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

Seven patients with cystic fibrosis who had complications of gastroesophageal reflux including abdominal pain, peptic esophagitis, upper gastrointestinal hemorrhage, and esophageal stricture are described. We believe that these are gastrointestinal complications of CF and that they may be responsible for significant morbidity. The mechanical influence of a depressed diaphragm caused by hyperinflation, along with increased abdominal pressure with chronic coughing, may contribute to GER in CF. Early detection and treatment are important not only to prevent esophageal complications but also to increase the quality of life by relief of pain and by avoiding the resultant decrease in appetite, which can contribute to malnutrition.
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PMID:Complications of gastroesophageal reflux in patients with cystic fibrosis. 706

Symptoms suggestive of gastro-oesophageal reflux disease are very common. The aim of the study was to assess the prevalence of these symptoms and factors influencing them in an unselected adult population. A questionnaire was mailed to a random sample of 2500 people aged > or = 20 years. The questions concerned heartburn, regurgitation, dysphagia, chest and upper abdominal pain, as well as medication and medical consultations for these symptoms. Of the 1700 (68%) responders, 9% had experienced heartburn on the day of response and 15%, 21% and 27% during the preceding week, month and year, respectively. The corresponding figures for regurgitation were 5, 15, 29 and 45%. During the past year 43% of the study group had had no such symptoms. Age, overweight, pregnancy and cigarette smoking significantly influenced the prevalence of symptoms. Using daily heartburn and/or regurgitation as dominant indicators 10.3% (95% CI 12-11.7) of the responders had gastro-oesophageal reflux disease. Medication (most commonly antacids) was used by only 16% of the symptomatic people, and only 5.5% had sought medical advice for symptoms during the past year. Thus, despite commonness of symptoms suggestive of gastro-oesophageal reflux disease only a minority of the individuals suffering from such symptoms use medication or have medical consultation.
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PMID:Prevalence of symptoms suggestive of gastro-oesophageal reflux disease in an adult population. 774 2

Patients are often referred for evaluation of a wide range of GI complaints including dysphagia, abdominal pain, bloating, nausea, constipation or diarrhoea. Many are diagnosed with 'functional' disease when endoscopy or conventional radiological studies fail to identify an anatomic cause for the patient's symptoms. In such cases nuclear medicine offers non-invasive methods for objectively demonstrating disease involving different areas of the gastrointestinal tract. Increasingly scintigraphy is playing a primary role in the evaluation of patients with suspected acute cholecystitis, active gastrointestinal bleeding, gastroparesis, and small and large bowel motility disorders. In addition, it supplements other studies when results are inconclusive in diagnosing oesophageal dysmotility, gastro-oesophageal reflux, acalculous cholecystitis, and postoperative complications of gastrointestinal surgery.
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PMID:Current applicability of scintigraphic methods in gastroenterology. 777 16

The cases of three patients who underwent fundoplication to correct gastroesophageal reflux and who subsequently had herniation above the diaphragm of abdominal contents through the esophageal hiatus are described. In two patients, the fundoplication was performed through a transabdominal approach, and in one patient through a transthoracic approach. The main symptoms were vague but persistent (48 hours) abdominal pain in three, associated with nausea and vomiting in one. The diagnosis was confirmed with an upper GI series in all three; the proximal stomach was displaced in all, the transverse colon in one. Elective reoperation to reduce the displaced abdominal contents and to narrow the esophageal hiatus was done in the three cases. All recovered uneventfully and were relieved of their preoperative symptoms. Eight years later, one patient developed a gastric carcinoma requiring esophagogastrectomy; another patient remained asymptomatic 1 year after operation; the third was lost to follow-up 1 month after his operation. The presence of herniation of abdominal contents through the esophageal hiatus is a rare complication that should be suspected in patients who previously underwent fundoplication, either through the abdominal or thoracic approaches, and who complain of mild but persistent abdominal pain. Narrowing of the esophageal hiatus by approximating with sutures the diaphragmatic crura at the time when the fundoplication is done would appear to be an important technical point to avoid this complication. When it occurs, elective repair is advisable.
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PMID:Esophageal hiatus hernia after fundoplication. 797 84

Gastrointestinal and liver disorders are often observed in high performance athletes, especially those training for the increasingly popular endurance sports including the marathon and the triathlon. The disorders often start with stress before competition or training, followed by dehydration during the event. Insufficient training is an aggravating factor as are certain environmental factors including hot climate, irregular terrain and high altitude. Athletes may also consume non-steroid anti-inflammatory drugs, for example after a minor bone lesion or joint sprain, in an attempt to maintain their highest level of performance. Gastric signs include epigastric pain known to be caused by ischaemic gastritis resulting from decreased splanchnic flow and increased vasoconstriction in the gastric mucosa. Gastrooesophageal reflux results from modifications in sphincter tone and gastric emptying. Drinking hyperosmolar liquids also plays a role. Abdominal pain, diarrhoea, melena and uncommonly ischaemic colitis are the main signs of colic disorders. Mesenteric ischaemia may occur due to lowered splanchnic blood supply (by as much as 80% in some cases). Mechanical trauma is another mechanism; in marathon runners the "caecal slap syndrome" is a repeated microtrauma of the caecum against a hypertrophied muscular wall. Waterborne infectious agents may also lead to colic lesions. Exertion heat stroke is an emergency situation which can cause multiple organ damage and usually occurs after long intense exercise, often, but not always in a hot environment. Uncompensated thermogenesis and excessive loss of water by perspiration leads to central hyperthermia and ischaemic hepatic necrosis. Fatal liver failure has been observed. More or less severe symptoms of gastrointestinal or hepatic disorders are observed in 30% of high performance athletes and the incidence may reach 40% in those who have trained insufficiently. Such disorders lead to reduced performance in 10% of these athletes.
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PMID:[Hepato-digestive disorders in athletic practice]. 802 25

A 13-yr-old boy was scheduled for emergency appendicectomy because of abdominal pain. His preoperative medical history was complicated by a recent hospital admission for management of asthma. He had presented to hospital seven days earlier because of dyspnoea, tachypnoea and oxygen desaturation to 77% on room air. Following admission, he required intensive nonventilatory management of his asthma, including intravenous salbutamol, methylprednisolone, and aminophylline, as well as use of an ipratroprium bromide inhaler and 100% oxygen by mask. He was discharged to the ward, and continued on prednisone (delta-cortisone), beclomethasone inhaler, ipratroprium inhaler, and salbutamol inhaler. During his ICU stay, he complained of nonspecific abdominal pain, interpreted as gastro-oesophageal reflux. After four days, he was discharged to the ward. On his sixth hospital day, he began to experience right-sided lower abdominal pain and right shoulder pain. A surgeon was consulted, and the patient was found to have a very tender right lower quadrant with guarding and rebound pain. He was therefore scheduled for appendicectomy; antibiotic therapy with ampicillin, gentamicin, and metronidazole was initiated.
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PMID:Anaesthetic management of an asthmatic child for appendicectomy. 806 95

Helicobacter pylori is an important factor in the pathogenesis of chronic gastritis and gastroduodenal ulcer disease. However, the basic causal mechanisms of H pylori colonization on the gastric mucosa are still unclear. The authors evaluated the prevalence of H pylori colonization in 266 children who underwent upper gastrointestinal endoscopy during a 12-month period. The indications for endoscopy were follow-up of esophagitis related to gastroesophageal reflux (n = 17), suspicion of gastroesophageal reflux (n = 51), abdominal pain (n = 28), vomiting (n = 30), follow-up of esophageal atresia (n = 46) and duodenal atresia (n = 28), inflammatory bowel disease (n = 28), and miscellaneous (n = 38). The methods used to detect H pylori colonization were histology and the rapid urease test. H pylori colonization was demonstrated in 31 (11.6%) of the 266 patients. In two patient groups, a high prevalence of colonization was identified. In patients with an operated duodenal atresia, 36% (10 of 28) had H pylori on the gastric mucosa. The organism was demonstrated on the gastric mucosa in 47% (8 of 17) of the patients with gastroesophageal reflux-related esophagitis; five of the eight patients had neurological impairment. In the other patient groups, the prevalence of H pylori infection ranged from 2% to 14%. The present study suggests that, in children, the disturbed esophagogastroduodenal motility, which is commonly associated with gastroesophageal reflux and duodenal atresia, predisposes to H pylori infection.
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PMID:Does disordered upper gastrointestinal motility predispose to Helicobacter pylori colonization of the stomach in children? 807 8

The diagnostic approach of children with recurrent abdominal pain (RAP) was investigated by means of a standard protocol. The protocol consisted of recently developed laboratory techniques and 'routine' investigations. In addition, all patients were subjected to an extensive psychological investigation. The main results show that in a high percentage (42%) of patients organic abnormalities could be found. Particularly the small bowel seemed to be involved in the pathogenesis of the complaints. Furthermore, gastro-esophageal reflux appeared to be present in as many as 50% of the patients investigated and there might be a relationship with the abdominal pain complaints. Helicobacter pylori did not appear to play an important role in these patients. Comparing the results of the psychologic investigation with a pain-free control group, we did not find clear evidence that psychological factors play a role in the pathogenesis of these patients' complaints. Children with RAP, particularly when complaints exist longer than 6 months, need to be investigated for the presence of organic abnormalities that might provide an explanation for the complaints.
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PMID:[Chronic recurrent abdominal pain in school children]. 821 38

Approximately one in ten children are seen by a health care professional for a complaint of chronic recurrent abdominal pain. In most cases these complaints are non-organic. Organic causes of abdominal pain may include gastroesophageal reflux, peptic ulcer disease, gallbladder, pancreatic or kidney disease. In addition, infection of the gastric antrum with Helicobacter pylori is now included in the differential diagnosis of chronic abdominal pain in children. H. pylori are "S" or "C" shaped, gram negative bacilli with a smooth outer coat and two to four unipolar flagella. There is no known natural reservoir for H. pylori in the environment. The mode of transmission is also unknown. Multiple drug therapy is necessary to maintain long-term eradication of the organism. Until epidemiologic data are determined, universal precautions should be employed in cases of suspected H. pylori infection.
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PMID:Helicobacter pylori: a cause of chronic abdominal pain in children. 832 93

Recent antigliadin antibody (AGA) determination has become an important diagnostic tool in coeliac disease (CD). Although this test has high sensibility for the disease, it is less specific, especially for IgG class, because of its having been found in some acute and chronic common intestinal childhood diseases. We studied the behaviour of AGA, IgA and IgG, in 234 children affected by various gastrointestinal diseases, comparing the results with those obtained in 125 coeliac children and 788 normal children. The intestinal diseases were as follows: irritable bowel syndrome, cow's milk protein intolerance, acute infectious diarrhoea, parasitosis, lactase deficiency, recurrent abdominal pain, cystic fibrosis, chronic constipation, gastroesophageal reflux, intestinal lymphangiectasia, chronic intractable diarrhoea and nodular lymphoid hyperplasia. Our results showed that while AGA-IgA were absent in all children studied, with the exception of 3 cases of acute diarrhoea, a moderate percentage of AGA-IgG was observed in subjects with cow's milk protein intolerance, acute diarrhoea, irritable bowel syndrome, lactase deficiency, chronic intractable diarrhoea and in a low percentage of children with parasitosis, intestinal lymphangiectasia and nodular lymphoid hyperplasia. There was no antibody movement in subjects with cystic fibrosis, gastroesophageal reflux, recurrent abdominal pains and chronic constipation. The different behaviour of the two antibody classes could be explained by the fact that AGA-IgG were detected in diseases where scattered areas of mucosal damage could allow the permeability of the macromolecules inducing passage of gliadin through the mucosal barrier and immune system-induced antibody stimulation.
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PMID:[The predictive value of antigliadin antibodies (AGA) in the diagnosis of non-celiac gastrointestinal disease in children]. 834 Dec 33


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