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)

A total of 415 women treated for laparoscopically verified pelvic inflammatory disease (PID) were reviewed after 9.5 years. Of these, 88 (21.2 per cent) were involuntarily childless after one or more infection; in 72 cases (17.3 per cent) this was due to tubal obstruction; 263 (63.4 per cent) women became pregnant; 64 (15.4 per cent) were voluntarily childless. Tubal occlusion was diagnosed after one infection in 12.8 per cent, after two infections in 35.5 per cent, and after three or more infections in 75 per cent of the women. Tubal occlusion was more common after nongonorrheal than after gonorrheal salpingitis. Infertility varied with the inflammatory changes seen at laparoscopy. The ratio between ectopic and intrauterine pregnancies after the infections was 1/24. Chronic abdominal pain was reported by 18.1 per cent of the women. Corresponding findings in 100 healthy control subjects were: involuntary childlessness in three despite normal Fallopian tubes, one ectopic in 147 intrauterine pregnancies, and chronic abdominal pain in five cases.
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PMID:Effect of acute pelvic inflammatory disease on fertility. 12 23

Chronic abdominal pain affects 10% to 12% of school-aged children. In 90% to 95% of such patients, no organic cause can be elicited. Certain behavioral and personality characteristics are frequently evident in these children. Significant stress is usually present in the families. The goal of the evaluation is education of the child and family about the abdominal pain. The reality of the pain is acknowledged, but the stress is dealt with as the primary issue.
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PMID:Abdominal pain. 649 98

Chronic abdominal pain syndrome is becoming increasingly important with regard to the quality of life of the patients and its social and economic impact, in terms of cost of hospitalization, income loss due to sick leave, and pharmaceutical costs for treatments which fail to offer either significant clinical improvement or resolution of the pain symptoms. The main symptom is chronic abdominal pain, which may vary in intensity and may be associated with constipation and episodes of vomiting, when the clinical picture evolves toward one of subocclusion or total occlusion of the bowel. We considered the following criteria in our selection of patients for this study: 1) quality of life, 2) constant use of antispastic and analgesic medications, 3) absence of any other diagnosticable pathology prior to the operation. From August 1992 to April 2000 we operated on 105 patients with this syndrome (16 males and 89 females). Among these 8 patients had never been subjected to a laparotomy, while 97 had previously undergone surgical procedures (126 laparotomies). In the first 85 patients in the series (81%) we used a 10 mm laparoscope (0-30 degrees) to evaluate the presence of abdominal-visceral adhesions based on the type of surgery the patient had undergone previously, as well as the location of the pain reported by the patient. In 41 cases (48.2%) the pneumoperitoneum was obtained with the Veress needle. In another 44 cases (51.8%) the Hasson technique was used. Since June 1999, we have carried out the exploration of the abdominal cavity in 20 patients (19%) using a trocar and 2.2 mm laparoscope in the left hypochondrium along with a mini-trocar placed either in the right or left flank. (The positioning of the trocars depended on the previous surgical procedures performed). The exploration included inspection of the abdominal cavity. In 8 of the patients the procedure was carried out under local anaesthesia We performed laparoscopic adhesiolysis in 93 cases; in 7 cases no signs of adhesions were seen, while in another 5 cases it was necessary to convert the original laparoscopic procedure to a laparotomy. The types of adhesions found were fine-filmy (46%), dense-vascularised (46%), and cohesive (16%). In 6 cases during lysis of the adhesions complications of serous-muscular lesions occurred, which required laparotomic repair. In 5 cases we diagnosed a pathological condition which was not suspected. The average postoperative hospital stay was 2 days (range: 1-7); no major postoperative complications were noted. In the course of the follow-up of 78 patients over an average of 37 months (range: 6-72) the results obtained were as follows; 47 patients (60.2%) had complete pain relief, 18 patients (23.1%) had partial pain relief, and the remaining 13 patients (16.7%) had no significant pain relief. Laparoscopic exploration in patients with chronic abdominal pain is technically feasible in a simple manner in most patients. By means of careful and accurate preoperative selection of the patients partial if not complete pain relief can be achieved in a high percentage of cases (83.3% in our series).
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PMID:[Impact of laparoscopic surgery in the treatment of chronic abdominal pain syndrome]. 1219 34

Chronic abdominal pain occurs in 17% of children aged 0-14 years with a peak of 33% at the age of 7 years. According to the Rome II criteria abdominal pain disorders can be classified as functional dyspepsia, irritable bowel syndrome, functional abdominal pain, abdominal migraine, and aerophagia. This new classification will hopefully lead to a more careful diagnosis of functional abdominal pain syndromes and to better treatment strategies. A thorough history taking and physical examination are the cornerstone of diagnostic workup in children with chronic abdominal pain. An extensive explanation and reassurance are the basis of an adequate treatment and in the majority of cases this is successful.
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PMID:[Functional childhood gastrointestinal disorders. I. Chronic abdominal pain]. 1286 62

Chronic abdominal pain in children can be dependent from motility disorders. The aim of the work was evaluation the frequency of changes in oesophageal manometry in children with chronic abdominal pain. Manometry studies were performed in 40 children with functional abdominal pain (group A, which was divided into subgroups: A1--functional dyspepsia, A2--irritable bowel syndrome, A3--nonspecific abdominal pain), in 11 children with gastritis (group B) and in 24 children as a control (group C). Disorders of lower oesophageal sphincter (LES) function were observed in 72.5% of group A and 45.5% of group B; transient lower oesophageal sphincter relaxations (TLESR) were noticed in 13.5%. Abnormalities of body function with the features of non-specific oesophageal motility disorders were observed in 62.5% in group A and 54.5% in group B during "dry" swallows and in 47.5% and 18.2% respectively during "wet" swallows. These changes were more frequent in dyspeptic children (85.7%). Statistical differences were established among values of resting LES pressure in analysed groups (group A or B versus group C; p < 0.05). In conclusion we mentioned that in oesophageal manometry abnormalities (LES and body function) were observed in children with functional abdominal pain and with gastritis. Characteristic features can not be defined in each group.
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PMID:[Motility disorders in oesophageal manometry in children with chronic abdominal pain]. 1507 18

Chronic abdominal pain is the most distressing symptom in patients with functional digestive disorders (FDD). IBS is the most common gastrointestinal disorder seen in primary care and gastroenterology practice. IBS is a functional bowel disorder in which abdominal pain is associated with defaecation or a change in bowel habit, with features of disordered defecation and with distension. The underlying pathophysiology of IBS is unknown but a chronic visceral hyperalgesia, in the absence of detectable organic disease, is implicated. The exact location of abnormality of visceral pain processing is not known. Theories of its etiology have range widely from the original view that the disease represents a primary disturbance of gut mucosa to emerging conception of the syndrome as emanating from a complex disordered interaction between the digestive and nervous systems. Several lines of evidence suggest a strong modulatory or etiologic role of the central nervous system in the pathophysiology of IBS. A major advance in the understanding of the central mechanisms of pain processing has evolved from application of functional imaging techniques, as represented by positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). In humans, multiple components are involved in somato-visceral pain processings, including sensory-discriminative components, affective components, and cognitive components. Silverman et al, using PET, were the first to explore neural correlates of abdominal pain induced by rectal distension. If healthy subjects activated the ACC, the IBS patients did not while they presented an activation of the left PFC. These findings were consistent with an IBS model that includes both the exaggerated activation of a vigilance network (dorsolateral PFC) and a failure in pain inhibition network anterior cingulate cortex (ACC). In contrast, Mertz et al., using fMRI, observed that pain led to a greater activation of the ACC than did non-painful stimuli thus arguing for an up-regulation of afferent sensitivity to pain. Using fMRI, we also characterized cerebral loci activated by a rectal distension in healthy volunteers. The activation patterns presented a strong similarity with the central processing of somatic pain. In contrast, in a women predominant population of IBS patients, we did not observed any neuronal activation in locations activated in healthy volunteers (ACC, dorsolateral PFC) while a significant deactivation was observed in the IC and in the amygdala, a limbic structure with a role to assign emotional significance to a current experience related to anxiety and fear. Brain imaging techniques thus appear as useful tools to characterize normal and abnormal brain processing of visceral pain in patients with FDD. Reversal effects of chemical compounds targeting these abnormalities either at a peripheral or a central level should be of interest.
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PMID:Visceral sensitivity perturbation integration in the brain-gut axis in functional digestive disorders. 1507 47

Chronic abdominal pain, defined as long-lasting intermittent or constant abdominal pain, is a common pediatric problem encountered by primary care physicians, medical subspecialists and surgical specialists. Chronic abdominal pain in children is usually functional-that is, without objective evidence of an underlying organic disorder. The Subcommittee on Chronic Abdominal Pain of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition has prepared this report based on a comprehensive, systematic review and rating of the medical literature. This report accompanies a clinical report based on the literature review and expert opinion. The subcommittee examined the diagnostic and therapeutic value of a medical and psychologic history, diagnostic tests, and pharmacological and behavioral therapy. The presence of alarm symptoms or signs (such as weight loss, gastrointestinal bleeding, persistent fever, chronic severe diarrhea and significant vomiting) is associated with a higher prevalence of organic disease. There was insufficient evidence to state that the nature of the abdominal pain or the presence of associated symptoms (such as anorexia, nausea, headache and joint pain) can discriminate between functional and organic disorders. Although children with chronic abdominal pain and their parents are more often anxious or depressed, the presence of anxiety, depression, behavior problems or recent negative life events does not distinguish between functional and organic abdominal pain. Most children who are brought to the primary care physician's office for chronic abdominal pain are unlikely to require diagnostic testing. Pediatric studies of therapeutic interventions were examined and found to be limited or inconclusive.
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PMID:Chronic Abdominal Pain In Children: a Technical Report of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. 1573 76

Chronic abdominal pain, defined as long-lasting intermittent or constant abdominal pain, is a common pediatric problem encountered by primary care physicians, medical subspecialists, and surgical specialists. Chronic abdominal pain in children is usually functional, that is, without objective evidence of an underlying organic disorder. The Subcommittee on Chronic Abdominal Pain of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition has prepared this report based on a comprehensive, systematic review and rating of the medical literature. This report accompanies a clinical report based on the literature review and expert opinion. The subcommittee examined the diagnostic and therapeutic value of a medical and psychological history, diagnostic tests, and pharmacologic and behavioral therapy. The presence of alarm symptoms or signs (such as weight loss, gastrointestinal bleeding, persistent fever, chronic severe diarrhea, and significant vomiting) is associated with a higher prevalence of organic disease. There was insufficient evidence to state that the nature of the abdominal pain or the presence of associated symptoms (such as anorexia, nausea, headache, and joint pain) can discriminate between functional and organic disorders. Although children with chronic abdominal pain and their parents are more often anxious or depressed, the presence of anxiety, depression, behavior problems, or recent negative life events does not distinguish between functional and organic abdominal pain. Most children who are brought to the primary care physician's office for chronic abdominal pain are unlikely to require diagnostic testing. Pediatric studies of therapeutic interventions were examined and found to be limited or inconclusive.
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PMID:Chronic abdominal pain in children. 1574 94

Chronic abdominal pain syndrome is becoming increasingly important. The main symptom is persistent abdominal pain, which may vary intensely and be associated with constipation and episodes of vomiting, evolving towards sub- or total occlusion of the bowel. A 65-year old man presented with malignant peritoneal mesothelioma, with environmental asbestos exposure and chronic abdominal pain for more than one year. Due to his poor general condition, only palliative surgery was performed to resolve small and large bowel obstruction.
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PMID:[Chronic abdominal pain and peritoneal mesothelioma: case report]. 1591 55

Chronic abdominal pain can be associated with benign and malignant disease. Pain associated with pancreatic cancer and chronic pancreatitis can be severely debilitating, with significant impairment in quality of life. Frequently, chronic abdominal pain is not adequately responsive to conventional medical therapies, including nonsteroidal anti-inflammatory drugs and opioids. For this reason, alternative methods to alleviate pain have been developed. Celiac plexus neurolysis and celiac block involve injecting an agent at the celiac axis, with the goal of either selectively destroying the celiac plexus or temporarily blocking visceral afferent nociceptors to alleviate chronic abdominal pain. Agents most commonly used for this purpose include alcohol or phenol for neurolysis and bupivacaine and triamcinolone for temporary block. Methods to administer such agents to the celiac ganglion include CT imaging, percutaneous ultrasound, fluoroscopy, endoscopic ultrasound, or surgery (ganglionectomy). Response rates and complications vary depending on technique but are relatively low. This review highlights the techniques of celiac plexus neurolysis and celiac block and their status in the treatment of chronic pancreatitis and pancreatic cancer pain.
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PMID:Techniques and results of neurolysis for chronic pancreatitis and pancreatic cancer pain. 1653 71


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