Visceroptosis is a prolapse or a sinking of the abdominal viscera (internal organs) below their natural position. "Ptosis" being the defining term, any or all of the organs may be displaced downward. When only the intestines are involved, the condition is known as enteroptosis. When the stomach is found below its normal position, the term gastroptosis is used. The condition exists in all degrees of severity and may not give rise to any adverse symptoms. Generally, when adverse symptoms are associated with the condition, however, there may be loss of appetite, heartburn, nervous indigestion, constipation, diarrhea, abdominal distention, headache, vertigo, emaciation, and loss of sleep. Any or all of these symptoms may be present. The condition may be brought about by loss of muscular tone, particularly of the abdominal muscles, with relaxation of the ligaments that typically hold the viscera in place. Tightlacing has been held to be a cause as well. Corsets to reduce the circumference of womens waists have been used to enable fashionable styles occurring during several historical periods, such as the late 1800s and early 1900s, when these symptoms were described for treatment by physicians. Adverse symptoms may be alleviated by supporting the organs with a properly applied bandage, or other similar device. Rest in bed, attention to diet, hygiene, exercise, and general muscular strengthening will cure the majority of cases. In some cases, surgical intervention may become necessary.Visceroptosis is a known risk factor for the development of Superior mesenteric artery syndrome.
On average, symptoms begin 3-4 hours after consumption, but can begin anywhere from several minutes to 18 hours afterward. Symptoms typically include neurologic and gastrointestinal issues including:
nauseavomiting
diarrhea
numbness and tingling in the lips, mouth, face, and extremitiesThe latter has been described as “nerves being on fire” or “ants crawling and biting all over”.Other less common symptoms can include:
ataxia
loss of coordination
limb paralysis
reversal of hot and cold sensations
slurred speech
headache
pupil dilation
generalized fatiguePatients may be thought to be disoriented or intoxicated. Rarely, patients may experience respiratory distress requiring ventilatory support. Despite this seemingly severe constellation of symptoms, there have been no documented deaths due to NSP. NSP can present similar to other disorders such as:
common food poisoning
seafood allergy
paralytic shellfish poisoning
ciguatera fish poisoning
pesticide poisoning
alcohol intoxication
certain psychiatric disorders.Due to the extensive list of disorders with similar symptoms, a detailed food history is necessary to make the diagnosis. Management and treatment
Treatment for NSP is mostly supportive with monitoring and symptom management. Intravenous fluids and observation of respiratory function are the mainstay of treatment along with pain control. Activated charcoal can be given if the patient presents within four hours of consumption to decontaminate the gastrointestinal tract. Currently, there is no specific antidote for brevetoxins, however there may be a role for mannitol (the primary treatment for ciguatoxin, a dinoflagellate-produced toxin found in some species of fish) or brevatal, a natural antagonist of brevetoxin produced by K. brevis. Though public health policy differs by state, measures are taken to prevent shellfish poisoning outbreaks.