By J. M. Naish
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Extra resources for Basic Gastro-Enterology. Including Diseases of the Liver
A permanent feeding gastrostomy is occasionally the only answer, but an unsatisfactory one, to a most difficult situation. When pain is a major symptom, oral pethidine 100 mg. and chlorpromazine 50 mg. given every 4 or 6 hours often induce tranquillity and relief, but sometimes injections of morphine or diamorphine are required. T h e latter 28 BASIC GASTROENTEROLOGY is less liable to cause nausea and vomiting. Refreshing mouth-washes and gargles are soothing, and if the obstruction is incomplete, nutrition can be maintained by glucose-fortified drinks, fruit juices, meat juices, and milk foods.
It has been suggested that the relief of ulcer pain by food and alkalis, which occurs not at once but after a few minutes, is due not to neutralization of acid and consequent inhibition of the peptic digestion of the ulcer base, but to the diversion of blood-flow away from the painful ulcer surroundings to the secretory glands in the body of the stomach. Whatever the mechanism responsible, food, drink, and alkalis usually relieve ulcer pain, but the aftermath is more pain, often accompanied by nausea and sometimes by vomiting.
Such tubes encourage necrosis and bleeding and may eventually slip through or cause ulceration and mediastinitis. A permanent feeding gastrostomy is occasionally the only answer, but an unsatisfactory one, to a most difficult situation. When pain is a major symptom, oral pethidine 100 mg. and chlorpromazine 50 mg. given every 4 or 6 hours often induce tranquillity and relief, but sometimes injections of morphine or diamorphine are required. T h e latter 28 BASIC GASTROENTEROLOGY is less liable to cause nausea and vomiting.