What is watermelon stomach?
Watermelon stomach is the common name for Gastric Antral Vascular Ectasia i.e. GAVE disease. In this disease, the inner lining of the stomach bleeds and forms lines like a watermelon skin when seen through an endoscope. It does not mean that there is bloating or the stomach swells, as the name might suggest. Watermelon stomach is observed in the people of all ages but is mostly seen in older women of the age 70 and above.
GAVE can be of acute or chronic type causing momentary or prolonged blood loss from the stomach. This can sometimes lead to anemia in many older women. The dilation of the blood vessels of the atrium cause bleeding in the stomach and intestine. This is a very rare disorder and it is very tough to diagnose the exact cause of the watermelon stomach.
Watermelon stomach has symptoms similar to lots of other gastrointestinal tract disorders and usually gets looked over while trying to find the cause of the bleeding in the stomach. There are very few severe GAVE cases that might lead to excessive blood loss and need a blood transfusion, but if not treated on time, watermelon stomach can be very harmful.
Watermelon stomach or GAVE is of two types namely:
- Classic GAVE: In this type, streaks like watermelon are observed in the inner lining of the stomach. This is associated with rheumatologic or autoimmune disorders like anemia and systemic sclerosis.
- Diffused GAVE: In this type, some small benign tumors are found near the antrum. Diffused GAVE is associated with cirrhosis and hypertension. This accounts for 30% of the GAVE patients.
Is Watermelon stomach serious?
Watermelon stomach can be serious if not treated properly or if it is associated with other diseases. In some cases, the blood loss in the stomach is so prolonged that blood transfusion is required. Since watermelon stomach is mostly seen in the older people than the younger ones this can have much worse effects on them. The older people do not have a strong immune system and their bodies need a lot more time to heal. Even with medication, in some cases, blood loss is so much that the body is unable to cope up with it and it leads to acute anemia. Blood transfusion is required to bring back healthy blood in the body. In addition to this, in some people, the blood loss continues even after the treatment and the transfusion has to be repeated again.
If the watermelon stomach happens in combination with stomach ulcer, cirrhosis, scleroderma, CREST syndrome, metabolic syndrome and liver diseases, the conditions might get very serious and immediate medical assistance is required. Also, if a person feels shooting pain, cramps, vomiting, headache and stomach ache and if the situation is not diagnosed on time there might come a few complications and the blood loss can be deadly.
Pictures of Watermelon Stomach
Symptoms of watermelon stomach
When a person is suffering from watermelon stomach he is most likely to get bloody stools. There is a lot of fresh blood lost in the stools. Apart from the fresh blood, there is a loss of old blood that has been accumulating in the stomach for a long time. The blood is usually maroon or black in color. In addition to this clots from the stomach can also come out in stools. The stools seldom cause pain or discomfort. The black and tarry stools are called melena and the red fresh blood stools are called hematochezia. The bleeding is similar to the one experienced during stomach ulcer. Bloody stools if prolonged for a long period of time cause anemia.
Blood in Vomit
Blood in vomit or Hematemesis is a condition in which a person starts throwing up blood. The blood that is accumulated in the stomach comes out of the mouth along with mucus and some stomach juices. This can happen due to many reasons such as flu. The blood loss in vomiting combined with the blood loss in stools is the major reason for anemia.
Anemia is the deficiency of iron in the blood. Anemia is caused by the excessive blood loss through stool and vomiting. The body becomes deficient in hemoglobin. Iron is very important for the transportation of oxygen to the body and if the body is deficient in iron, not enough oxygen can be transported to the organs which leads to many other serious health issues.
Due to the low iron levels in blood and excessive blood loss, a person feels very weak and gets tired easily. Oxygen is very important for the production of energy in the cells and the lack of oxygen means no energy. The person feels dizzy and unable to perform even the normal daily tasks.
Difficulty in breathing
Watermelon stomach does not directly cause difficulty in breathing but the blood loss that happens can lead to breathlessness. This happens due to the weakness of the body organs and their inability to perform.
Occasional stomach cramps similar to the ones that happen during stomach ulcer might cause mild to severe pain. The cramps are usually felt on the lower part of the stomach or lower abdominal area.
Watermelon stomach can also lead to chronic headache and pain in the eyes. Also, lightheadedness can be experienced alongside the headache. There are cases where people feel chest pain and irregularity in the heart beat. Patients usually complain of increased heart beats or a pounding noise coming from the heart known as palpitation.
Liver Cirrhosis is a disease that affects about 30% of the people suffering from watermelon stomach. In this liver disease, the tissues of the liver get replaced by the scar tissues and the functioning of the liver becomes lesser and lesser with time.
The liver disease leads to higher blood pressure in the veins. Since liver cirrhosis causes an enlargement of the collateral veins and the spleen, blood pressure rises.
What causes watermelon stomach pain?
Pain in the stomach is usually not caused by the watermelon stomach but because of the other diseases related to it. Rashes and bruises get formed in the lining of the stomach or the intestine. The stomach releases acid that aids in the digestion of the food. Along with the acids, there are other juices like bile which are also somewhat acidic in nature gets secreted into the stomach. These acids and juices, when come in contact with the wall of the stomach, causes pain and burning sensation. Sometimes if a food particle rubs along the bruise on the wall of the stomach, a short-lived intense pain is felt in the gut area.
Even though the exact cause of the disorder is yet to be found, there are a few hypotheses that have been given about the condition. The first one is Arteriovenous Malformations in which the vascular lesions make the blood flow direct from the veins without passing into the capillaries. If the symptoms of AVMA persists, it leads to watermelon stomach symptoms such as anemia and bloody stools. Hypergastrinemia is a condition in which excessive secretion of gastrin happens which leads to the extra production in the gastric acids. This leads to the proliferation of spindle cells which leads to the rise of venous pressure in the gut.
There are also diseases like Proliferation of neuroendocrine cells, abdominal trauma, heart disorders, irritable bowel syndrome, autoimmune disease and much more that causes watermelon stomach.
The diagnosis of the disease is done by the following methods:
Endoscopy – The endoscope is a thin fiber tube with an attached camera. It is inserted into the stomach. If there are long watermelon like stripes seen through the camera on the lining of the stomach the doctor usually concludes it to be GAVE disorder. But the results can be usually mistaken for severe gastritis or hemorrhage.
Biopsy – This is usually done to confirm the test done by endoscopy. In this process, a small piece of tissue is taken and examined for the damage that has been caused to the lining of the stomach.
Surgery – If the liver or any other organ is involved in the stomach bleeding, an exploratory surgery is done to determine the exact cause of the bleeding. This is usually done as a last measure when the symptoms are very severe and the exact cause cannot be found.
Stool test – This test is done to detect the blood in the stool which is caused due to bleeding in abdominal area. The stool test is the first diagnosis to determine whether the bleeding is happening from the abdomen or lower abdominal area. This test is usually followed by endoscopy and biopsy.
The treatment is either done simply with drugs or surgery is required if the symptoms are very severe. The treatment is done by:
Elimination – Some anti-inflammatory drugs like ibuprofen and aspirin are the reason for the abdominal bleeding and irritation in the stomach. So, in the case of abdominal bleeding such medicines are eliminated from a person’s diet by the doctor.
Iron Supplements – Since there is rapid blood loss which leads to anemia, iron supplements are given to the patients so that the iron deficiency is cured. The iron supplements are given in combination with dextran, gluconate and other such salts.
Endoscopic Ablation – In endoscopic ablation, the lesions are removed from the abdominal tissues. The treatment involves cryotherapy, radiofrequency or photodynamic done with the help of an endoscope.
Argon Plasma Coagulation – This is a very common treatment that is used to stop or control the bleeding in the gastrointestinal area. This involves a jet of ionized argon which is passed through the endoscope. The argon gas is then sprayed on the lesions in the stomach at a very high voltage. This results in the coagulation of the bleeding lesions. But the drawback to this is that it is not permanent and has to be done again and again. This is the most effective way in stopping bleeding and anemia.
Blood Transfusion – In the case of excessive blood loss, transfusion of blood is done. This not only restores the blood in the body but also helps the person to reach a healthy blood level.
There is a special diet that needs to be followed while suffering from the watermelon stomach.
- Spices – Avoiding foods that are very spicy is highly recommended. Spicy foods cause irritation in the stomach and cause pain and cramps.
- Alcohol – People suffering from watermelon stomach and liver cirrhosis should completely avoid any alcohol consumption. Alcohol is very harmful to the liver and regular consumption might lead to the total inability of the liver to function properly.
- Oily foods – Oily foods cause burning sensation and irritation in the stomach. If a person is suffering from watermelon stomach, oily and spicy foods need to be totally avoided.
Foods rich in fibers, whole grains, fresh fruits, and vegetables should be consumed. Foods rich in iron should also be consumed to cope up with the iron deficiency in the blood. Following this restricted diet helps the person heal better and faster.
Along with the medicinal and surgical procedures, some natural remedies can also be applied to treat watermelon stomach such as:
- Water – Drinking a lot of water helps immensely. The more water a person drinks the easier digestion process becomes. Also, water helps in the dilution of the acid in the stomach causing relief from stomach cramps and pain.
- Fibers – Fibers are easily digested by the stomach and does not cause unnecessary gas or bloating. Thus it can be very helpful in easing the discomfort from the stomach. You can also take probiotics drinks in order to improve your digestion and to ease the unnecessary production of acids in the stomach.
- Breathing Exercises – Since there is a deficiency of oxygen in the body, some breathing exercises that include taking deep breaths can be done in order to compensate for the lack of oxygen in the blood.
- Small Meals – Instead of eating three big meals a day, try eating six small meals. This helps in faster digestion and your stomach does not get stuffed which provides you a relief from the pain and inflammation.