Synonyms

Cardialgia, gastrospasmus, and gastrodynia.

By the term gastralgia is designated the occurrence of attacks of pains of more or less severity in the gastric and epigastric regions. These persist for a certain period and alternate with perfectly free intervals.

Symptomatology

The attacks of pains rarely appear suddenly. As a rule, they are preceded by short periods of various abnormal sensations; thus a slight feeling of nausea or of tension in the gastric region may exist. Increased salivation is also frequently one of the prodromal symptoms. Headache, feelings of faintness or vertigo may also precede the real attack. Very soon afterward an intense pain appears in the epigastric region, extending especially to the left side.

There exist a crampy sensation and a feeling of constriction, or there may be a feeling of intense burning. These pains and sensations frequently radiate to the back, to the shoulder blades, and over the whole abdomen. At such times the patient is overcome by a feeling of great anxiety. The extremities often grow cold, and cold perspiration appears on the forehead. The face is extremely pale, and bears the expression of anguish and anxiety. The patient frequently is unable to lie straight, and often assumes a bent position, so that the abdominal muscles are not stretched, but kept in a curved and relaxed condition. Sometimes the patient puts a pillow upon his abdomen and curls himself around it, holding it with his arms. The character of the pulse is variable. As a rule, it is accelerated, sometimes, however, it is rather retarded. The gastric region is mostly sunken; in rare instances protruding. While this region is sensitive to slight palpation, a more profound pressure does not, as a rule, cause any pain, and frequently rather relieves the patient's suffering for a moment. The duration of such an attack is very variable; it may last fifteen minutes only or several hours.

At the end of the attack the pains disappear quite suddenly, and the patient now experiences a sensation of hunger. If the attack was of short duration (half an hour or so) the patient does not retain any symptoms of malaise after it, and is able to attend to his usual work. It is quite different with a severe attack that has lasted several hours. The latter leaves a feeling of extreme weakness for several days, during which the patient has to remain abed.

The frequency of these attacks is very variable, and different in each case. In some cases the attacks occur once in a few months or once in a year, while in others they appear every week or even every day. The attacks of idiopathic gastralgia do not seem to be dependent upon the quality or quantity of food ingested, nor to show any relation to the time of its ingestion.

Etioloyy

With regard to etiology, gastralgia may be divided into the following forms:

(1) Gastralgia of stomachic origin; (2) central gastralgia; (3) neurotic gastralgia; (4) constitutional gastralgia; (5) reflex gastralgia.