Overview: What Is Gastric Perforation?
Gastric perforation is one of the most common surgical emergencies in abdominal surgery. It typically presents with sudden, sharp, knife-like pain in the upper abdomen, which quickly spreads throughout the entire abdomen as diffuse peritonitis develops.
The primary causes include:
- Peptic ulcers (most commonly gastric or duodenal ulcers)
- Stress-induced ulcers
As an ulcer deepens over time, it erodes through the muscular and serosal layers of the stomach wall until it finally penetrates the stomach wall entirely, causing a perforation.
Other contributing factors may include:
- Gastric cancer
- Abdominal trauma
- Heavy smoking or alcohol abuse
- Overeating
- Long-term use of corticosteroids
Treatment Recommendations
Management depends on the severity and timing of the perforation:
- Small perforations without peritonitis (e.g., those occurring while fasting) may be treated conservatively:
- Strict NPO (nothing by mouth)
- Nasogastric tube insertion to decompress and drain gastric contents
- Intravenous fluids to correct dehydration and electrolyte imbalances
- Antibiotics to prevent secondary intra-abdominal infection (e.g., cefoperazone in normal saline, given IV)
- Potassium chloride supplementation as needed
- Perforations after a meal are medical emergencies:
When stomach contents leak into the peritoneal cavity, they trigger chemical peritonitis, followed rapidly by bacterial peritonitis and potentially septic shock.
➤ Immediate surgical intervention is required—delay can be life-threatening.
Dietary & Lifestyle Advice for Prevention
To reduce the risk of gastric perforation and support overall stomach health:
- Avoid pickled, salty, or highly processed foods (e.g., pickled vegetables, salted duck eggs).
- Limit spicy, raw, or irritating foods such as chili peppers, raw garlic, onions, and strong seasonings.
- Eat regular, moderate-sized meals—chew thoroughly and eat slowly.
- Prefer small, frequent meals over large ones.
- Choose soft, easily digestible foods; avoid coarse or rough-textured items.
✅ Recommended foods:
- Fresh fruits and vegetables rich in vitamin C (e.g., apples, bananas, oranges, bok choy, spinach, rapeseed greens)
- Moderate amounts of lean protein: skinless poultry, eggs, low-fat milk, and lean meats
✅ Lifestyle tips:
- Keep your abdomen warm—cold exposure can impair gastric function.
- Never binge eat. After a large meal, take a gentle walk instead of bending over, squatting, or engaging in strenuous activity, as these actions increase intra-abdominal pressure and may trigger perforation in vulnerable individuals.
Prevention is key: Managing ulcers early, avoiding risk factors, and maintaining healthy eating habits significantly lower the chance of this life-threatening condition.