I have a relative who has a condition described as a thickening of the stomach wall. What does this mean? What are the possible causes?

S.M.D.

Thickening of the stomach wall is usually found incidentally during an abdominal CT scan done to check for other complaints. In this exam, oral contrast solution is given just before the scan to distend the stomach and small intestine enough to obtain adequate images. If the stomach is not well distended, the wall collapses and appears thickened. The same "thick" appearance is sometimes seen on an upper GI barium test. In both cases, when further investigations are done (usually by endoscopy), no abnormality is found in most people.

However, in a few cases, the wall thickening is a true abnormality. In these instances, the thickening is because of some process that leads to an enlargement of the stomach wall. Several diseases can cause this. Tumors of either the inner lining or central muscle layer of the stomach may appear as thickened folds on imaging studies. Infections by certain viruses or tuberculosis can also result in wall thickening. Other rare causes include Menetrier's disease (a benign disorder characterized by overgrowth of the inner stomach lining) and gastrinoma (thickening of the stomach's inner lining, along with increased acid secretion, because of a hormonal influence).

In any patient diagnosed with a thick stomach wall on an imaging study, further evaluation is required. Initially, an endoscopy with biopsy of any abnormal tissue is done. Additionally, endoscopic-guided ultrasound can be done to better characterize the involved area. The course of therapy varies widely depending on the results of these tests.