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)

Dyspepsia, defined as chronic or recurrent upper abdominal pain or nausea, is a common occurrence. Dyspepsia without an ulcer (non-ulcer dyspepsia) is diagnosed in patients at least twice as often as peptic ulceration. Diseases that may present with similar symptoms include gastroesophageal reflux, biliary tract disease, chronic pancreatitis, and irritable bowel syndrome. A careful history and physical examination, supplemented by selected tests, usually lead to a correct diagnosis. The pathogenesis of non-ulcer dyspepsia remains unknown. Gastric acid secretion, duodenogastric reflux, psychological factors, environmental exposures, and heredity probably do not play a major role. Some patients may have motility disturbances, but whether these disturbances cause dyspepsia is unknown. Campylobacter pylori infection and associated gastritis are common in non-ulcer dyspepsia, but their etiologic role is controversial, as is the importance of chronic duodenitis. By recognizing the heterogeneity of patients who present with non-ulcer dyspepsia, more rational management may be possible. Although an empiric trial of antacids or H2 blockers has been recommended to treat dyspepsia, most controlled trials show that although these substances reduce severity of symptoms, they are no more effective than placebos in non-ulcer dyspepsia.
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PMID:Non-ulcer dyspepsia: potential causes and pathophysiology. 328 48

Gastritis cystica polyposa was diagnosed in five patients between ages 29 and 61 years. All five had been operated on for peptic ulcer disease three to 26 years earlier, when gastroenteric anastomoses had been made. The presenting complaint was abdominal pain, nausea and vomiting, or gastrointestinal bleeding. The lesions, located on the gastric side of the anastomosis, consisted of polypoid mucosal changes associated with hyperplasia and cystic dilatation of glands. Radiologic and endoscopic findings were often nondiagnostic, and surgical intervention was necessary to relieve obstruction and to rule out carcinoma. Resection of the gastrojejunostomy site and choosing anastomotic techniques to minimize bile reflux into the stomach appear to be the preferred methods of treatment.
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PMID:Gastritis cystica polyposa. 334 16

Campylobacter pylori, a suspected agent of gastritis and peptic ulceration, rapidly hydrolyzes urea. Because urease serves as the basis of detection of the organism in gastric biopsies and may represent an important virulence factor, biochemical characteristics of the enzyme were determined. C. pylori was isolated from antral biopsies from 10 patients with complaints of abdominal pain or history of peptic ulcer disease. All isolates were urease positive, with an average rate of hydrolysis by cell lysates being 36 +/- 28 mumol of NH3 per min per mg of protein, more than twice that of Proteus mirabilis and 10 times that of other urinary tract isolates. The enzyme had an apparent molecular weight of 625,000 +/- 15,000 by column chromatography, an isoelectric point of 5.9, a Km of 0.8 +/- 0.1 mM urea, an optimal temperature of 45 degrees C, and an optimal pH of 8.2. Ten isolates tested produced ureases with identical electrophoretic mobilities on nondenaturing 5% polyacrylamide activity gels. Acetohydroxamic acid (100 micrograms/ml), hydroxyurea (85 micrograms/ml), flurofamide (0.05 micrograms/ml), and EDTA (8 mM) inhibited enzyme activity by 50%. Cell lysates retained 50% of initial urease activity after 6 days and 40% activity after 18 days when stored at 4 degrees C in 20 mM sodium phosphate, pH 6.8. At -70 degrees C for 18 days, 1 mM EDTA or 15% glycerol preserved 40 or 34%, respectively, of initial activity. The urease of C. pylori appears to be biochemically unique from the enzymes of other common urease-producing species.
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PMID:Characterization of urease from Campylobacter pylori. 338 8

The clinical course of a child who developed an adenocarcinoma of the stomach at 11 years of age is described. At 6 years of age, the child was evaluated for abdominal pain, weight loss, and vomiting. She was found to have hemorrhagic, atrophic gastritis, achlorhydria, and panhypogammaglobulinemia. The gastritis improved with corticosteroid therapy, but relapsed each time that the steroid dosage was tapered. The clinical course was marked by severe growth failure, recurrent infections, and intermittent abdominal pain. Radiographic studies done when the patient was 11 years of age demonstrated a large fungating mass on the lesser curvature of the stomach. Endoscopy and biopsies done 1 year previously had not revealed any sign of malignancy. A radical gastrectomy was performed. Microscopic studies revealed multifocal adenocarcinoma of the stomach with no evidence of invasion of the submucosa or local lymph nodes. The patient died of Candida septicemia and pneumonia 6 months after the gastrectomy. There was no evidence of recurrence of the tumor on autopsy. The relationship between common variable immunodeficiency and gastrointestinal disease is described.
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PMID:Multifocal adenocarcinoma of the stomach in a child with common variable immunodeficiency. 338 60

Campylobacter pyloridis infection of the stomach has been associated with gastric ulcer, duodenal ulcer, nonulcer dyspepsia, and gastritis. The etiological role of C. pyloridis in most of those conditions remains unclear. We reviewed what is known about C. pyloridis infections in man. Considerable clinical data on C. pyloridis infections was available in older literature concerning gastritis and gastric urease. C. pyloridis causes a form of type B gastritis. In some individuals the acute infection is associated with abdominal pain and transient hypochlorhydria. C. pyloridis infection is difficult to eradicate with current therapies. The mechanisms by which C. pyloridis infection may lead to development of peptic ulcers, nonulcer dyspepsia, or atrophic gastritis are discussed. Recent technological advances, such as the 13C-urea breath test, provide rapid noninvasive methods of identifying active C. pyloridis infection. These methods will permit the rapid execution of definitive investigations of the epidemiology, transmission patterns, and possible reservoirs of C. pyloridis infection and will delineate the spectrum of C. pyloridis-associated disorders.
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PMID:Campylobacter pyloridis gastritis: the past, the present, and speculations about the future. 355 84

In order to help clarify the clinical importance of chronic erosive gastritis, we describe our experience of 28 patients with this disorder who were seen over a 2-yr period. Twenty patients were male. Twenty-four patients presented with abdominal pain, for which no cause other than chronic erosive gastritis was found in 20 patients. Ten patients had pain for more than 1 yr. Three patients presented with painless vomiting. The antrum was involved in 27 patients and the body in 17 patients. There was no correlation between the number of erosions and the duration of symptoms. Double contrast barium meal was positive in nine of 21 patients. Of 19 patients treated with cimetidine, 15 improved clinically and six of eight had endoscopic improvement. The treatment of choice is unknown and controlled trials are needed. Symptoms in patients with chronic erosive gastritis appear to be due to the gastritis itself rather than to associated lesions.
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PMID:Chronic erosive gastritis: a clinical study. 356 32

Three National Cancer Institute of Canada phase II studies of N-methylformamide (NMF), given in a three times/week oral schedule, closed early because of frequent and occasionally severe toxicity. Eighteen of 41 (44%) cycles of treatment were not completed because of problems with NMF-induced hepatic and gastrointestinal toxicity. Several other reactions occurred, including skin rashes, abdominal pain, and gastritis, which were drug induced. One death occurred on study and was thought to be due in part to NMF toxicity. Further work exploring alternative schedules is needed before phase II studies of oral NMF can be done.
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PMID:Toxicity of oral N-methylformamide in three phase II trials: a report from the National Cancer Institute of Canada Clinical Trials Group. 371 79

We performed upper gastrointestinal endoscopy in 60 rural Haitian patients who complained of chronic upper abdominal pain. Twenty-five of 37 men (68%) and 5 of 23 women (22%) had abnormal findings. In men the predominant abnormalities were severe duodenal ulcer, duodenitis, and pyloroduodenal obstruction; duodenal ulcer or duodenitis appeared to precede obstructive disease by about 20 years. In women the abnormal findings invariably were milder than in men and consisted of duodenal ulcer, duodenitis, and gastritis. These observations as well as the observations of others indicate that peptic ulcer disease is common in developing countries, particularly among men. We hypothesize that this familiar abnormality reported from unfamiliar places represents the ordinary spectrum of peptic ulcer disease, but that inadequate treatment of recurrent episodes over time leads to obstruction. Physicians need to learn more about the epidemiology of peptic disease in developing countries and to devise better methods of effective treatment to prevent the late complication of gastric outlet obstruction.
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PMID:Tropical peptic ulcer disease: an endoscopic study from rural Haiti. 376 May 17

The dietary and supplementary intake of food, energy, and nutrients were examined in 54 patients after various gastrointestinal operations and in 33 patients with gastritis, peptic ulcer, or undefined abdominal pain. Forty-six of the operated and 21 of the nonoperated patients had to avoid certain foods (p less than 0.001, chi 2-test), mainly milk, beans, cabbage and other vegetables, bread, and fried foods. Only a few patients got discomfort from coffee, fatty foods, and meat. The intake of energy was at the level of light physical work. The dietary intake of iron, vitamin A, and niacin did not reach the level of the recommended daily allowance (RDA). One-half of the patients used vitamins and supplements, which increased their intake over the level of RDA. It is important to inform patients before operations about the possibility of persistent abdominal symptoms after the operation.
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PMID:Dietary and supplementary intake of nutrients by patients with gastrointestinal diseases. 380 66

Bile reflux gastritis is a disabling postgastrectomy condition characterized by abdominal pain, bilious vomiting, and weight loss. The syndrome appears to be caused by free enterogastric reflux of bile and other proximal small bowel constituents. Endoscopic confirmation of bile reflux and documentation of gastritis support the diagnosis but are not specific for it. Results of medical therapy with chelating agents or drugs that promote gastric motility have been disappointing. Diet and antacids frequently aggravate symptoms. The only effective treatment is surgical diversion of bile away from the gastric mucosa. During a recent seven-year period, 15 patients had diversionary operation for bile reflux gastritis diagnosed by history and endoscopic findings. Before operation, medical management had failed to yield improvement in any case. After operation, all patients showed improvement, and pain was relieved in 85%. Based on our experience, we conclude that current medical therapy may alter but not cure symptoms of bile reflux gastritis; Roux-en-Y diversion is the treatment of choice in patients with persistent symptoms; and delayed gastric emptying is a common complication after the Roux-en-Y procedure, but in our series, the incidence was reduced by using the Tanner 19 modification. New cytoprotective agents that may offer an alternative to operation are currently being studied.
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PMID:Bile reflux gastritis. 381 Feb 8


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