My grandmother has recently been told her stomach is reversed (upside-down). I've been unable to find any information about this condition. Could you provide me with any knowledge you may have?

Monica

I'm not sure what your grandmother's doctor meant when he described her stomach as "upside-down," but there may be two explanations. Gastroenterologists sometimes use the term "J-shaped stomach" to describe an unusual appearance of the stomach seen during an endoscopic exam. In such cases, the stomach appears to fold back on itself. It is not known if this abnormality has any significance at all, or if it causes any symptoms in patients.

The second, and more likely, possibility for your grandmother's "upside-down" stomach is a condition known as gastric volvulus. Volvulus refers to a twisting of the stomach. In one configuration, it can twist so that the lower part of the stomach ends up higher than the upper stomach on X-ray images, thus giving the impression of an upside-down stomach.

Elderly people are more prone to volvulus, probably due to the weakening of ligaments that usually keep their organs in place. Also, a hiatal hernia (a condition in which part of the stomach protrudes above the diaphragm into the chest) can predispose a person to volvulus.

Gastric volvulus can cause sudden pain, severe bloating and an inability to vomit or belch. If this disorder is not recognized quickly, perforation of the stomach can occur due to a lack of blood supply to the twisted area. Such perforation often needs to be treated with emergency surgery. Other volvulus patients may experience less severe, chronic symptoms such as mild abdominal bloating and heartburn. In such people, the diagnosis may not be considered until an X-ray study of the stomach is done to evaluate these symptoms. Less severe volvulus may not need any treatment, or the patient may get relief with medication and dietary changes.

You should find out what your grandmother's doctor meant specifically when he mentioned the appearance of her stomach, and what therapy (if any) he recommends.