Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Crohn's disease (regional enteritis) is a chronic non-specific inflammatory intestinal disorder of unknown etiology. Most commonly the terminal ileum in involved, a segmentary involvement of the bowel wall is rather characteristic. Main symptoms are recurrent abdominal pain, fever, diarrhea and weight loss. Radiological and endoscopic examination confirms the diagnosis, granulomas in the biopsy specimen are pathognomonic. In differential diagnosis ulcerative and ischaemic colitis have to be ruled out. Conservative therapy with prednisolone and salazopyrin is the method of choice, however, complications like small bowel obstruction, toxic megacolon and fistulae ask for surgical intervention.
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PMID:[Morbus Crohn (enteritis regionalis)]. 0 46

Thirty children less than 15 years of age with Crohn's disease are reported. The mean age of onset was nine years and five months. Delay in diagnosis may stem from the varying modes of presentation. The mean delay in diagnosis was two years. Chronic diarrhea and/or recurrent abdominal pain associated with extraintestinal manifestations, particularly abnormalities of growth and development suggests the possibility of Crohn's disease in the pediatric age group. Involvement of the terminal ileum occurred in 29 of the 30 patients. In addition, colonic disease occurred in 13 and jejunal involvement in one. Four patients presented with an acute onset of their disease. A favorable response to either medical or surgical therapy occurred in all four. Twenty-six patients had an insidious onset and tended to have a chronic course despite either medical and/or surgical therapy. Thirteen patients had an intestinal resection, with recurrence occurring in three from 1-4 years postoperatively. To date there has been one death.
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PMID:The pediatric corner: the varied manifestations of Crohn's disease in children and adolescents. 2 92

The most common initial symptoms in 169 patients with Crohn's disease, followed from 1956 to 1973, were diffuse abdominal pain, diarrhoea without any blood admixture, loss of weight, and fever. At the onset of the disease 84% of patients were aged 10-39 years. The most important complications (in descending order of frequency) were fistulae and abscesses, ileus, anaemia, and malabsorption. A breakdown into active and passive phases indicated that the younger the patient at onset of the disease, the more severe its course. The disease seemed to take a more favourable course when only the colon, but not the terminal ileum, was involved. Recurrence occurred more frequently after a short than after a long preoperative history. Recurrences were more frequent in patients under than over 31 years of age at their first operation.
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PMID:[Crohn's disease: course and prognosis in 169 patients (author's transl)]. 2 19

Records of 1084 patients entered into the National Cooperative Crohn's Disease Study were analyzed to gather information concerning the natural history and clinical features of Crohn's disease. The age of onset reached a single peak between the second and fourth decade and was evenly distributed in both sexes. There was an average interval of 35 mo from onset of symptoms to diagnosis. Involvement of both colon and terminal ileum was the most frequent pattern and was present in 55% of patients. The disease was confined to the terminal ileum, other areas of the small intestine, or colon-only in 14%, 3%, and 15% of patients, respectively. Sigmoidoscopic abnormalities were seen in 34% of all patients and 51% of patients with Crohn's colitis. Diarrhea, abdominal pain, weight loss, and fever were present in the majority of the patients. Lower GI bleeding, fever, and perianal complications characterized patients with colon-only involvement. The frequency of extra intestinal manifestations was similar in all groups. Among patients who were randomized to placebo, 32% achieved a spontaneous remission by the end of 17 wk, and 53% of these were still in remission at the end of 24 mo. Clinical remission was associated with an improvement in barium x-rays in 18% of the patients. The predicted factors associated with favorable outcome in placebo-treated patients were: previous surgical removal of all observable disease, absence of perianal disease, and Crohn's Disease Activity Index value under 200.
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PMID:Clinical features and natural history of Crohn's disease. 38 Oct 94

23 consecutive patients (13 women, 10 men; mean age 31 years) with acute exacerbation of Crohn's disease were treated by a dietary regimen based on "resting" the bowel by parenteral nutrition or a balanced synthetic diet (Vivasorb), followed by stepwide introduction of a low-residue diet. Cardinal symptoms such as severe abdominal pain, diarrhoea, incomplete ileus or weight loss responded favourably to treatment in each case. Postoperative fistulae closed in two of three patients. Enterocutaneous fistulae, however, remained open in all five patients, although the volume of secretion decreased distinctly in four. During the follow-up period (averaging nine months after discharge from hospital) symptoms recurred in five patients, necessitating operative treatment in three.
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PMID:[Results of treating the acute stage of Crohn's disease by a dietary regimen (author's transl)]. 41 56

Histoplasma capsulatum involves some part of the gastrointestinal tract in 75% of patients with disseminated disease, but clinically obvious gastrointestinal involvement is infrequent. Symptoms include crampy abdominal pain, diarrhea, nasopharyngeal ulcers, and rectal ulcers. Granulomatous constrictive lesions may simulate either carcinoma anywhere in the gut or less commonly Crohn's disease. We describe a patient and discuss gastrointestinal histoplasmosis.
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PMID:Gastrointestinal histoplasmosis. 55 99

In 19 patients with gastrointestinal tumors the diagnosis was made by ultrasound. 7 patients were examined for further investigation of an abdominal mass; 12 patients, presented with symptoms suggesting malignants, e. g. weight loss, vomiting, fever, abdominal pain, and/or anaemia from bloodloss were first investigated by ultrasound. In 5 patients with colon tumors, diagnosed by ultrasound, a resection and anastomosis was possible. 13 cases were found to be inoperable during laparotomy, one patient had an ileocolitis Crohn with stenosis. Ultrasonic examination with real-time scanning technique proved to be a valuable method as a screening procedure for patients with suspected gastrointestinal tumors. During the same procedure local (mesenteric) or liver metastases can be detected. A normal abdominal ultrasonography does not exclude malignant intestinal lesions in any location during the early stage and in the region of cardia and rectum even in the more advanced stage.
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PMID:[The use of ultrasound in the diagnosis of gastrointestinal tumors (author's transl)]. 68 40

This is the first published report in Israel of ischemic colitis in a woman using the contraceptive pill; 20 such cases have been reported in other parts of the world. The patient was a 46 year old married woman with 3 children; she had been in good health except for obesity and chronic hypertension. Her medications included an oral contraceptive for a period of 3 years, and methyldopa for treatment of her hypertension. She presented with abdominal pain and diarrhea of 5 weeks duration. She underwent surgical reanastamosis of the bowel and was doing well at follow-up 1 year after surgery. The presence of ischemic colitis was definitively diagnosed by histological examination; the differential diagnosis included cancer, ulcerative colitis, Crohn's disease, and infectious disease. The authors note that although there is possible association between taking oral contraceptives and the appearance of ischemic colitis, there is not yet any statistical evidence for such a relationship. Similar cases have been reported among young women who were not using oral contraceptives.
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PMID:[Ischemic colitis in a woman on contraceptive pills]. 84 35

In 32 patients with Crohn's disease which started in childhood, abdominal pain, diarrhoea, and weight loss were the common presenting symptoms, but unexplained fever and failure to grow were also prominent. Stunted growth was the most frequent physical abnormality when first seen in hospital. The mean delay in diagnosis was almost 3 years and the principal contributing factor here was failure to consider the diagnosis and thus perform a barium follow-through examination. The cumulative relapse rate after medical therapy or surgical resection was disappointingly high, but because the median relapse time is much longer for surgically treated patients, surgery is recommended at an early stage, especially in those patients who are growth-retarded or whose education is suffering because of time lost from school.
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PMID:Crohn's disease in childhood. 92 8

A patient over 40 years of age who complains of lower abdominal pain, constipation or diarrhea or both, and increased flatulence should be suspected of having diverticulosis. When pain becomes more severe and persistent, diverticulitis must be considered. Diagnosis depends on roentgen demonstration of the presence of diverticula. Sigmoidoscopy and barium enema study are essential to exclude coexisting disease but in diverticulitis may need to be postponed until severe local and systemic signs of inflammation have subsided. A number of diseases can simulate diverticulitis, and differential diagnosis may present considerable difficulty. Irritable colon syndrome and acute appendicitis may be indistinguishable clinically from diverticulitis. Differentiation from carcinoma is usually not difficult, but exclusion of coexistent carcinoma may be impossible except by resection. Ulcerative colitis is also easily distinguished except when, rarely, it coexists. Crohn's disease of the colon is less easily differentiated, especially in patients over 40, in whom the two diseases often coexist. Other colonic diseases, such as ischemic colitis, and pelvic inflammatory diseases usually show characteristic features which make them readily distinguishable from diverticulitis.
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PMID:Diagnosis and differential diagnosis of colonic diverticulitis. 103 35


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