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)

The sexual problems of 50 women with Crohn's disease, of whom 45 had a stable relationship, were investigated by structured interview and compared with age-matched controls. Twenty-four percent patients had either infrequent or no intercourse compared with 4% of controls (chi 2 = 8.3, p < 0.005). However, amongst patients and controls who were sexually active, the frequency of intercourse was similar. Reasons for sexual inactivity included abdominal pain (24%), diarrhoea (20%) and fear of faecal incontinence (14%). Dyspareunia was common in patients (chi 2 = 6.5, p < 0.01) and this was irrespective of the site of disease (large vs. small bowel chi 2 = 0.85, NS). Women with perianal disease and fistulae were more likely to have dyspareunia than women with neither (chi 2 = 4.2, p < 0.05), although this was not so for less extensive involvement with only perianal disease (chi 2 = 2.8, NS) or fistulae (chi 2 = 0.8, NS). Vaginal candidiasis was more common in patients (chi 2 = 5.8, p < 0.02), and on occasions this may have contributed to dyspareunia. Women with Crohn's disease experience sexual problems much more than healthy controls and they need support, sympathetic investigation and management.
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PMID:Sexual dysfunction amongst women with Crohn's disease: a hidden problem. 145 52

The prevalence of chronic gastrointestinal symptoms and the irritable bowel syndrome (IBS) in the elderly, and their impact on health, is largely unknown. The prevalence of symptoms compatible with IBS was estimated in a representative sample of elderly community residents, and the impact of these symptoms was determined on presentation for health care. An age- and sex-stratified random sample of noninstitutionalized Olmsted County, Minnesota, residents aged 65-93 years were mailed a valid questionnaire; 77% responded (n = 328). The age- and sex-adjusted prevalence (per 100 persons) of frequent abdominal pain was 24.3 [95% confidence interval (CI), 19.3-29.2]. Chronic constipation and chronic diarrhea had prevalences of 24.1 (95% CI, 19.1-29.0) and 14.2 (95% CI, 10.1-18.2), respectively. Fecal incontinence more than once a week was reported in 3.7 per 100 (95% CI, 1.6-5.9). The prevalence of symptoms compatible with IBS (greater than or equal to 3 Manning criteria with frequent abdominal pain) was 10.9 per 100 (95% CI, 7.2-14.6). Among the subjects sampled who had abdominal pain, chronic constipation, and/or chronic diarrhea (n = 152), only 23% had seen a physician for pain or disturbed defecation in the prior year, and this behavior was poorly explained by the symptoms. It is concluded that complaints consistent with functional gastrointestinal disorders are common in the elderly, but symptoms are a poor predictor of presentation for medical care.
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PMID:Prevalence of gastrointestinal symptoms in the elderly: a population-based study. 153 25

We obtained follow-up information on 13 patients who underwent subtotal colectomy for severe idiopathic constipation 19-45 months previously. Stool frequency increased from one bowel movement per 11.5 days before colectomy to 5.3 bowel movements per day after colectomy. Nine patients have required readmissions for abdominal pain and four have required further surgery for symptoms of small bowel obstruction. Ten patients consider that their quality of life is improved, although five have variable amounts of fecal incontinence. Preoperative studies did not predict the three patients who failed to improve. Subtotal colectomy palliates constipation in most patients with severe idiopathic constipation but patients should be cautioned that not all improve and some are left with significant abdominal pain, obstructive symptoms, diarrhea, and fecal incontinence.
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PMID:Subtotal colectomy for severe idiopathic constipation. A follow-up study of 13 patients. 244

As no adequate comparison of these widely used drugs has been made, we have performed a double-blind cross-over trial in 30 individuals with chronic diarrhea. Each underwent three randomized treatment periods of 4 wk duration. Patients were instructed to increase the daily dose gradually until control was achieved or side effects became intolerable. Stool frequency, consistency, urgency, and incontinence were then compared when a stable dose was reached. Though 2.3 capsules (4.6 mg) of loperamide, 2.3 capsules (103.5 mg) of codeine and 2.5 capsulses (12.5 mg) of diphenoxylate all reduced stool frequency to the same extent, diphenoxylate was significantly less effective in producing a solid stool. Before treatment 95% of patients experienced urgency, sometimes associated with fecal incontinence, often as their major diability. Loperamide and codeine were more effective in relieving this than was diphenoxylate. Side effects, particularly central nervous effects, were greatest with diphenoxylate and least with loperamide. Approximately equal numbers discontinued each preparation; poor control and central-nervous-system side effects were the usual reasons for stopping diphenoxylate and codeine, and abdominal pain and constipation for stopping loperamide. We conclude that both loperamide and codeine phosphate are superior to diphenoxylate in the symptomatic treatment of chronic diarrhea.
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PMID:Double-blind cross-over study comparing loperamide, codeine and diphenoxylate in the treatment of chronic diarrhea. 700 6

To assess the value of history in evaluating abdominal pain, 45 outpatients (25 women and 20 men) aged 16-76 completed a questionnaire. The affirmative replies of the patients with organic disease were compared with those of patients with irritable bowel syndrome (IBS) by the chi 2 test. 17 patients had organic diseases while 28 had IBS. The features indicating an organic lesion (p less than 0.0005) were age over 50, history of short duration, bloody stools, bowel incontinence and urgency, pain at night, pain lasting minutes, colicly pain, and onset of pain 1-2 h after meals. Typical features of IBS (p less than 0.0005) were age below 50, frequent bowel movements of normal consistency, increased pain with emotional stress, a rigid personality and an exceptionally well-groomed appearance. From these findings the following conclusions are drawn: 1. Patients with organic disease always present with two symptoms indicative of an organic origin and with one highly significant symptom of IBS at most. 2. IBS is characterized by a broad range of various highly significant symptoms simultaneously. There is a larger number of significant symptoms against IBS (n = 10) than for it (n = 4). History serves rather to rule out IBS than to prove it.
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PMID:[Irritable colon--yes or no? Does the anamnesis help in the decision?]. 707 92

Early diagnosis of colorectal cancer may be delayed by the wide prevalence of gastrointestinal symptoms in the general population. This study assessed, with respect to age, the frequency of gastro-intestinal symptoms in patients with colorectal carcinoma in comparison with community controls and also compared the frequency of such symptoms between 'young' (under 70 years) and 'old' (70 year or over) subjects. Two hundred and seventy three consecutive unselected colorectal cancer patients and 273 age and sex matched community controls were interviewed in a structured manner. Among controls, the 'old' group compared with the 'young' reported abdominal pain (p < 0.05), mucous discharge (p < 0.01), faecal incontinence (p < 0.05), change in flatus production (p < 0.05) significantly more often. There were no significant differences in regularity and frequency of bowel habit by age group. All the symptoms considered were significantly more common in colorectal cancer cases than controls (except abdominal bloating), but the association was less strong in the 'old' group. This study confirms that symptoms attributable to the lower gastrointestinal tract are reported by a clinically important number of community subjects and by a significantly higher proportion of elderly people.
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PMID:Comparison of gastrointestinal symptoms in colorectal carcinoma patients and community controls with respect to age. 795 35

Nineteen women aged 19-64 years (median 38) with intractable constipation were assessed by Indium-111 DTPA colonic transit scan and barium evacuation proctogram. Patients were classified as having an isolated (I) or predominant disorder of colonic transit (II), a mixed disorder of colonic transit and rectal evacuation (III), a predominant disorder of rectal evacuation (IV) or normal colorectal emptying (V). Twelve patients fell into categories I and II and were considered suitable for surgery. Three responded to further vigorous aperient therapy and nine (32-55 years, median 38) underwent subtotal colectomy with ileorectal anastomosis at the level of the sacral promontory. Two patients required re-operation for suspected anastomotic leak. One patient required readmission on two occasions for small bowel obstruction. Follow up has been 2-21 months (median 16). Eight of the nine patients no longer take oral aperients. Eight patients have a satisfactory stool frequency of 2-8 per 24 h; the other patient has an ileostomy and incapacitating postprandial abdominal pain. Abdominal pain is troublesome in two other patients. Two patients require antidiarrhoeal therapy but none experience faecal incontinence. In severely constipated patients with a proven disorder of colonic transit but normal or near normal rectal evacuation subtotal colectomy provides excellent symptomatic relief.
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PMID:Surgery for severe constipation: the use of radioisotope transit scan and barium evacuation proctography in patient selection. 811 96

We have studied the bowel habits of a theoretically normal working population to know the range defecation patterns, characteristics and main factors that may influence it. We have designed a questionnaire composed of 80 questions and distributed to 837 people. Answers, were evaluated in 414 cases (187 men and 227 women), with a median age of 33 years (range 20-64 years). The average number of stools was 7.1 +/- 3.3 per week and in 62.4% of subjects they were between the range of 5 and 8. Bowel movements were less frequent in women than in men, and the same finding was seen about self-reported constipation; nevertheless there were no differences in regard to age. Laxatives were used regularly by 11.3%, and 36% referred straining at stool at least 25% of the time and 8.3% referred straining for loose stools. Alternating bowel function presented in 19.4% and functional abdominal pain in 28% with a female predominance. Faecal incontinence occurred in 6.8% of population; an important prevalence. We also analyse variables such as diet influence, physical activity, obstetrical, gynaecological and psychosocial factors. Although this survey has revealed that a normal bowel function is very variable, only a 7.5% of the subjects, consulted a doctor for bowel complaints.
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PMID:[The defecation habits in a normal working population]. 829 32

Our objective was to obtain national data of the estimated prevalence, sociodemographic relationships, and health impact of persons with functional gastrointestinal disorders. We surveyed a stratified probability random sample of U.S. householders selected from a data base of a national market firm (National Family Opinion, Inc.). Questions were asked about bowel symptoms, sociodemographic associations, work absenteeism, and physician visits. The sampling frame was constructed to be demographically similar to the U.S. householder population based on geographic region, age of householder, population density, household income, and household size. Of 8250 mailings, 5430 were returned suitable for analysis (66% response). The survey assessed the prevalence of 20 functional gastrointestinal syndromes based on fulfillment of multinational diagnostic (Rome) criteria. Additional variables studied included: demographic status, work absenteeism, health care use, employment status, family income, geographic area of residence, population density, and number of persons in household. For this sample, 69% reported having at least one of 20 functional gastrointestinal syndromes in the previous three months. The symptoms were attributed to four major anatomic regions: esophageal (42%), gastroduodenal (26%), bowel (44%), and anorectal (26%), with considerable overlap. Females reported greater frequencies of globus, functional dysphagia, irritable bowel syndrome, functional constipation, functional abdominal pain, functional biliary pain and dyschezia; males reported greater frequencies of aerophagia and functional bloating. Symptom reporting, except for incontinence, declines with age, and low income is associated with greater symptom reporting. The rate of work/school absenteeism and physician visits is increased for those having a functional gastrointestinal disorder. Furthermore, the greatest rates are associated with those having gross fecal incontinence and certain more painful functional gastrointestinal disorders such as chronic abdominal pain, biliary pain, functional dyspepsia and IBS. Preliminary information on the prevalence, socio-demographic features and health impact is provided for persons who fulfill diagnostic criteria for functional gastrointestinal disorders.
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PMID:U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. 835 66

In a survey of bowel patterns and anxiety on 1264 health maintenance organization (HMO) members undergoing health assessment, I found (a) Stool frequency increased with age (p = 0.001), was greater in men than women (p < 0.00001), and was greater in whites than blacks (p = 0.07); (b) Fecal incontinence increased with age in women (p < 0.001) but was not age-related in men (p > 0.10); (c) Laxative use was greater in women than men at all ages (p < 0.01), and there was an age effect on use in women (p < 0.025) but not in men (p > 0.20); (d) Bowel pattern change and abdominal pain were frequently caused by stress, and both effects declined with age in each gender (p < 0.05); (e) More women than men at all ages reported stress effects (p < 0.001), and subjects who reported either stress effect scored higher on both parts of the State-Trait Anxiety Inventory (p < 0.00001) than other people. Bowel patterns and their relation to anxiety have demographic characteristics.
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PMID:Bowel patterns and anxiety. Demographic factors. 840 15


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