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

Irritable bowel syndrome (IBS) is characterized by abdominal pain and alteration of bowel habits. Manning et al. have reported that certain symptoms distinguished IBS from organic gastrointestinal disease (OGD); these were pain relieved by defecation, looser or more frequent stools at the onset of pain, abdominal distention, mucus, and a feeling of incomplete evacuation. Another simple scoring system for discriminating IBS from OGD that incorporated historical data, physical examination findings, and basic investigations was first devised by Kruis et al. In differential diagnosis of IBS from OGD, to evaluate the reliability of Manning's criteria and Kruis scoring system when used apart or combined; we studied 347 out-patients who completed a bowel disease questionnaire which objectively measured Manning's criteria and scoring system of Kruis. The group included 165 patients with IBS and 182 patients with OGD. The Manning's criteria discriminated IBS from OGD with a sensitivity of 90% and a specificity of 87% if three or more items were regarded as positive. Also the Kruis scoring system discriminated IBS from OGD with a sensitivity of 81% and a specificity of 91%. When used together, these systems discriminated IBS from OGD with a sensitivity of 80% and a specificity of 97%. Manning's criteria and Kruis scoring system had a strong correlation when compared in IBS, but not in OGD.
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PMID:Kruis scoring system and Manning's criteria in diagnosis of irritable bowel syndrome: is it better to use combined? 908 21

IBS is one of the most common of the gastrointestinal disease, but it can be a diagnostic challenge because of the many symptoms that overlap with other such diseases. Most common among the symptoms are abdominal pain, a feeling of intestinal distention or bloating, and either diarrhea or constipation. Patients may be found to have an exacerbation of symptoms with stress, and they may have an increased sensitivity to bowel distention. History and physical examination findings often can be relied on to make the diagnosis, avoiding overuse of laboratory testing. Treatment consists of patient education and support, lifestyle and dietary changes, and use of several pharmacologic agents for symptom relief. Antidepressants are being investigated as a possible additional form of treatment.
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PMID:Irritable bowel syndrome. Streamlining the diagnosis. 930 28

Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder, defined as a variable combination of chronic or recurrent gastrointestinal symptoms not explained by structural or biochemical abnormalities. It is attributable to the intestine with symptoms of abdominal pain, altered bowel habits and bloating. The diagnosis is primarily based on typical symptoms and prudent use of investigations to exclude organic disorders. The initial positive diagnosis is accurate and on a longterm follow-up its revision rarely required. A change in its clinical manifestation may imply the superimposition of another disorder. Treatment primarily rely on the confidence in the diagnosis and a strong physician-patient relationship. High fiber diets and bulking agents may be effective in alleviating symptoms. Though antispasmodic, antidiarrheal and psychotropic drugs are repeatedly used in patients with moderate to severe symptoms their effects remain uncertain. Psychotherapy, hypnosis and biofeedback may relief symptoms and may be considered for motivated patients with moderate to severe symptoms.
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PMID:[Irritable colon]. 945 69

The number of dyspeptic patients with upper abdominal pain that are referred for investigation is increasing and will undoubtedly continue to increase, because these days peptic ulcer disease is increasingly becoming a primary care management issue, the specialist being left to deal with the patients who cannot be helped by antibiotics and antisecretory drugs prescribed by their general practitioner. Many of these patients are referred for an upper endoscopy to rule out organic disease. Carefully taken history, however, shows that a great number of those dyspeptics, on the basis of their clinical manifestations, do have a functional gastrointestinal disorder, representing the 'irritable gut'. A probable better term reflecting the direct relation is the syndrome of 'the constipated stomach'. In our opinion these patients are an important and increasing clinical problem for general practitioners, gastroenterologists, surgeons and physicians. The aim of this article is to make the practitioner aware of advancements in understanding pathophysiologic and psychosocial processes, as well as to give an overview of the great overlap between many functional gastrointestinal disorders, the important role of history-taking and some insights into the functional rectal outlet syndrome.
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PMID:The constipated stomach. An underdiagnosed problem in patients with abdominal pain? 951 52

The prevalence of eating disorders, such as anorexia nervosa, is increasing in young adults, particularly young adult women. Sometimes, gastrointestinal complaints in patients with anorexia nervosa may lead to an erroneous diagnosis of gastrointestinal disease and unnecessary diagnostic studies and therapies. In contrast, patients with gastrointestinal disease may experience anorexia because of abdominal pain and other gastrointestinal symptoms induced by eating. In these patients, anorexia minimizes symptoms and can obscure the underlying gastrointestinal disease by "resting" the bowel. Therefore, a careful history and physical examination and laboratory tests are needed to make the correct diagnosis and begin appropriate treatment.
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PMID:Nutritional management of anorexia. 982 80

Waterborne gastroenteritis outbreaks have often gone undetected or been incompletely defined in terms of source and extent. Methods which allow detection or clarification of such events are therefore useful. We describe the methods used to detect and investigate such an outbreak. In autumn 1996 high school absence rates and the rate of parents absent from work to care for sick children suggested a health problem in a Swedish town which had a history of unexplained outbreaks of gastrointestinal disease. A systematic sample of 300 households was surveyed by post. Respondents represented 10% of the total population of the town. Questions concerning symptoms and exposures were included. The same questionnaire was used in a nearby town as a control. Sixty four percent of respondents reported an acute gastrointestinal illness during a two month period. Diarrhoea (90%) and abdominal pain (88%) were the most frequent symptoms among the sick. Two percent of those sick sought medical care. Exposures associated with disease were being a member of a large household, young age, and consumption of water from the community water supply. Attack rate showed a dose response relationship with increasing frequency of water consumption. The peak incidence of gastrointestinal illness occurred shortly after raw water quality control data had shown a rise in indicator bacteria. Further analysis, dividing those infected into groups according to when they became ill and whether they were the first member of their household to fall ill, supported the hypothesis of primary cases being infected from the water supply with some secondary person to person spread.
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PMID:Epidemiological explanation of an outbreak of gastro-enteritis in Sweden in the absence of detailed microbiological information. 984 33

Constipation, diarrhea, and irritable bowel syndrome are commonly encountered in the primary care practice. Most episodes of constipation and diarrhea are benign and self-limited. Patients with chronic constipation should undergo a screening evaluation to exclude organic disease, after which most can be managed successfully with dietary modification and fiber supplementation. The cause of chronic diarrhea usually can be discerned clinically, with irritable bowel syndrome, inflammatory bowel disease, and lactose intolerance being diagnosed most frequently. Irritable bowel syndrome is a functional gastrointestinal disorder characterized by abdominal pain and disordered defecation, which is successfully managed with a strong physician-patient relationship and periodic pharmacologic intervention.
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PMID:Constipation, diarrhea, and irritable bowel syndrome. 992 98

IBS is a functional gastrointestinal disorder in which the patient has chronic or recurrent gastrointestinal symptoms (diarrhea, constipation or abdominal pain and bloating) that are unexplained by any structural or biochemical abnormalities. Research has demonstrated no causal relationship between psychosocial factors and the development of IBS. IBS cannot be diagnosed through radiologic, endoscopic or laboratory studies because the symptoms are not explained by structural or chemical abnormalities. One of the most important components of treatment is the development of an effective provider patient relationship. Behavioral treatments may be helpful in select patients. Dietary management can also reduce symptoms if the patient can identify foods that trigger them.
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PMID:Managing irritable bowel syndrome. 1003 Jan 69

In view of its potential risk for the development of gastrointestinal disease or even gastric cancer at a later age, the study of Helicobacter pylori infection in childhood is gaining increasing importance and H. pylori infection is being considered a major issue of public health. H. pylori infection can be detected by a variety of methods. Because of its easy use, affordability, and overall availability, serology is the preferred diagnostic test, especially for large epidemiological studies. Based on our results, one might consider treating a child with recurrent abdominal pain and positive serology for H. pylori without further work-up, and only perform additional investigations when an anti-H. pylori therapy fails to resolve the complaints. According to this proposition, endoscopy of the upper gastrointestinal tract remains indicated in children if the noninvasive tests for Helicobacter pylori are negative in the absence of a diagnosis, or if symptomatology persists despite treatment.
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PMID:Diagnosis of Helicobacter pylori. 1077 25

A 69-year-old woman with a 6-year history of rheumatoid arthritis treated solely with an orally administered NSAID had slowly progressing persistent mild abdominal pain and diarrhea, accompanied with marked sing of inflammation as well as hypoproteinemia due to protein-losing gastroenteropathy. Examinations of the large intestine revealed variously shaped ulcerative lesions, centered around the left hemicolon, as well as luminal narrowing. The course of the disease and the shape of the lesions strongly suggested involvement of rheumatoid vasculitis; oral administration of prednisolone was effective.
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PMID:Rheumatoid arthritis accompanied by colonic lesions. 1077 27


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