The stomach is a hollow, muscular dilated segment of the digestive system that lies between the oesophagus and the small intestine. It is on the left side of the upper abdomen. It is a ‘j’-shaped organ, with two openings-the oesophageal and the duodenal- and is divided into four regions- the cardia, fundus, body and pylorus. It secretes protein digesting enzymes and hydrochloric acid, which helps in digestion of food. The surface of the stomach is lined by ridges of muscle tissue called rugae. Muscles in the stomach wall contract periodically, helping churn the food and speed up the digestion of food. As food enters the oesophagus, a muscular ring or valve called the lower oesophageal sphincter or LES, located at the end of the oesophagus, relaxes and allows the food to pass in to the stomach. After entering the stomach, the food is broken down, by digestive juices produced in the stomach. Relaxation of the pyloric sphincter allows the food to pass from the stomach into your small intestine.
Almost everyone experiences some form of stomach disorder at some point of their life. Some of the digestive disorders that affect the stomach include indigestion, heartburn, gastritis, peptic ulcer disease, gastric ulcer, gastroparesis (delayed gastric emptying), Zollinger-Ellison syndrome (ZES), gastric varices, and cancers of the stomach. Gastro-oesophageal reflux disease (GORD) is a condition where the stomach contents (food or liquid) rise up from the stomach into the oesophagus, a tube that carries food from the mouth to the stomach.
Most stomach problems can be relieved with over-the-counter medications and lifestyle changes. However, surgery may be considered in more serious conditions or in patients not responding to the conservative approach. Nissen’s fundoplication is a surgical procedure in which the upper part of the stomach is wrapped around the end of your oesophagus and oesophageal sphincter, where it is sutured into place. This surgery strengthens the sphincter and helps prevent stomach acid and food from flowing back into oesophagus.
Endoluminal gastroplication or endoscopic fundoplication technique requires the use of an endoscope with a sewing device attached to the end, known as EndoCinch device. This instrument place stitches in the stomach below the LES to create a plate which helps reduce the pressure against the LES and helps strengthen the muscle.