition in which the organs in your abdomen slide down lower than where they normally sit. It can involve organs like the small and large intestines, stomach, liver, spleen, gallbladder, pancreas, uterus, fallopian tube, ovaries, kidneys, urinary system, and various blood vessels. It's like a drooping or sinking of the organs. Mostly, it does not cause any problems, but it can make your stomach feel upset.

This condition is also called Glénard's disease. Some people are more likely to have visceroptosis, especially those with a rare connective tissue disorder called Ehlers-Danlos syndrome.

What Are the Epidemiology and Risk Factors of Visceroptosis?

Visceroptosis can happen to anyone. But it’s more common in women (especially between the ages of 20 and 50). Doctors do not know exactly how many people have it.

Here are some things that can make it more likely:

• Females, mostly because of their broader pelvis. Further, pregnancies and childbirth can increase the risk.

• Presence of a condition like Ehlers-Danlos syndrome (characterized by joint hypermobility and skin hyperextensibility).

• Weak abdominal muscles from aging, pregnancy, or not exercising.

• Lifestyle factors include lifting heavy objects, chronic coughing, and wearing tight clothes.

• Abdominal surgeries like cholecystectomy, appendectomy, or hysterectomy.

• Presence of a large ventral hernia.

• Malnutrition can also cause weakness and prolapse.

What Are the Types of Visceroptosis?

These can be classified into two types depending on how one might get them:

• Hereditary type: Here, the person is born with it. The person has inborn internal organ defects leading to the condition's development.

• Acquired type: Here, the person develops the condition later in life. The individual develops this condition due to underlying pathology, such as prolonged illness (syphilis, tuberculosis, alcoholism), frequent pregnancies, or sudden weight loss, with weight loss being the most common etiology.

It can also be classified based on the organ involved:

• Gastroptosis: Here, the stomach slides down. The lower border of the stomach goes below the iliac crest (the top border of the ilium that makes up the pelvis bone). This type can cause gastric problems.

• Enteroptosis: This condition involves prolapse of the intestine (mostly the small intestine). It can cause issues like constipation, bloating, back pain, and a feeling of heaviness in the abdomen. In rare cases, it can cause intestinal obstruction.

• Nephroptosis: This involves the kidneys, also known as a floating kidney. In this condition, the kidney slides down more than 1.9 inches or two vertebral bodies when the person stands from a lying position. It can cause kidney infections; in some rare cases, it can even cause blockage of the ureter, causing Dietl crisis.

• Splenoptosis: This involves the spleen, also known as wandering spleen. It can cause complications like gangrene, infarction, or even pancreatic necrosis.

What Are the Common Symptoms of Visceroptosis?

General symptoms include chronic trouble with digestion, such as:

• Dull ache in the abdomen.

• Loss of appetite.

• Abdominal distention.

• Belch (excess air released through the mouth).

• Weight loss and loss of strength.

• Nausea.

• Anorexia (eating disorder).

• Bloating.

• Flatulence (expulsion of air from the anus).

• Frequent headaches.

• Vomiting.

• Diarrhea (less common).

• Easy satiety.

• Lower resistance to widespread infections and constipation.

One may also have symptoms like:

• Vertigo.

• Nervous indigestion.

• Mood changes.

• Sleep disturbances.

• Menstrual troubles.

• Eye troubles.

• Low blood pressure.

What Are the Conditions Associated With Visceroptosis?

Visceroptosis usually comes with other problems in the body. Here are some of them:

• Weight loss: Sometimes people with visceroptosis lose a lot of weight quickly. Weight gain can relieve symptoms.

• Neurological conditions: Visceroptosis is associated with neurological conditions. The person may feel tired, shaky, dizzy, or can’t sleep well. However, the association between visceroptosis and nervous disorders remains unclear.

• Abdominal surgeries: Sometimes, visceroptosis occurs after someone has a surgery, such as removing a tumor or having a hysterectomy. Tumors of the abdomen act as a support to abdominal organs and cause prolapse after the tumor removal.

• Gastrointestinal symptoms: These include dyspepsia (also called indigestion), acid reflux, nausea, bloating, vomiting, constipation, diarrhea, and chronic abdominal pain.

• Hypermobile Ehlers-Danlos syndrome (hEDS): A connective tissue disorder that causes joint instability and joint hypermobility, along with chronic pain.

• Superior mesenteric artery syndrome: In some cases, visceroptosis can compress the first part of the intestine, called the duodenum, causing various gastric problems.

How Is Visceroptosis Diagnosed?

Here’s what the doctors do to diagnose the condition:

1. Clinical examination:

• The doctors begin by asking questions regarding the symptoms.

• This is followed by a physical examination, during which the abdominal organs are gently palpated to assess their positions. Tenderness while palpating and displacement may provide clues.

• A test called Glénard's test, or girdle test, is done in which the doctor gently lifts the organs to see if the organs inside move back into place.

2. Laboratory tests:

• Gastric analysis detects stasis (inactivity) and the absence of obstruction; in addition, stomach secretions are reduced in acidity.

• Other than these, complete blood count (CBC) and comprehensive metabolic panel tests are conducted.

3. Imaging techniques:

• Abdominal X-rays to visualize organs, along with gas patterns.

• Fluoroscopy (an X-ray that gives real moving images) detects weak gastric peristaltic waves.

• Barium swallow detects enteroptosis.

• Ultrasounds and MRI (magnetic resonance imaging) also help visualize organs.

What Is the Management and Treatment of Visceroptosis?

Non-surgical management:

• The measures to manage the condition are to be followed for a lifetime.

• Limit food and liquid intake and lie down after taking food to prevent overloading and pain.

• Consuming dry food is advised.

• Increased carbohydrate intake, as they are digested easily.

• Patients must consume fluids between meals.

• A routine exercise with bending the thigh towards the body and massaging can strengthen the abdominal muscles.

• Weak abdominal muscles are supported with an abdominal belt.

• A diet of 3500 to 4000 calories is required for weight gain.

• Regular bowel movements are essential to prevent a bilious attack.

• Paraffin oil is beneficial for inducing bowel movements.

• Wearing loose-fitting clothing.

• Adequate rest.

Surgical treatments: These are advised when all the other non-surgical treatments fail:

• First, the caecum is raised and fixed in the iliac fossa to empty the bowel.

• Laparoscopic surgical procedures may help fix displaced organs.

What Are the Potential Complications of Visceroptosis?

Here are some things that might happen due to visceroptosis:

• Stomach issues.

• Chronic abdominal pain.

• Anorexia.

• Abdominal distention.

• Gastroparesis (causes delayed gastric emptying).

• Superior mesenteric artery syndrome.

Conclusion

Visceroptosis is a condition in which the organs in the abdominal area slide down. It usually happens more in females, and there are many reasons for it. Most of the time, this condition causes stomach issues. Management usually includes eating healthy food, doing special exercises (physical therapy), wearing support garments, and, in serious cases, surgery.

Note from iCliniq

• Visceroptosis occurs when the abdominal organs slide down from their normal position.

• Visceroptosis does not cause any symptoms. But in some cases, it may cause stomach issues.

• Visceroptosis can occur in anyone, but it is more common among women.

• Don't worry. Visceroptosis, if diagnosed early and properly cared for, can help people live better and healthier lives.

• If you or someone you care about is having stomach troubles because of visceroptosis, don’t worry, just reach out to our gastroenterologist. We’re here to help you feel better!