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

We have undertaken a prospective randomized trial of one month's antimicrobial therapy for patients with symptomatic relapse of Crohn's disease. Criteria for entry included two major symptoms: fever, abdominal pain, diarrhea, weight loss, abdominal mass or complications (excluding perianal disease); and two hematologic abnormalities: hemoglobin, ESR, albumin, C reactive protein, iron, or total iron binding capacity. Patients were monitored for the aforementioned clinical and hematologic (hemoglobin, albumin, CRP) parameters over six weeks and for changes in fecal flora. Randomization was to four groups: metronidazole alone (M), cotrimoxazole alone (C), metronidazole and cotrimoxazole (C plus M), or double placebo (P). Seventy-two patients entered the study (18 = M, 16 = C, 21 = C plus M, 17 = P). After two weeks, improvement was reported as follows: M = 67 percent, C = 17 percent, C plus M = 71 percent, P = 35 percent. In the metronidazole group, two patients required surgery and one had troublesome side effects. In the cotrimoxazole group, two had side effects. In the combined group (C plus M), four had troublesome side effects and two of the placebo group (P) required operation. By four weeks, there was no difference in response among the groups: (M = 44 percent, C = 62 percent, C plus M = 57 percent, P = 41 percent). Antimicrobials had no effect on fecal flora or hematologic parameters. These results indicate that antimicrobials have little therapeutic potential for relapse of intestinal Crohn's disease.
 ...
PMID:Antibiotic therapy for treatment in relapse of intestinal Crohn's disease. A prospective randomized study. 388 64

Small bowel diverticula may cause abdominal pain, diarrhoea, malabsorption and weight loss. The same symptoms are also seen in Crohn's disease. Two elderly sisters with simultaneous small bowel diverticulosis and Crohn's disease are presented.
 ...
PMID:Crohn's disease and small bowel diverticulosis in two sisters. 392 Aug 49

This paper reviews our 10 year clinical experience (1974 to 1983) with 33 patients with Crohn's disease; eight were diagnosed during the first five years and 25 during the second five years of the review. There were only 10 patients with ulcerative colitis during this period. The median age of diagnosis was 13 years, range 6 to 16 years. The main presenting clinical features were abdominal pain (29 patients), weight loss (26 patients), and diarrhea (23 patients). The method of diagnosis included radiological investigations and fiberoptic endoscopy with biopsy. The colon was involved in 20 patients. The therapy included Salazopyrine, steroids, parenteral nutrition (11 patients) including home parenteral nutrition (seven patients) and surgery (13 patients). Significant weight gain was observed in patients after intestinal resection. There were no deaths. We conclude that the incidence of pediatric Crohn's disease appears to be increasing, is more common than ulcerative colitis, and requires surgical treatment in a high proportion of patients. In our experience these patients respond well to aggressive nutritional therapy including home parenteral nutrition and carefully selected surgical treatment.
 ...
PMID:Pediatric Crohn's disease. 393 34

A 16-years-old male with a history of Job's syndrome and a recent diagnosis of Crohn's disease was admitted to the hospital because of abdominal pain, nonbloody diarrhea, weakness, and fever. Due to failure to respond to medical therapy it was decided that an operation was indicated, and resection of the terminal ileum and right colon was performed. Cecum and ileum were inflamed, and pathologic studies revealed the presence of budding yeasts which on special stain were diagnostic of Histoplasma species. Successful management was accomplished with oral ketoconazole.
 ...
PMID:Ileocecal histoplasmosis mimicking Crohn's disease in a patient with Job's syndrome. 394 95

To better characterize Crohn's disease in the elderly, 24 patients ranging in age from 64 to 85 years were reviewed and compared with a younger group (20 to 61 years of age) matched for sex and duration of disease. Forty-one variables encompassing clinical, laboratory, and radiologic data and medical and surgical aspects of treatment were analyzed. The older group was characterized by a longer delay in diagnosis, more hematochezia, and a higher incidence of diverticular and cardiovascular disease. Elderly patients had less pain, less often a palpable abdominal mass, less small-bowel disease, less drug treatment, and no family history of inflammatory bowel disease. Otherwise, the disease in the two groups had similar manifestations, and no discriminating features to enable easy diagnosis in the elderly were found. Crohn's disease must be considered when evaluating older patients with diarrhea, abdominal pain, weight loss, and bleeding.
 ...
PMID:Crohn's disease in the elderly. A statistical comparison with younger patients matched for sex and duration of disease. 396 58

Two hundred and fourteen patients with Crohn's disease (CD) were investigated by radiological methods, endoscopy, and histological examinations of multiple biopsy and surgical specimens. Radiological lesions suggestive of CD were found in all patients with small-bowel disease but in less than half of those with large-bowel CD. Endoscopic findings were conclusive in 36% of patients with small-bowel disease, in 91% of those with small- and large-bowel disease, and in 86% of those with CD of the large bowel. Histological examinations of biopsy specimens were conclusive in less than one third of the patients. Histological examination of operative specimens, however, was conclusive in 90-100% of all patients. In 43 patients initially diagnosed as having ulcerative colitis, abdominal pain was less frequent, but diarrhea and visible blood were more frequent as initial symptoms. Of these patients, 21 had combined small- and large-bowel disease at the end of the observation time. In intestinal CD, multiple biopsy specimens may disclose Crohn-specific lesions even in endoscopically normal mucosa at a distance from visible lesions.
 ...
PMID:Crohn's disease. Diagnostic procedures and problems. 403 85

Two hundred and fourteen patients with Crohn's disease (CD) consecutively admitted during a 5-year period were observed for a mean of 9 years (range, 0-35 years). Sixty-five per cent had their initial symptoms between 10 and 30 years of age and 9.2% after the age of 50 years. The CD diagnosis was delayed for more than 10 years in 8% (mean, 4.5; range, 0-31 years). Large-bowel involvement was seen in 82.5% and was the only localization of the disease in a fourth of the patients. Recurrent abdominal pain occurred in two-thirds of patients with ileal or ileocolic disease. Acute abdominal pain was the cause of laparotomy in 14% of the patients with ileocolic CD. Diarrhea and rectal bleeding occurred significantly more often in colonic CD, whereas fistula complicated ileocolic disease more often than isolated involvement of small or large bowel. Associated extraintestinal diseases were seen in 117 patients (55%), most frequently related to colonic involvement (joint disease, 21%; eye, 12%, skin, 8%). Of 26 patients (12%) with liver pathology, 10 patients had amyloid deposits. Amyloidosis was diagnosed in altogether 12 patients (6%).
 ...
PMID:Crohn's disease. Clinical manifestations. 403 86

During the past 2 years, we have encountered 14 patients whose onset of clinical symptoms of Crohn disease occurred after the age of 50, accounting for 14% of all Crohn disease patients studied in our department during this period. Most patients presented with diarrhea, abdominal pain, or perianal disease, and many also had anemia or rectal bleeding. The disease occurred slightly more often in the colon (n = 10), although many patients had terminal ileal disease (n = 7). The radiographic appearance was similar to that of Crohn disease in younger patients, with ulceration, fistula, and stricture formation. Occasionally, the disease mimics neoplasia or diverticulitis. Extraintestinal complications were also evident, with one patient each with renal calculi and ankylosing spondylitis. The occurrence of Crohn disease in the elderly is not uncommon, and a prompt diagnosis is important so that proper therapy can be initiated.
 ...
PMID:Crohn disease in the elderly. 404 36

We report two cases of focal lymphoid hyperplasia (FLH) of terminal ileum in adult patients. Both cases showed identical morphological findings. The first was discovered during cholecystectomy in a 75-year-old woman who complained mild non-specific abdominal discomfort. The second was manifested by right lower quadrant abdominal pain in a 32-year-old man. The surgical specimens revealed a thickened wall, a narrowed lumen and multiple ulcerations. The histologic features were small cell, well differentiated lymphocyte infiltration, with several follicles showing large germinal centers; regional lymph nodes revealed a conspicuous reactive size enlargement. Further clinical investigations revealed no other abnormalities. Clinical course showed benign evolution after 6 and 3 years of respective follow-up. FLH should be differentiated from terminal ileum inflammatory and infectious diseases. It can be differentiated from Crohn's disease by the absence of characteristic histological features; from Yersinia infection by the absence of significant rates of specific serum antibodies. Moreover, FLH can be differentiated from malignant lymphoma by the presence of follicles and enlarged germinal centers and by the long-term benign evolution. The nature of FLH in terminal ileum, as well as those of the stomach and colo-rectum is still to be determined. Several hypothesis are proposed: reactive, benign neoplastic, or prelymphomatous lesion?
 ...
PMID:[Focal lymphoid hyperplasia (pseudolymphoma) of the terminal ileum in adults]. 407 21

Our therapeutic management to Crohn's disease was analyzed retrospectively. Among 17 cases with Crohn's disease, 14 (82%) were operated. Operative indications were due to obstruction (7), perforation (2), fistula (2), stenosis (2) and intractability (1). Postoperative recurrence was developed in 8 out of 14 (57%) and 4 were reoperated. Most of recurrent lesions were around the previous anastomosis. Operation per se does not cure the Crohn's disease but operation should be indicated when complicated obstruction, fistula and perforation. Nutritional treatment has been also performed 8 times. Crohn's disease activity index (CDAI) was decreased in all but one. In individual item of CDAI, frequency of bowel movement, abdominal pain and general status were improved but items such as anal lesion, fistula and fever were not improved. CDAI values were turned to remission value in all of cases with complicated stenotic lesions, but it remained in active stage in all cases with complicated fistula, obstruction and abscess. Nutritional treatment seemed less effective in cases complicated fistula, obstruction and abscess.
 ...
PMID:[Management of Crohn's disease]. 408 64


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>