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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

197 consecutive, non-acute, medical patients who presented with upper abdominal pain were subjected to a standard programme of investigation. The investigation represents an attempt to supplement general clinical experience with exact data. In about half the patients no cause of the pain was found and a diagnosis of X-ray negative dyspepsia was made by elimination. It is concluded that a special research effort is needed to explain the complaint in this large group of patients. Duodenal ulcer was twice as common as gastric ulcer, and two patients suffered from gastric cancer. The diagnostic value of the symptomatology was analysed, but only the relation of pain to meals was found to be of diagnostic interest. In particular, the probability of duodenal ulcer was low and that of X-ray negative dyspepsia high, if the pain was provoked by eating. The age, sex, and acid production also had diagnostic value.
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PMID:A diagnostic study of patients with upper abdominal pain. 120 11

The clinical pictures of 109 patients with X-ray negative dyspepsia (XND) are described, and a comparison is made with the clinical pictures of 39 gastric ulcer patients and 61 duodenal ulcer patients. In addition it has been attempted to subdivide XND into clinically relevant subgroups by means of a Venn diagram. The XND patients were characterized by an equal sex distribution and, in comparison with the ulcer patients, a shorter length of history. The upper abdominal pain was less frequently relieved by eating and more frequently provoked by eating in XND than in ulcer disease. The XND patients also suffered more frequently from irritable colon symptoms. Endoscopy only revealed an ulcer in 11 patients with XND, and the clinical pictures of these patients differed from those of patients with radiologically demonstrated ulcers. The clinical pictures of XND are further analysed in the context of current hypotheses, and it is concluded that Venn diagrams are useful for the analysis of heterogeneous clinical syndromes.
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PMID:Nosography of X-ray negative dyspepsia. 126 40

Given the absence of any demonstrable organic reason for non-ulcer dyspepsia, and the well known fact, that the psyche influences stomach function, it is widely held, that psychological factors cause NUD. To now, studies are concerned with the psychopathology and personality of NUD-patients, their illness behaviour, and with the relation between stress and abdominal pain. A critical review of these studies revealed, that among the psychological variables mainly anxiety and illness behaviour seems to play a central role in NUD. However, future studies should focus more on the distinction towards other functional disorders and on the differentiation within the heterogeneous group of NUD-patients (especially with regard to physiological variables). Besides this, it seems rewarding to examine the so far scientifically neglected group of subjects with abdominal pain, who do not contact a physician.
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PMID:[Psychological factors of non-ulcer dyspepsia]. 128 95

It is sometimes impossible to come to a final diagnosis in patients with dyspepsia and upper abdominal pain in spite of extensive investigation. Such patients are usually given vague diagnoses like "non-ulcer dyspepsia" and they represent an important diagnostic challenge.
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PMID:Primary benign ulcer of the gall bladder. 135 1

Asymptomatic biliary lithiasis can be defined as biliary lithiasis having determined no complication and no episode of biliary pain. Biliary pain is a consequence of acute increase of pressure inside the biliary tract. The increased pressure is induced by a stone transiently obstructing the cystic duct or the Oddi sphincter. In most patients, the site of the pain is epigastric. The level of the pain is high. The duration of the episode of biliary pain is usually less than 5 hours. Abdominal pain having other characteristics, dyspepsia, and headache are not related to biliary lithiasis.
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PMID:[Definition of asymptomatic biliary lithiasis]. 141 Nov 66

Data from four double-blind studies of the treatment of patients with rheumatoid arthritis or osteoarthritis were combined. For 4 to 12 weeks, 747 patients received Arthrotec, a combination of 50 mg of diclofenac and 200 micrograms of misoprostol, and 754 patients received 50 mg of diclofenac; the drugs were given twice or three times daily. The five most commonly reported adverse events were abdominal pain by 23.2% of the diclofenac/misoprostol patients and 19.8% of the diclofenac patients; diarrhea by 19.9% and 11.3%; nausea by 11.8% and 6.5%; dyspepsia by 11.2% and 7.8%; and flatulence by 8.0% and 3.1%. Other adverse events, reported by similar proportions of both treatment groups, included headache, gastritis, dizziness, vomiting, and constipation. In the diclofenac/misoprostol-treated patients, the abdominal pain and diarrhea were rated mild in 30.6% and 24.3%, moderate in 49.1% and 51.4%, and severe in 20.2% and 24.3%. Serious adverse events occurred in eight of the diclofenac/misoprostol-treated patients and in 13 of the diclofenac-treated patients; 12.6% and 10.1%, respectively, were withdrawn from the study because of adverse events. Results of laboratory tests of hepatic and renal function were similar in the two treatment groups.
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PMID:Overall safety of Arthrotec. 143 22

Motility-like dyspepsia, a clinical subgroup of functional dyspepsia, refers to the cluster of symptoms which suggests an underlying motility disturbance of the upper gut. Characteristic symptoms, in addition to upper abdominal pain or discomfort, are nausea, vomiting, early satiety, anorexia, postprandial abdominal bloating and excessive repetitive postprandial belching. Patients with concomitant symptoms of irritable bowel syndrome are currently excluded from this clinical entity. Delayed gastric emptying of solids and/or liquids, postprandial antral hypomotility and antroduodenal incoordination, gastric myoelectrical arrhythmias and dysfunction of visceral afferents are the major alterations in upper gut sensorimotor activity which have been described. An empirical trial of medical therapy is warranted if there are no "alarm" symptoms at presentation. If symptoms are not relieved after 2-4 weeks, then investigations of the upper gastrointestinal tract, preferably by endoscopy, to exclude the presence of organic disease, is advisable. Management approaches are then reassurance, dietary manipulations and attention to psychosocial aspects. Prokinetic agents appear to be useful as short-term medical therapy in some patients, but optimum long-term treatment strategies, including the use of medications which may improve a diminished tolerance to gut distension, are not established.
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PMID:Motility-like dyspepsia. Current concepts in pathogenesis, investigation and management. 144 83

Persons who contacted the Anorexia/Bulimia Association of Norway for information and stated that they had an eating disorder were asked to participate in this questionnaire study. The answers from the 32 women who fulfilled the DSM-III-R criteria for bulimia nervosa are presented. Usually the women's eating problems had started in the teens after a period of voluntary dieting. The mean duration of bulimia nervosa was six years. 31% had a history of anorexia nervosa. At the time of the study almost all had normal body weight, but nevertheless felt overweight. 78% practised self-induced vomiting, 22% used laxatives and 16% used diuretics to reduce weight. Depressive and anxiety symptoms were common in connection with the overeating episodes, but also more generally, which interfered with everyday life. Somatic symptoms (abdominal pain, diarrhoea, constipation, dyspepsia, headache, dry mouth and eyes, parotid gland swelling, muscular symptoms, fatigue, and oligomenorrhoea) were also common.
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PMID:[Bulimia nervosa and self-reported symptoms. A questionnaire study among 32 women with bulimia nervosa]. 147 Nov 6

The most certain symptomatic manifestation of gallstones is episodic upper abdominal pain. Characteristically, this pain is severe and located in the epigastrium and/or the right upper quadrant. The onset is relatively abrupt and often awakens the patient from sleep. The pain is steady in intensity, may radiate to the upper back, be associated with nausea and lasts for hours to up to a day. Dyspeptic symptoms of indigestion, belching, bloating, abdominal discomfort, heartburn and specific food intolerance are common in persons with gallstones, but are probably unrelated to the stones themselves and frequently persist after surgery. Many, if not most, persons with gallstones have no history of pain attacks. Persons discovered to have gallstones in the absence of typical symptoms appear to have an annual incidence of biliary pain of 2-5% during the initial years of follow-up, with perhaps a declining rate thereafter. Gallstone-related complications occur at a rate of less than 1% annually. Those whose stones are symptomatic at discovery have a more severe course, with approximately 6-10% suffering recurrent symptoms each year and 2% biliary complications. The far higher rates of symptom development reported in a few studies raise the possibility that these incidence estimates may be too low. The best predictors of future biliary pain are a history of pain at the time of diagnosis, female gender and possibly obesity. The risk of acute cholecystitis appears to be greater in those with large solitary stones, that of biliary pancreatitis in those with multiple small stones, and that of gallbladder cancer in those with large stones of any number. Drugs that inhibit the synthesis of prostaglandins may now be the treatment of choice in patients with gallstones who are suffering acute pain attacks. Persistent dyspeptic symptoms occur frequently following cholecystectomy. A prolonged history of such symptoms prior to surgery and evidence of significant psychological distress appear to be the best predictors of unsatisfactory outcome.
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PMID:Symptoms of gallstone disease. 148 6

Cyclosporin A (CsA) is an effective therapy for severe intraocular inflammation but nephrotoxicity and hypertension are major side effects even in low dose in combination with oral corticosteroids and clinical studies on the long-term effects of low-dose CsA therapy outside the field of organ transplantation are lacking. This multicentre, open, longitudinal study has been established to evaluate the long-term efficacy and side effects of low-dose CsA therapy (initial dose less than or equal to 5 mg/kg/day, with a maximum dose of 7 mg/kg/day, and total treatment duration greater than 3 months) in severe ocular inflammation where conventional therapy had failed to control the disease or caused intolerable side effects. Visual response to treatment, clinical signs and symptoms of side effects, biochemical and haematological parameters have been recorded at 3-monthly intervals since January 1987 and will continue until December 1993. Data for 74 patients (age 35.5 +/- 16.6 years) and 293 follow up visits are presented in this preliminary report. [table: see text] Other side effects include (% of all visits): hypertrichosis (4.2), headache (2.8), cramps (1.8), arthropathy (1.8), paraesthesiae (1.8), abdominal pain (1.5), weakness (1.5), dyspepsia (1.4), nausea (1.4), others (4).
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PMID:Low-dose cyclosporin therapy of ocular inflammation: preliminary report of a long-term follow-up study. 150 18


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