Patients often experience recurrent upper-abdominal discomfort related to the low position of the stomach, delayed emptying and secondary reflux:
- Epigastric pain or dull ache, usually within 1 h after meals, worsened by standing or activity and eased by bending forward or hugging the knees
- Marked fullness: feeling distended after only a small meal, accompanied by frequent belching
- Dyspepsia: acid regurgitation, nausea, occasional retching with gastric (non-bilious) content
- Delayed gastric emptying leads to loss of appetite and, in the long term, weight loss and fatigue
- Some cases report retro-sternal or back radiation, linked to reflux gastritis
- Symptoms are aggravated by prolonged standing, fatigue, post-prandial exertion or emotional stress, and are usually relieved by lying flat or at night
Persistent or recurrent complaints should prompt upright barium meal or gastroscopy for confirmation.
| Symptom group | Typical description | Precipitating/relieving factors |
|---|---|---|
| Epigastric pain | Post-prandial dull or distending ache, may radiate to back | Standing↑ Bending↓ |
| Fullness | Feeling filled after small intake | Post-meal↑ Supine↓ |
| Belching/acid | Frequent sour eructations | Activity↑ Knee-hug↓ |
| Nausea/appetite↓ | Occasional retching, reduced food intake | Stress↑ Rest↓ |
| Weight loss | Result of chronic inadequate intake | Fatigue↑ Small-frequent meals↑ |