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)

Nine cases of Crohn's disease from the Department of Medicine, Singapore General Hospital were collected over a duration of 9 years (1978-1986). Male (5): Female (4) ratio was nearly equal. Predominantly young people (mean age 30.5 year, range 12-59 year) from all races in Singapore were affected. Presentation could be acute (1), subacute (2), or chronic (6). The commonest symptoms were abdominal pain (8) diarrhoea (6) and weight loss (6). Three patients had a palpable right iliac fossa mass, 3 had definite malabsorption from ileal disease and 1 had perianal involvement leading to an anal stricture. The only extraintestinal manifestations of disease were clubbing and sacroiliatis. Haematological (haemoglobin, total white count, erythrocyte sedimentation rate) and biochemical (albumin) parameters generally reflected the degree of activity and chronicity of disease prior to presentation. The diagnosis and assessment of disease sites were based on a combination of radiological, endoscopic, operative and histological criteria. Ileal disease (4) per se was commonest followed by ileocolic disease (3) and colonic disease (2). Medical treatment consisted of sulphasalazine +/- steroids in all patients. Azathioprine and metronidazole were used for steroid sparing and perianal disease respectively. Laparotomy was performed in 2 patients. Six patients were well with infrequent (less than or equal to 2 times/year) or no relapses during follow up. Of the remaining three, 2 had either chronically active disease or frequent relapses (greater than 2 times/year) and one severe recurrent disease despite repeated gut resection.
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PMID:Crohn's disease--a diagnostic rarity in Singapore. 343 15

The diagnosis of inflammatory bowel disease rests on radiologic, endoscopic, and histologic criteria. Five patients, 2 to 17 years of age, sought medical attention because of chronic abdominal pain, diarrhea, and heme-positive stools. Rectal biopsies, visual inspection of colonic mucosa through the colonoscope, and contrast radiographs of the large and small intestine yielded nonspecific results. Serial endoscopic biopsies demonstrated a gradient of inflammatory changes diminishing in severity distally from the ileocecal valve and cecum. The disease process was most evident in specimens from the cecum, whereas biopsies distal to the transverse colon had a normal histologic appearance in all five patients. Biopsies from the proximal colon may provide evidence of inflammatory bowel disease not detectable using standard techniques. The combination of chronic abdominal pain, diarrhea, and heme-positive stools associated with inflammatory changes in biopsy specimens obtained from the proximal colon, but normal findings on radiologic, colonoscopic, and rectal biopsy examinations, may represent an early stage in the evolution of chronic nonspecific inflammatory bowel disease, including ulcerative colitis or regional enteritis (Crohn disease).
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PMID:Chronic nonspecific inflammatory bowel disease of the cecum and proximal colon in children with grossly normal-appearing colonic mucosa: diagnosis by colonoscopic biopsies. 361 98

A low tolerance for pain has been postulated as a factor in the expression of symptoms in patients with irritable bowel syndrome. This has been based on previous work demonstrating reduced intestinal thresholds for rectal pain induced by balloon distention in patients with irritable bowel syndrome. As the disease may alter the rectal response to distention, inferences regarding pain perception and reporting behavior cannot be drawn from these data. In this study, using electrocutaneous stimulation, we found that patients with irritable bowel syndrome had pain reporting behavior comparable to patients with Crohn's disease. Both patient groups were less likely than normals to report a noxious stimulus as painful. This suggests that pain perception and reporting is attenuated in patients with chronic abdominal pain and, accordingly, a generalized reduction in the threshold for reporting pain is not a factor in the expression of symptoms in the irritable bowel syndrome.
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PMID:Patients with irritable bowel syndrome have greater pain tolerance than normal subjects. 362 19

We found shallow serpiginous, longitudinal ulcerations in the descending colon at the first examination of a 17-year-old female patient with Crohn's disease. Four months later at the second examination, we observed that a polypoid lesion had formed longitudinally in the region of the healed ulcers. The third examination, one year later, showed the presence of pedunculated and semi-pedunculated giant polyps in the descending colon. The lesion of the descending colon was removed surgically to cure the crampy abdominal pain caused by colonic obstruction. The segmental colectomy specimen showed longitudinally aligned pedunculated polyps of various sizes. The pathological diagnosis was inflammatory polyposis. To the best of our knowledge, there have been very few reports on the appearance of a number of pedunculated polyps such as in this case. This reports shows, through endoscopic pictures, the evolution of the polyp and discusses its formation.
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PMID:Crohn's disease associated with giant inflammatory polyposis. 369 6

Neurotensin is a 13-amino acid hormonal peptide, localized to specific areas in both the brain and gastrointestinal tract of many mammalian species. It has been described as causing a wide variety of central and peripheral actions. At present there is almost no information concerning the possible physiological and pathophysiological significance of this peptide especially in childhood. Therefore we investigated plasma concentrations of neurotensin-like immunoreactivity in 113 healthy and 103 children suffering from various gastrointestinal diseases. The fasting levels (48.7 +/- 17.4 pg/ml) were slightly lower (p less than 0.05) than our postprandial concentrations (72.9 +/- 28.1 pg/ml) 2-3 hours after breakfast. There was no age distribution. Significantly elevated levels were found in CF-patients (185.4 +/- 96.1 pg/ml; p less than 0.0001) and three children with active coeliac disease (252.3 pg/ml), whereas patients with Crohn's disease, ulcerative colitis and abdominal pain had normal values. Children after large bowel resection showed elevated plasma levels of neurotensin-like immunoreactivity (87.3 +/- 36.4 pg/ml), however, the differences were not significant.
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PMID:[Immunoreactive neurotensin in children with gastrointestinal diseases]. 370 82

Four cases of giant inflammatory polyps were found in a series of 86 consecutive colectomies for inflammatory bowel disease. Two presented a distinctive clinical syndrome of abdominal pain and chronic iron-deficiency anemia due to blood loss. Secondary ulceration of the heads of the polyps accounted for the bleeding and anemia, and the size of the polyps accounted for the abdominal pain. In both cases unusually long portions of colon were involved by the giant polyps. The third and fourth cases had rare complications--reactivation of an enterocutaneous fistula and perforation of an acquired diverticulum. These cases demonstrate that giant inflammatory polyps may produce symptoms independently of the underlying inflammatory bowel disease. In reported cases of giant inflammatory polyps, approximately two-thirds had Crohn's disease and one-third had ulcerative colitis. The transverse colon was the commonest location, pain was the commonest symptom, and the polyps were localized to a short segment of colon in the majority of cases. More than 50% of cases mimicked neoplasm on barium enema. Giant inflammatory polyps may produce a variety of distinctive signs and symptoms and deserve independent recognition.
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PMID:Giant and symptomatic inflammatory polyps of the colon in idiopathic inflammatory bowel disease. 371 97

Recurrent abdominal pain in childhood can be caused structurally, functionally, metabolically or psychosomatically. In the neonatal period there occur malformations, in infancy chronic inflammations of bowel as well as obstructions due to adhesions following laparotomies or chronic intussusceptions or volvulus. In pre-school and school-age symptoms of appendicitis, lymphadenitis, Crohn's disease or Colitis ulcerosa occur. But every 8th to 9th child of school-age suffers from functional abdominal pain without structural origin, probably caused by an "irritable colon".
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PMID:[Chronic abdominal pain in childhood]. 375 Oct 69

Acute self-limited colitis (ASLC) must be distinguished from chronic ulcerative colitis (CUC) for the proper early management of patients with the acute onset of bloody diarrhea. This study was undertaken to determine if any clinical, endoscopic, microbiologic, or histologic parameters can be used to make this distinction reliably and quickly. Forty-eight patients with ASLC, 36 patients with chronic ulcerative colitis during their first attack [CUC(F)], and 84 patients with recurrent flares of chronic ulcerative colitis [CUC(R)] were studied prospectively. The presence of fever (temperature greater than 100 degrees F), abdominal pain, or the time from onset of bloody diarrhea to presentation were not discriminatory. Overall clinical and endoscopic severity were identical among the three groups. Microbiologic studies identified an infectious agent in only 42% of patients with ASLC. Histopathologic features always distinguished patients with CUC from those with ASLC. No case of ASLC was misdiagnosed histologically as CUC or vice versa. Plasmacytosis in the lamina propria extending to the mucosal base and mucosal distortion were present in all cases of CUC(F) and CUC(R), but were absent in all cases of ASLC. The finding of focal cryptitis during the resolving phase of ASLC could be confused with similar lesions in biopsy specimens from patients with Crohn's disease and mandates clinical follow-up. Histopathology is thus the only reliable diagnostic tool for the rapid differentiation of ASLC from CUC. However, biopsy specimens are only diagnostic when obtained during the acute phase of illness; that is, usually within the first 4 days from the onset of symptoms.
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PMID:Histopathology differentiates acute self-limited colitis from ulcerative colitis. 379 68

Colonic lymphoid hyperplasia has been diagnosed in 10 children, aged from 11 months to 12 years, with heterogeneous clinical symptoms such as rectal bleeding, abdominal pain, chronic diarrhea and constipation. The Authors underline the value of endoscopy in the diagnosis of colonic lymphoid hyperplasia which also permitted to exclude other colonic diseases often misdiagnosed by double contrast barium enema (familial polyposis, lymphoid polyps, Crohn's disease, Ulcerative colitis). In This study the Authors discuss the probable etiopathogenetic mechanisms and the prognosis of colonic lymphoid hyperplasia: it should be considered as a benign conditions reflecting a non-specific response to different stimuli.
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PMID:[Endoscopic study in the diagnosis of nodular lymphoid hyperplasia of the colon in childhood]. 383 43

A 16 year old man with complaints of abdominal pain, diarrhea, high fever and loss of body weight was made a diagnosis of Crohn's disease. During the administration, he had intestinal obstruction and several episodes of massive intestinal bleeding. Selective angiography of the superior mesenteric artery demonstrated the bleeding site in the ileum. Microangiography of the surgical specimens revealed abrupt interruptions of arteriae rectae in the submucosa indicating the bleeding site from the diseased intestine.
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PMID:Microangiographic findings of massive intestinal bleeding in a patient with Crohn's disease: a case report. 387 76


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