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Biomedical subjects

S N Sullivan

Publications and source records attributed to S N Sullivan.

At least 19 recordsLinked to original sources
PubMed1994

A prospective study of unexplained visible abdominal bloating.

AIMS: To investigate the relationship between irritable bowel syndrome, constipation, obesity and abdominal muscle strength in patients whose primary complaint is visible abdominal bloating. METHODS: Over two years 46 patients with the primary problem of nonorganic, visible abdominal bloating were seen. The details of their bloating as well as other symptoms were recorded. Body mass index and abdominal muscle strength were measured. Sixty-two sex matched patients with a primary complaint other than bloating served as controls. Twenty-four patients recorded changes in their weight and girth during episodes of bloating; 24 age and sex matched volunteers served as controls. RESULTS: The patients with bloating did not differ from the other patients with regard to age, sex, body mass index, or the prevalence of constipation or the irritable bowel syndrome. They were more likely to have recently gained weight (p < 0.003) and to have weak abdominal muscles (p < 0.012). During episodes of bloating the increases in girth but not weight were greater than the daily fluctuations seen in the normal volunteers (p < 0.01). CONCLUSION: Patients whose primary complaint is visible abdominal bloating have greater increases in girth but not weight during bloating episodes than the normal daily fluctuations seen in healthy controls. They have weak abdominal muscles and frequently have recently gained weight. They are not more likely to have constipation, irritable bowel syndrome or obesity than patients whose primary complaint is something other than bloating.

Abdomen↗
PubMed1994

Does running cause gastrointestinal symptoms? A survey of 93 randomly selected runners compared with controls.

AIM: To investigate the belief that running causes diarrhoea and gastroesophageal reflux. METHODS: Diet and gastrointestinal symptom questionnaires were completed by 93 randomly selected runners and 95 age, sex matched sedentary controls. RESULTS: The runners ate more fibre and had more frequent bowel movements which were more often loose or urgent. They had less constipation but there was no difference in the use of laxatives or the prevalence of the irritable bowel syndrome. Although most runners tried to empty their bowels before running, the urgent need to have a bowel movement was still the most common reason for a runner to stop during a run. Heartburn, vomiting and bloating were more common when not training while retching, stitches and fecal incontinence were more common when running. Few runners ate before running and upper gastrointestinal symptoms while running were rare. CONCLUSIONS: Lower gastrointestinal symptoms may be caused by running or the running lifestyle. Upper gastrointestinal symptoms are not due to running alone.

Adult↗
PubMed1994

Functional abdominal bloating.

Ten to 25% of healthy persons have bloating at some time or other. It is very common in those with the irritable bowel syndrome, constipation, or anorexia nervosa. Although the cause of functional bloating remains unknown, old explanations such as a low diaphragm, exaggerated lumbar lordosis, and psychiatric problems have been disproved. New suggestions on its etiology include recent weight gain, weak abdominal muscles, and retained fluid in loops of small intestine. No treatment is of proven benefit, but treatment by weight loss, exercise, and prokinetics should be studied.

Abdomen↗
PubMed1993

"Not so easy to diagnose" dyspepsia.

The diagnosis of the cause of a dyspepsia should not rest on indiscriminate "routine" investigation. It should be based on historical and physical evidence supported by a therapeutic trial that confirms the clinical diagnosis. If necessary, it should be followed by selected investigations to confirm or exclude serious diseases that are likely to be the cause of the symptoms. If an organic explanation cannot be provided, it should not be assumed that one does not exist, only that the more serious and treatable causes have been excluded. "Sophisticated" high-technology investigations should not become part of the "routine" investigation of dyspepsia.

Dyspepsia↗
PubMed1992

Runners' diarrhea. Different patterns and associated factors.

One hundred and nine distance runners participated in a questionnaire survey of bowel function related to running. Thirteen (12%) had had fecal incontinence while running. Sixty-eight (62%) had stopped to have a bowel movement while training. Forty-seven (43%) had "nervous" diarrhea before competition and 13 (12%) had stopped during competition for a bowel movement. Fifty-one (47%) had experienced diarrhea after racing or hard runs and 17 (16%) had seen blood in their stool in the same situations. Runners who had nervous diarrhea before competition were more likely to have symptoms of milk intolerance and irregular bowel function when not exercising, and runners who had symptoms of the irritable bowel syndrome often had to stop for a bowel movement during training. Runners with diarrhea after racing or hard runs frequently experienced severe abdominal cramps, nausea and vomiting, and occasionally, rectal bleeding at the same time. Any form of "runners' diarrhea" was unrelated to age, previous intestinal infection or food poisoning, food allergies, or dietary fiber.

Adult↗
PubMed1992

Effects of erythromycin on gut transit in pseudo-obstruction due to hereditary coproporphyria.

We studied gastrointestinal transit in a 57-year-old man with chronic intestinal pseudo-obstruction along with peripheral and autonomic neuropathy due to hereditary coproporphyria and we evaluated the effects of acute and chronic therapy with erythromycin. Noninvasive scintigraphic studies of regional transit of solid residue through the gut were obtained before treatment, during the acute i.v. administration of 500 mg, every-8-h doses of erythromycin for 24 h and after 15 weeks of oral therapy (500 mg, three times daily). During acute i.v. administration, symptoms and transit measurements dramatically improved; however, all parameters and symptoms returned to pretreatment levels during chronic oral therapy. We conclude that hereditary coproporphyria with associated autonomic neuropathy results in significant delay in small bowel and colonic transit; chronic administration of 500 mg three times a day oral erythromycin was not associated with maintenance of the improvement in regional transit and symptoms observed following acute i.v. administration of the drug at the same dose.

Administration, Oral↗
PubMed1990

Thoracic succussion splash: a new symptom and sign of achalasia.

A patient with a "thoracic succussion splash" due to achalasia is described. She noted a splashing or sloshing sensation in her chest related to jogging and bending. On examination a splashing sound could be heard over the mid sternum and the posterior chest when the patient was rocked vigorously back and forth.

Adult↗
PubMed1987

The midclavicular line: a wandering landmark.

Although the midclavicular line (MCL) is the usual reference point for clinical assessment of liver size and localization of the cardiac apex beat, we found substantial interobserver variation in locating the MCL. The distance from the midline to the MCL as estimated by 20 clinicians in three subjects varied by up to 10 cm. More variation was found for estimates in the obese subject than for those in the two subjects of normal build (p = 0.004). No difference in variation was found between consultants and house staff. The limitations of the MCL as a reference point are discussed in light of these findings.

Cardiomegaly↗
PubMed1987

Sulfasalazine lung. Desensitization to sulfasalazine and treatment with acrylic coated 5-ASA and azodisalicylate.

A patient with ulcerative colitus developed fever, dyspnea, eosinophilia, and pulmonary infiltrates while taking sulfasalazine. The abnormalities resolved when the sulfasalazine was stopped but the colitus recurred. Desensitization to sulfasalazine was unsuccessful, but treatment with azodisalicylate (olsazine) controlled the colitus and did not cause pulmonary problems.

Adult↗
PubMed1986

The supersensitive hypertensive lower esophageal sphincter. Precipitation of pain by small doses of intravenous pentagastrin.

The clinical and investigative features of eight patients with attacks of epigastric pain believed due to a hypertensive lower esophageal sphincter (LES) are described. Radionuclide esophageal transit studies were normal in all but one patient. Two patients had positive acid perfusion studies. Only three had an abnormal baseline esophageal manometry, but after small intravenous doses of pentagastrin all subjects experienced their presenting pain coincident with increases in LES pressure ranging from 75 to 140 mmHg. Five patients eventually required surgical myotomy of the LES, but pain relief which was immediate and complete in all proved permanent in only one. Two of the operated patients continued to experience severe attacks of pain refractory to medical therapy. The diagnosis of a hypertensive LES is best made by pentagastrin stimulation of the sphincter, but cutting the sphincter may not cure the patient.

Adolescent↗