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Cascade Stomach
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Cascade Stomach

I just want to make people aware of a condition called Cascade Stomach, also known as Cup and Spill, flip over stomach and shelf stomach.

This is a common factor in people suffering from GERD, basically the stomach is divided into two and on a barium swallow the radiologist will clearly see two different fluid levels in the stomach whilst in the vertical position, one high up near the fundus and another near the pyloric valve, normal stomachs only have one fluid level.
What happens when you eat is that the upper sac fills up 1st and then it slowly cascades over into the lower part of the stomach, the difference between a cascade stomach and an hour glass stomach is that the upper sac is devoid if tonicity like that of a flaccid sac, the lumen outline of the upper sac with also be thin and therefore does not carry the same protection against acids as a normal stomach.
The upper sac can not digest food it just sits there, and with some people after a big meal if slouched over with the stomach and esophagus in a compressed form, the olower esophagus can literally dip into the upper stomach contents, in most cases due to the closer proximity it is easier for stomach acids to jump up into the esophagus.

Most surgeons do not consider this condition as problematic, but they know it causes GERD and we all know the problems GERD can cause, so it is a clear contradiction.

Some doctors and specialists do not even know what this condition is when questioned and dismiss it as nothing because they are uneducated, but if you research "Cascade Stomach" on google you will see the condition can be very problamatic and I think a lot of people on here may be undiagnosed.

Luckily there is an easy treatment, after you eat simply lay on your left side, this will allow the upper sac to empty, slowly sit back up into the vertical position to let it empty down into the lower stomach which will still be fully functional, repeat this process until you feel like the upper sac has emptied.

Any of you out there feel like food is sitting in the top of your stomach and the bottom part feels empty?

The only way to get diagnosed is with barium swallow xray, endoscopy's do not highlight this condition, you need to look at the stomach from a distance to see it, you also need a radiologist who actually knows how to spot this condition.

Many people get all sorts of digestive problems who have this disorder, most end up having fundoplication surgery to stop the reflux, but often only fundoplication and a gastopexy together will actually be fully succesful, the stomach has to be pulled into shape and sutured either to the stomach wall or looped over a rib, this prevents food getting stuck in the top part of the stomach and can prevent future life threatening problems like the stomach folding over on itself even more.
The condition was once thought to be rare but recent studies have shown that is is not and it is a stomach deformity caused by lax stomach ligaments.

People with Cascade stomach, have been documented to have an elevated upper left crus of the diaphram with a build up of pressure and gas, this can displace the heart and spleen, there is a documented case of this happening during an actual barium swallow, due to the upper abdominal distention and build up of pressure, the Barium solution backed up 5 inches above the esophageal sphincter, the patients pain increased and increased until eventually the barium squirted into the upper sac of the stomach, the patient described feeling better instantly.
Has anybody ever had one of these episodes?
If you think you may have any of these symptoms try the emptying tet by laying on your left hand side.

I hope this will help people who may be suffering with unexplained or undianosed conditions.
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6 Comments Post a Comment
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Avatar_m_tn
Just wanted to add that it is characteristic of Cascade stomach for the upper sac which does not function properly to be much larger than the lower fully functioning part of the stomach, this means small meals are a must and the emptying of the upper sac may take some time aagain leading to slow digestion, you may find this is the cause of large gurgling sounds as the food passes from the upper to lower stomach with this you will literally feel the food lower down in your abdomen and the upper abdominal discomfort will go with it.
This is one condition where excess acids in the upper flaccid sac can cause a burning sensation, to immediately relieve this just eat some dry toast, you will feel the discomfort go almost immediately.

Because of the nature of this conditio it is important to sleep well elevated, as is in a sun lounger, do not just lift the head, the elevation must start from hip level, so that the entire upper body gets elevated, the elevation needs to be 25-30deg, good hospitals automatically place you at this angle even as a sleeping position, it may be uncomfortable at 1st, but after while you will find it more comfortable than laying flat, your night time/morning abdominal pains will disappear as a result.

A note to people who are also suffering bile reflux, laying on the right alleviates symptoms, gravity taking bile down the intestines instead of into the stomach, so as soon as you feel the upper sac empty by laying on your left, then return to laying on the right to stop bile entering the stomach, so many catch 22 situations with stomach problems, solving one problem can cause another and leave you feeling like nothing works, you have to monitor yourself closely and feel and listen to what the stomach is doing, what has an affect and what does not.
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Avatar_m_tn
Hello!
Thank you for posting this article.
I happen to have a cascade stomach and excess acid as a result from it.
I read your article carefully BUT I really want to ask you to specify something about one part of it - "future life threatening problems like the stomach folding over on itself even more". That is what worries me the most. Is this just a possible complication or a 100% certain thing??? Can a cascade stomach patient not be on that road to hell?
My personal treatment is regular antacids, food regime and life style and body elevation while asleep.
Please answer. Thank you!
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Avatar_f_tn
Hiya iv also got this defect, even though they treated it as a hiatus hernia for 3 years! Every doctor iv seen has had to google it and they act like its nothing but it affects my life greatly. I dont know the answer to your questions but I have a question for you....when u dont eat for quite a few hours do you feel really sick and in agony? I dont know if this is genetic but im 27 and at the exact age my sister had a twisted stomach and had to operate. My trust in doctors is disappearing, iv never had an xray to actually confirm iv got this Iv had 2 endoscopys a barium and a tube up my nose into my throat for 24 hours. Theres hardly any information about this defect. Im currently waiting to see if there going to operate on me.iv also put on weight as the only thing that stops the pain is to eat but then if I eat to much im sick!
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Avatar_m_tn
Hi!
To answer your question, yes I do feel a little bloated after I eat because it takes a while till the food transfers-cascades to the proper side of the stomach, but it is nothing serious and maybe it is like that because I eat more often but less and I take my antacid medications regularly.
Also it is important to elevate your upper body while you are asleep.
Best of luck!
I actually asked a question and I ended up giving suggestions :)).
I think it is a good sign.
Take care!
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Avatar_f_tn
Hi am 52yr lady recently ago 2 months. Am suffering from sever reflux and keep feel food taste on my tongue .. And I had lost more than 12kg of my weight
My Gastro doctor had diagnosed me as Cascade stomache case .. Now am only living on little food ,anti acid and life style modification
Can any one give inf. about possibilty of surgical option ??

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Avatar_f_tn
I was just diagnosed with this condition. Doctors have recommended a Nissen Fundoplication surgery. I meet with the surgeon in 3 weeks. I'm in constant pain which Ibuprofen is the only relief I've found, so I take it around the clock. I can only lay on my left side to sleep. I'm bloated after any food. Even water makes me burp constantly. If I eat and then nap after I'm better, but at work that isn't an option. By the time I leave work I'm nauseous and feel like I'm 9 months pregnant! Please help!
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