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)

In order to investigate the possible role of fiber in the etiology of acute appendicitis, 203 consecutive appendectomized children with histologically proved appendicitis and 1922 controls were studied by the diet history method. Statistics were performed by multivariate analysis of variance, discriminant analysis and chi 2. Appendectomized children had statistically significant lower mean daily intake of fiber (17.4 g versus 20.4 g, P < 0.001) including all fiber fractions: cellulose, uronic acid, pentose, exose and lignin. No statistical difference was found for energy, protein, carbohydrate and fat intake. Discriminant analysis proved that only cellulose and exose are independently correlated to appendicitis and lower fiber intake is thought to be the cause in 70% of the cases. Recurrent abdominal pain, chronic constipation and positive family history of appendectomy were more frequent in appendectomized children (P < 0.001). This study gives evidence that low fiber intake could play an important role in the pathogenesis of appendicitis.
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PMID:Fiber intake and childhood appendicitis. 1094 10

We report a case of internal hernia of the small intestine in a 13-year-old boy with presentation of partial intestinal obstruction. The patient suffered from recurrent abdominal pain and chronic constipation over the past few years. An abdominal mass was suspected from clinical manifestations and images derived from abdominal echography. Upper gastrointestinal contrast study revealed poor motility at the distal jejunum with barium stasis. Follow-up film on the next day delineated medially and downwardly displaced splenic flexure and proximal descending colon. At operation, total herniation of small intestine into a retroperitoneal space through a defect on left mesocolon was noted. A left paraduodenal (mesocolic) hernia was diagnosed. The patient made an uneventful recovery after the hernia was repaired. This report provides unusual image clues of internal hernias of the small intestine presenting as ileus. Though rare, paraduodenal hernia should be taken into account in a differential diagnosis of intestinal obstruction. Early surgical intervention allows uneventful recovery to occur and also prevents the possible complication of gangrenous bowels.
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PMID:Left paraduodenal hernia presenting as intestinal obstruction: report of one case. 1143 65

Existing pharmacotherapeutic options for the treatment of patients with irritable bowel syndrome (IBS) are limited in treating the multiple symptoms associated with the disorder. There is much interest in the use of serotonin agents as new therapeutics. Acting primarily through 5-HT3 and 5-HT4 receptors, serotonin elicits changes in motor function and possibly visceral sensation. Two serotonin agents were developed specifically for IBS: tegaserod, a 5-HT4 receptor partial agonist, and alosetron, a 5-HT3 receptor antagonist (which is no longer available). Phase III clinical trial data show that during a 12-week treatment period with tegaserod, IBS patients with abdominal pain and discomfort, bloating, and constipation experienced significant global relief (i.e., improvement in overall well-being, abdominal pain, and bowel habit) compared with placebo. Improvement in bowel movement frequency and consistency was achieved and pain was relieved by 1 week. During 12 weeks of treatment, alosetron was shown to elicit significant relief of abdominal pain and discomfort compared with placebo or mebeverine in female IBS patients with diarrhea. Alosetron slowed colonic transit and treatment efficacy was apparent after a week of treatment. Another 5-HT4 receptor agonist, prucalopride, which is being developed for chronic constipation, accelerates colonic transit and increases stool frequency. Therefore, this agent may be of benefit in IBS patients with constipation.
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PMID:Drug therapy options for patients with irritable bowel syndrome. 1147 11

Irritable bowel syndrome (IBS) is common and can be disabling. Several drugs that modulate serotonin (5HT) and other neurotransmitters in the gut (neuroenteric modulators) have either become available or are in development, but progress has been slowed by toxicity. Blockade of 5HT(3) receptors slows colonic transit, increases fluid absorption and increases left colon compliance. Alosetron, a potent 5HT(3) receptor antagonist, has, in women but not in men, a clinically significant but modest therapeutic gain over placebo in the relief of abdominal pain and discomfort and bowel-habit disturbance (but not bloating) in diarrhoea-predominant IBS. However, the drug unexpectedly was associated with ischaemic colitis and, very rarely, severe constipation-induced complications, and alosetron has been withdrawn. Cilansetron may have similar efficacy in men and women. 5HT(4) receptor stimulation results in accelerated colonic transit, and tegaserod, a partial 5HT(4) receptor agonist, has modest but clinically significant advantage over placebo in constipation-predominant IBS; the benefit seems to be confined to females. Long-term published data are lacking and safety concerns have been raised. Prucalopride, a full 5HT(4) agonist that has been promising in idiopathic chronic constipation, may also be limited by toxicity. Other 5HT receptor antagonists and agonists are under development for IBS. However, for modulators of single receptors to achieve a substantial therapeutic gain, and to do so safely, drug targets based on the pathophysiology of IBS need to be better defined.
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PMID:Serotoninergic neuroenteric modulators. 1175 32

We present a case of a 78 year-old man with the pathological antecedent of chronic constipation that comes to our emergency room at the Victor Lazarte Echegaray Hospital. He presented abdominal pain and progressive abdominal distension, nausea and bilious vomits of two days of evolution. The clinical examination showed an evident abdominal distension, and some metallic intestinal noises. A frontal and lateral simple abdominal x- ray showed a considerable distension of the gastric camera and intestinal loops and free fluid all over the abdominal cavity, all of which was compatible with the diagnosis of intestinal obstruction. At the operating room we proceeded with a exploration and we founded an intestinal obstruction at the ascending colon (Ladd's Bands) of high location with bloody fluid in the abdominal cavity, multiple fecalomas in the descending colon, and intestinal ischemia in the distal small bowel, the color, tone and coiling of the intestine recovered after section of the Ladd's bands. The patient evolved favorably.
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PMID:[Intestinal obstruction for malrotation in an adult patient. Report of a case]. 1217 Feb 88

Retrograde irrigation enemas are commonly used in the treatment of chronic constipation especially in the elderly. We report a case of colorectal perforation due to self-administered retrograde water enema. A 55 year-old chronically constipated male patient was admitted to the emergency unit with severe diffuse abdominal pain. He administered rectal enema using a garden hose directly connected to the water two hours before admission, until he felt a sudden sharp abdominal pain. At the operation he was found to have a perforation along the antimesenteric border of distal sigmoid colon extending to the upper rectum. Primary resection and anastomosis with intraoperative colonic lavage was performed. Postoperative course was favorable without any wound infection or intraabdominal sepsis.
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PMID:[Colorectal perforation due to self administered retrograde enema]. 1456 89

In 12 patients aged 9 to 17 years (14.1 +/- 2.3 SD years) (11 girls, 1 boy) complaining of abdominal pain and chronic constipation, barium large bowel X-ray examination showed the following anatomical and positional abnormalities: ptosis of the transverse colon to the small pelvis was found in 11/12 patients, ptosis of the hepatic flexure of the transverse colon (2/12), ptosis of both the hepatic and lienal flexures (2/12), dolichocolon (2/12), and dolichosigma (2/12); 10 of 12 children had symptoms characteristic of irritable colon syndrome. It seems that clinical symptoms accompanying these abnormalities begin to manifest mainly in girls during adolescence because at that time the final length of the colon is established, the transit time reaches its maximal value, and the shape of the pelvis becomes characteristic for this gender. These abnormalities are rather constitutional than acquired since previously it has been reported that the vertical ptosis of the kidney(s) occurs also mainly in adolescent girls.
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PMID:[Changes of the position and length of the transverse colon causing abdominal pain and chronic constipation during adolescence]. 1459 59

OBJECTIVE: To check whether signs and symptoms referred to by parents are associated with chronic constipation. METHODS: A comparative survey was carried out in a group of children with constipation and another group without constipation selected from a random sample. Data were collected from mothers using a structured questionnaire. Children with chronic constipation were expected to have undergone painful defecation or defecation with effort during at least thirty days with stools of hard consistency and/or bowel movements frequency below three times per week. RESULTS: An assessment was made of the variables: inappetence, abdominal distension, abdominal pain, fecal bleeding, soiling, urinary problems and vomit. Statistical differences were observed among children with and without constipation for inappetence, abdominal pain and faecal bleeding (p<0.05). CONCLUSIONS: An association was detected between the signs and symptoms analyzed and constipation. This study stresses the need to investigate accurately whether children have constipation and the extent of its relationship with those complications.
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PMID:[Signs and symptoms associated with chronic constipation] 1464 73

The disease of Mya-Hirschsprung (HD) it's rare and congenital, usually diagnosed in child age, but that it can also remain unknown until the adult age. It's associated to genetic mutations and it can involve other pathologies and malformations. The variability of the anatomopathological and clinical phenomena is correlated to the length of the aganglionic segment. The Authors describe the clinical case of one young female patient, who presented chronic constipation (less than 3 evacuations to week), tenesm, meteorism, abdominal pain. To the inspection of the anal region after the evacuation the presence of complete rectal prolapse (3) cylinders of the length of 30 cm was appraised, with presence of ulcerations of the mucosa. The patient came subordinate to diagnostic study that they demonstrated the presence of HD. The Authors operated the patient with the technique of Frykman and Goldberg. In the follow-up the patient had the complete remission of the symptomatology and resumption of the rectoanal inhibitory reflex, remarkable diminished in the preoperative manometric examination. The pathogenesis of the association of HD and rectal prolapse goes searched in the presence of ultrashort HD (aganglionic defect of a limited segment of rectum), pathological variety somewhat rare that can determine subocclusive phenomena and that it favors the prolapse of the rectum for the continuous evacuating strains.
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PMID:[Complete rectal prolapse in a patient with Hirschsprung disease: a clinical case]. 1466 84

OBJECTIVE: To review current information concerning the importance, pathophysiology, clinical presentation, and treatment of chronic constipation in Pediatrics. METHODS: Bibliographic review of Medline database and articles published by the authors. RESULTS: Constipation is a common disorder in childhood. The pathophysiology of constipation involves the interaction of several factors: low-fiber diet, early weaning, painful bowel movement, fecal retention, disturbance of intestinal motility, and genetic predisposition. The clinical presentation of children with constipation is variable. Several patients present the onset of constipation during the 1st year of life; however, the medical treatment is usually initiated only after a long period. Some patients are recognized due to the presence of complications, such as soiling, abdominal pain, and urinary abnormalities. The treatment should be adapted to each patient, and includes general orientation, complete colonic emptying, maintenance treatment, and a behavioral program to regulate bowel habits. Regardless of the fact that most children present functional chronic constipation, much attention should given to the entities that constitute the differential diagnosis. Specialized evaluation and diagnostic techniques should be indicated according to the patient s individual characteristics and when the clinical evolution is not satisfactory. CONCLUSIONS: The long-term control of chronic constipation depends on the acquisition of dietary habits that provide an adequate intake of dietary fiber. It is possible that a high-fiber diet is important not only to the control of constipation, but may also reduce the risk for diet-related chronic diseases during adulthood.
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PMID:[Constipation] 1467 18


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