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At least 145 records · Page 8Linked to original sources
PubMed1993

Functional dyspepsia versus other functional gastrointestinal disorders: a practical approach in Belgian general practices.

This paper identifies the symptom profile associated with the four main diagnoses of functional digestive disorders (dyspepsia, gastro-oesophageal reflux disease (GORD), gastritis, and constipation) made by general practitioners in Belgium. Results are also presented from a multicentre study in which the effects of cisapride, administered as an oral tablet or suspension, were evaluated in patients with these functional digestive disorders. Analysis of symptom patterns revealed that early satiety and postprandial abdominal bloating were the most prominent symptoms, followed by eructation (belching), heartburn, regurgitation, postprandial epigastric burning or discomfort, and nausea. These symptoms occurred in all diagnostic groups. However, different symptom patterns were associated with each of the disorders; for example, heartburn and regurgitation were the core symptoms in patients diagnosed as having GORD, early satiety and abdominal bloating were characteristic of patients diagnosed with dyspepsia, and fasting or postprandial pain were characteristic of patients given the diagnosis of gastritis. Therefore, it appears that these diagnoses used by general practitioners in Belgium closely correspond to reflux-like, dysmotility-like and ulcer-like dyspepsia, as defined by an international working party. Cisapride improved the core symptoms in about 80% of patients with GORD or dyspepsia, relieved all epigastric symptoms in about 80% of patients with gastritis, and significantly decreased the use of laxatives and increased stool frequency in constipated patients. Cisapride was well tolerated and thus appears to be a useful option in the treatment of functional digestive disorders in a general practice setting.

Adult↗
PubMed1998

Clinical and experimental study of therapeutic effect of Weixibaonizhuan pills on gastric precancerous lesions.

AIM:To observe the therapeutic effect of Wei-xibaonizhuan pills on gastric precancerous lesions.METHODS: Thirty patients with gastric precancerous lesions were treated with Weixibaonizhuan pills for 3 months. Of the 36 cases, 13 (36.1%) were mild atrophic gastritis, 14 (38.9%) moderate atrophic gastritis and 9 (25.0%) severe atrophic gastritis; among them 22 (61.1%) and 27 cases (75.0%) were accompanied with intestinal metaplasia (IM) and dysplasia (DYS) respectively. Of the 36 patients, 20 were men and 16 women, aged from 30-60 years and those aged 30-59 years accounted for 61.1%. The course of disease ranged from 3 months to 21 years, and 20 (55.6%) of them had a course of 5-10 years. The clinical manifestations were fullness of the abdomen (31 cases),abdominalgia (27 cases), anorexia (30 cases), gas eructation (26 cases), acid regurgitation (6 cases) and loose stool (9 cases). When treatment ended, the improvement of patients' clinical symptoms, atrophy of gastric mucosa, IM and DYS were analysed.RESULTS: After 3 months' treatment with Wei-xibaonizhuan pills,7 cases recovered, 11 cases were much improved, 13 cases showed some improvement, and 5 cases were ineffective; the total rate of symptomatic improvement was 86.1%. Of the 13 cases with mild atrophic gastritis, 11 cases changed into superficial gastritis, and 2 cases had no changes. Of the 14 cases of moderate atrophic gastritis, 4 cases changed into superficial gastritis, 7 cases changed into mild atrophic gastritis, and 3 cases had no changes. Five of 9 cases of severe atrophic gastritis were reduced to moderate atrophic gastritis, and 4 cases had no changes. The total effective rate was 77.8% in chronic atrophic gastritis. Of the 9 cases with mild IM, IM disappeared in 6 cases and 3 showed no change. Of the 10 cases with moderate IM, it disappeared in 2 cases, 5 cases changed to ild IM, and 3 cases had no change. One of the 4 cases of severe IM changed to moderate IM and 3 had no change. The total effective rate was 63.6% in IM. Of the 16 cases of mild DYS, 11 cases showed disappearance of DYS and 5 had no change. In 9 cases of moderate DYS, 2 showed disappearance, 5 changed to mild DYS and 2 had no change. Two cases of severe DYS, both showed no change. The total effective rate was 66.7% in DYS. Before treatment, the I, II, III and IV degree positive expressions of CEA were present in 13, 12, 9 and 2 cases, respectively, whereas after treatment, the positive expressions were present in 25, 7, 3 and 1, respectively. Before treatment, the I, II, III and IV degree positive expressions of PCNA were present in 16, 11, 10 and 4 respectively, but after treatment, they were present in 21, 9, 5 and 1 respectively. In short, the positive expressions of CEA and PCNA of gastric mucosa were significantly decreased after treatment (P < 0.01).CONCLUSION: Weixibaonizhuan pill has a therapeutic effect in gastric precancerous lesions.

Journal Article↗
PubMed1999

[Peppermint oil-caraway oil fixed combination in non-ulcer dyspepsia--comparison of the effects of enteric preparations].

223 patients with non-ulcer dyspepsia (dysmotility type dyspepsia or essential/idiopathic dyspepsia, also in combination with irritable bowel syndrome) were included in a prospective, randomised, reference- and double-blind controlled multicentre trial to compare two different preparations of a fixed combination of peppermint oil and caraway oil. The aim of the trial was to evaluate the equivalence of the efficacy and tolerability of these two preparations. The test formulation consisted of the drug combination in an enteric coated capsule containing 90 mg peppermint oil and 50 mg caraway oil, while an enteric soluble formulation containing 36 mg peppermint oil and 20 mg caraway oil was used as the reference. The main target item defined was the "difference in pain intensity between the beginning and the end of therapy", measured by the patient on a visual analogue scale (0 = no pain, 10 = extremely strong pain). In 213 patients (n = 108 on the test preparation, n = 105 on the reference preparation) with mean pain intensity baseline measurements of 6.1 points in the test preparation group and 5.9 points in the reference group a statistically significant decline in pain intensity was observed in the two groups (-3.6 resP. -3.3 points; p < 0.001; two-sided one-sample t-test). Equivalent efficacy of both preparations was demonstrated (p < 0.001; one-sided t-test for equivalence). With respect to concomitant variables, the results in both groups were also similar. Regarding "pain frequency", the efficacy of the test preparation was significantly better (p = 0.04; two-sided t-test for difference). Both preparations were well tolerated. Despite the higher dose, the adverse event "eructation with peppermint taste" was less frequent in the group treated with the test formulation, due to the enteric coated capsule preparation.

Adult↗
PubMed2000

Phase I clinical and pharmacokinetic study of perillyl alcohol administered four times a day.

We conducted a phase I dose-escalation trial of perillyl alcohol (POH; NSC 641066) given p.o. on a continuous four times a day basis to characterize the maximum tolerated dose, toxicities, pharmacokinetic profile, and antitumor activity. Sixteen evaluable patients with advanced refractory malignancies were treated at the following doses: level 1 (L1), 800 mg/m2/dose; L2, 1200 mg/m2/dose; L3, 1600 mg/m2/dose. POH was formulated in soft gelatin capsules containing 250 mg of POH and 250 mg of soybean oil. The predominant toxicities seen were gastrointestinal (nausea, vomiting, satiety, and eructation), which were dose limiting. There appeared to be a dose-dependent increase in levels of the two main metabolites, perillic acid and dihydroperillic acid. No significant differences were seen whether the drug was taken with or without food. There was a trend toward decreasing metabolite levels on day 29 compared with days 1 and 2. Peak metabolite levels were seen 1-3 h post ingestion. Metabolite half-lives were approximately 2 h. Approximately 9% of the total dose was recovered in the urine in the first 24 h, the majority as perillic acid. Evidence of antitumor activity was seen in a patient with metastatic colorectal cancer who has an ongoing near-complete response of > 2 years duration. Several other patients were on study for > or = 6 months with stable disease. The maximum tolerated dose of POH given continuously four times a day was 1200 mg/m2/dose. Gastrointestinal toxicity was dose limiting, although significant interpatient variability in drug tolerance was seen.

Administration, Oral↗
PubMed2000

[A retaining dam against reflux. Laparoscopic fundoplication helps even in stubborn cases].

The introduction of proton pump inhibitors (PPI) and laparoscopic fundoplication in the treatment of gastroesophageal reflux disease offered an opportunity for definitive healing. The indication for surgery is the failure of medical treatment, recurrence of symptoms following conservative treatment, severe side effects of the medication, and the patient's wish to stop taking drugs. The laparoscopic treatment has a low rate of complications. Apart from temporary dysphagia (30%), rapid satiety, increased flatulence and suppressed eructation are possible undesirable sequelae. Intra-operative bleeding and organ perforation (1%) are major feared occurrences. The rate of conversion to open surgery is 5.8%, and the mortality rate is 0.1%. Persistent dysphagia in 3.4% may be caused by a slipped cuff. A revision procedure is necessary in 0.7% of the patients. Patient satisfaction with the results of the operation ranges between 87 and 100%.

Esophagitis, Peptic↗
PubMed2000

Superior mesenteric artery syndrome: an uncommon cause of intestinal obstruction.

Superior mesenteric artery (SMA) syndrome is an atypical cause of high intestinal obstruction, most frequently occurring in patients who have had rapid weight loss. Identification of this syndrome can be a diagnostic dilemma and is frequently made by exclusion. The most characteristic symptoms are postprandial epigastric pain, eructation, fullness, and voluminous vomiting. The symptoms are caused by compression of the third portion of the duodenum against the posterior structures by a narrow-angled SMA. When nonsurgical management is not possible or the problem is refractory, surgical intervention is necessary. We report a case of SMA syndrome in a patient without a history of rapid weight loss. The patient complained of early satiety, nausea, and vomiting of partially digested food worsening over 2 years. Diagnostic evaluation revealed compression of the third portion of the duodenum by the SMA with resultant proximal dilatation. The patient successfully had duodenojejunal anastomosis.

Duodenal Diseases↗
PubMed2001

[Laryngeal mask of gastroesophageal reflux disease].

Gastroesophageal reflux disease has become a serious problem not only for general practitioners but for other specialists as well. It is caused by the fact that its clinical picture and symptomatology are very rich. Beside characteristic symptoms such as: heartburn, eructation, gastric contents reflux, epigastric burning or dysphagia, there may appear extroesophageal symptoms (frequently as single or leading ones). It is generally though that the above symptoms result from the direct effect of gastric contents on throat and larynx and/or through vagus nerve. Direct effect of hydrochloric acid and other gastric juice components on larynx may be the cause of subglottic laryngostenosis, neoplastic transformation and development of squamous cell carcinoma. This, it may be concluded that gastroesophageal reflux disease should be in the sphere of interest of laryngologists as well as gastroenterologists. Cooperation of these specialists is particularly useful as it quickens the choice of proper diagnostic procedure and an introduction of an appropriate therapeutic treatment.

Gastroenterology↗
PubMed2002

Gastrojejunocolic fistula following surgery for peptic ulcer complications: two case reports.

Two patients were admitted in the surgical unit--I of Mymensingh Medical College Hospital on January 2001 and March 2001 with the complaints of epigastric pain and discomfort, feculent eructation and fecal vomiting, diarrhoea with lienteric stools, weight loss and weakness. Both of them had previous history ulcer complications. The diagnoses of gastrojejunocolic fistula were made on the basis of history, barium enema examination and upper gastrointestinal endoscopy. Early resuscitation with correction of nutritional deficiencies, fluid and electrolyte imbalance was attempted along with blood transfusion, antibiotics and other supportive measures. But the first patient was too ill to cope up with the treatment and developed cardio-respiratory symptoms. A single stage procedure comprising of partial gastrectomy along with resection of the fistula and restoration of bowel continuity (by jejunojejunostomy, colocolostomy and closure of duodenal stump) was adopted in both patients. Early postoperative recovery was good in both but the first patient expired on 8th postoperative day from acute myocardial infarction, while the second one developed anastomotic leakage and wound infection, which were managed conservatively. On follow up the second patient was found in sound health till to date after his discharge from the hospital.

Adult↗
PubMed2002

[Relationship of pathological gastroesophageal reflux and some symptoms of chronic laryngeal and pharyngeal inflammation].

Sixty eight patients with laryngeal and pharyngeal complaints have undergone both otorhinolaryngological and gastroenterological examinations. Most of the examinees were diagnosed to have pathological gastroesophageal reflux (PGER). Typical complaints for heartburn and eructation occurred in less than half the patients with PGER. It is proposed to conduct a gastroenterological examination of patients with persistent chronic inflammation of laryngeal and pharyngeal mucosa.

Adolescent↗
PubMed2003

[Optimization of diagnostic and therapeutic programs in modern neonatal surgery].

Tendencies in neonatal surgery research are presented. Based on 187 cases, indications to preventive intestinal stomas creation in the newborns and also time of their closure are regarded. Surgical correction of malformation or treatment of acute process in the abdominal organs with intestinal stoma closing is finished to month 2-3 of childs life. The developed differential-diagnostic criteria of functional and organic lesion of ureteropelvic and ureterovesicular segments based on diuretic sonography permitted one to reveal early age pathology of urinary system and to correct it with surgical methods. The developed algorithm of diagnosis and treatment of newborns with eruct syndrome permits one to determine indications to surgery in 10% infants with gastroesophageal reflux.

Age Factors↗
PubMed1958

Effectiveness of antacids in reducing digestive disturbances in patients treated with prednisone and prednisolone.

To appraise the efficiency of complemental antacid administration in preventing and reducing digestive disturbances during prolonged treatment with prednisone and prednisolone, 100 patients with active rheumatoid arthritis who were maintained on combined antacid and prednisone or prednisolone therapy for periods of one year or longer, were studied clinically and roentgenographically. Antacid therapy consisted of 300 mg. of dried aluminum hydroxide gel and 50 mg. of magnesium trisilicate taken with each 2.5 mg. dose of the steroids. Digestive symptoms, such as indigestion, heartburn, sour eructations, gnawing epigastric distress and the like, were experienced by 18 per cent of patients during treatment with prednisone or prednisolone combined with antacids. Among patients who had been maintained on the steroids without antacids beforehand, the incidence of digestive complaints was reduced from 38 per cent to 17 per cent by the addition of alkali therapy, and the severity of the distress decreased in others. Active peptic ulcers were detected roentgenographically in three of the 100 patients. In two instances the ulcers were asymptomatic and in two instances they were considered as reactivations of previously healed lesions. The incidence of active ulcers in this series was substantially lower than that reported by several investigators among patients treated with prednisone and prednisolone without the concomitant administration of alkalis. The size of dosage and individual susceptibility appeared to be important factors in the development of digestive disturbances from steroids. Results of the study indicated that the complemental use of antacids with each divided dose of steroid is highly effective in reducing the frequency and severity of digestive symptoms during prednisone and prednisolone administration. The low incidence (3 per cent) for roentgenographically demonstrable active lesions in the series suggests that the addition of acid-neutralizing agents during prolonged treatment with these steroids may afford at least partial protection against the development and reactivation of peptic ulcers.

Aluminum Hydroxide↗
PubMed2004

[Gastrointestinal complications in diabetes mellitus].

Impaired function of the gastrointestinal tract related to diabetes mellitus (DM) results from diabetic autonomous neuropathy, impaired sensory innervation and a direct effect of chronic hyperglycaemia. Another possible connection between DM and the gastrointestinal tract can be infrequent autoimmune diseases associated with type I DM (celiac disease, autoimmune gastropathy, autoimmune chronic pancreatitis). Functional or organic changes resulting from diabetes can be seen in every organ of the gastrointestinal tract. Some of the diabetic gastrointestinal tract difficulties affect almost 60% of patients with long lasting diabetes. On one side, impaired function of individual organs in diabetics can significantly influence level of diabetes compensation and vice versa. On the other side, unsatisfactory diabetes compensation can result in manifestation of digestive problems. The most frequent and the most serious clinical complication is diabetic gastroparesis (DG). The highest incidence of impaired evacuation and motility of the stomach (and the small intestine) is described in diabetics with long lasting unsatisfactory diabetes compensation, microangiopathic complications, and diabetic neuropathy (55-75% in type I diabetes and 15-20% in type II diabetes). Symptoms accompanying impaired motility and emptying of the stomach (feeling of early fullness, eructation, nausea, vomiting and abdominal pains) can be only temporary or can be missing in some patients. Hyperglycaemia accompanied by slowing down evacuation of the stomach is different in patients with an empty stomach--glycaemia over 7.8 mmol/l, and postprandially--antral motility decreases after blood glucose levels get over 9.7 mmol/l. Treatment options for symptomatic diabetic gastroparesis are limited. Achieving normoglycaemia usually improves diabetic gastroparesis but in up to 80% of cases simultaneous administration of prokinetics is necessary.

Autoimmune Diseases↗
PubMed2004

[Surgical treatment of the GER with Boix-Ochoa technique. Long term results].

UNLABELLED: The Boix-Ochoa technique enable hipercorrection of the gastroesophageal reflux (GER), avoiding the disphagia and allowing the eructing capability as a consequence of the fundoplication procedure. MATERIAL AND METHODS: During the last decade 102 children were surgically treated using the Boix-Ochoa technique. The age range was 4.93 +/- 3.80 years. All patients have previously been studied with Xray, esophageal manometry, pHmetry during 24 h, and eventually with medical treatment. Failure of the medical treatment lead to the surgical treatment with the Boix-Ochoa technique. RESULTS: After surgery, 24 h controls of esophageal pHmetry showed reflux indexes greater than 5 in six patients. Two of them had neurological pathology and one of them suffered peptic stenosis previously treated by means of mechanical dilatation. The rest of patients showed normal value of reflux indexes after surgery. CONCLUSIONS: Excluding the esophageal atresia and caustic stenosis, the Boix-Ochoa technique is the best choice for the surgical treatment of GER.

Adolescent↗
PubMed2005

[Methanogens and manipulation of methane production in the rumen].

Methanogens belong to the kingdom of Euryarchaeota in the domain of Archaea. They are characterized by their ability to produce methane under anaerobic conditions. Methane production in the rumen represents a loss of energy for the host animal, and, in addition, methane eructated by ruminants may contribute to a greenhouse effect or global warming. Reduction or elimination of methanogenesis in the rumen has been touted as a way of improving animal production and may marginally benefit to control of anthropogenic release of methane. More and more scientists focus on ruminal methanogens and methanogenesis recently. Authors summarized the manipulation of methanogenesis in the rumen, including defaunation, feed formulation, adding electron acceptors and stimulation of acetogens. The characteristics of methanogenic Archaea and the recent knowledge of the methanogenesis in the rumen were also reviewed in this article.

Animals↗
PubMed2006

Superior mesenteric artery syndrome: an unusual case of intestinal obstruction.

Superior mesenteric artery (SMA) syndrome is an uncommon cause of proximal intestinal obstruction, frequently occurring in patients who have had an important weight loss. The diagnosis can be difficult and usually is made by exclusion. The most characteristic symptoms are postprandial epigastric pain, fullness, voluminous vomiting and eructation. These symptoms are due to the compression of the third portion of the duodenum against the posterior structures by a narrow-angled SMA and surgical management is necessary. We report a case of SMA syndrome in a 23 year old patient, with a long history (since childhood) of voluminous vomiting, epigastric pain and an important weight loss. We performed small bowel enteroclysis, upper gastrointestinal series and endoscopy, biopsy of gastric and duodenal mucosa, abdominal computer tomography and ultrasonography to establish the diagnosis. Finally, the patient successfully underwent duodenojejunal anastomosis with a postoperative favourable outcome.

Adult↗
PubMed2006

[Comparative study on Jinghua Weikang Capsule and famotidine in treating duodenal ulcer].

OBJECTIVE: To compare the effect and security of Jinghua Weikang Capsule (JWC) and famotidine in treating duodenal ulcer. METHODS: Two hundred patients with duodenal ulcer were randomly divided into the treated group treated with JWC, 160 mg 3 times per day and the control group treated with famotidine 20 mg twice per day, both by orally taking before meal for 4 weeks, 100 cases in each group. Changes of symptom score, adverse reaction, helicobacter pylori (Hp) infection and endoscopic figure before and after treatment were observed. RESULTS: The general remission rate and the ulcer healing rate in the treated group were equal to those in the control group respectively (both P > 0.05). Symptoms including belly ache, sour regurgitation and abdominal distension were ameliorated after therapy in both groups (all P < 0.05). The effect in relieving anorexia and eructation and Hp eradication rate were significantly higher in the treated group than those in the control group (all P< 0.05), while the incidence rate of adverse reaction in the treated group was remarkably lower than that in the control group (P < 0.05). CONCLUSION: JWC is an effective and safe remedy in treating duodenal ulcer, especially for symptom amelioration and Hp eradication, so it is worthy of expanding clinically.

Adolescent↗
PubMedDate not supplied

[Neuroendocrine tumors. A rare case of duodenal carcinoids].

The authors report their experience with a case of double duodenum carcinoid tumors occurring in a 59-year-old female patient. She presented with a one-year history of frequent abdominal painful episodes, associated with dyspepsia, emesis, pyrosis, eructation, skin flushing and easy strain. The laboratory examinations point out high hematic values of serotonin and gastrin, with a raising of urinary 5-HIAA. Preoperative endoscopic examinations showed the presence of 2 little sessile polypoid growths, placed in the duodenal bulb, one of this interested muscular tunic. The patient underwent Billroth I resection and was discharged on postoperative day 8. The authors after a little dissertation on that topic, go on to examine the current diagnostic and therapeutic possibilities. They confirm the elective role of surgical treatment of these rare tumors.

Carcinoid Tumor↗
PubMed1991

High sulfide concentrations in rumen fluid associated with nutritionally induced polioencephalomalacia in calves.

Nine 115- to 180-kg, hay-adapted, Holstein steers were fed an experimental diet with added sodium sulfate that induces polioencephalomalacia (PEM). Five calves developed the disease. Thiamine concentrations in blood, CSF, brain, and liver were not indicative of thiamine deficiency. The odor of hydrogen sulfide in eructated rumen gas was associated with the onset of PEM. Sulfide concentrations in rumen fluid were measured 1 or 2 times a week by 2 techniques. Sulfide concentrations progressively increased in all 9 calves after the feeding of the PEM-inducing diet commenced. The highest concentrations coincided with the onset of clinical signs of PEM and were significantly higher in the calves that developed PEM than in those that did not. This suggests that PEM can result from sulfide toxicosis following excess production of sulfide in the rumen.

Animals↗