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

Three cases of vincristine-induced gastrointestinal toxicity were treated with metoclopramide. Two patients had severe abdominal pain and adynamic ileus, while the third had severe constipation and abdominal bloating. Rapid resolution of symptoms occurred in all three patients. Metoclopramide may, therefore, prove useful in the treatment of these not infrequent toxic effects of vinca alkaloids.
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PMID:Metoclopramide in vincristine-induced ileus. 386 4

Chronic intestinal pseudo-obstruction is a disorder of gut motility resulting in severe abdominal pain, bloating, nausea, and vomiting after eating. The avoidance of food in order to minimize symptoms causes malnutrition. To date, no medical or surgical treatment has been shown to be of lasting benefit. We treated 10 patients disabled by chronic intestinal pseudo-obstruction using home parenteral nutrition. All were rendered minimally symptomatic as long as they refrained from significant oral intake. Nine of the 10 patients were malnourished prior to the institution of treatment. Home parenteral nutrition increased mean total body weight from 74.7 +/- 2.9 to 93.5 +/- 3.7% (p less than 0.001), mean lean body mass from 78.4 +/- 6.5 to a mean of 92.7 +/- 2.6 (p less than 0.02), and mean body fat from 57.1 +/- 8.8 to 83.8 +/- 8.2% of expected values (p less than 0.05). Mean total body potassium increased from 68.8 +/- 13.1 to 80.5 +/- 10.7 g (p less than 0.05). We conclude that in chronic intestinal pseudo-obstruction, home parenteral nutrition coupled with minimal oral intake effectively relieves symptoms and significantly improves the nutritional depletion.
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PMID:Successful management of chronic intestinal pseudo-obstruction with home parenteral nutrition. 392 33

A series of 64 women complaining of severe constipation is described, in each of whom delayed elimination of markers from the colon was demonstrated but a barium enema was normal. All completed a detailed questionnaire and the responses are compared with those obtained in an age-matched series of healthy women with no bowel complaint. In each group 40 women also recorded in a manner suitable for analysis all food eaten over a period of seven days. The patients passed about one stool weekly with the aid of laxatives, and were greatly troubled by abdominal pain, bloating, malaise and nausea, to the extent that the symptoms were a major social disability and many lost time from work. Decreased bowel frequency and other symptoms were often first noticed around the age of puberty and slowly became worse until they were severe by the third decade. In a few, the symptoms began suddenly after an abdominal operation c-accident. Comparison with the control group showed no evidence that the patients had been underweight at any time or that they took less fibre; treatment with a bran supplement did not usually help them. The patients experienced rectal sensation before defaecation less often than the control subjects and they used digital pressure to assist defaecation more frequently. The women with constipation tended to have more painful and irregular menstrual periods, and there was an increased incidence of ovarian cystectomy and hysterectomy. Hesitancy in starting to pass urine was more common, as were some somatic symptoms such as cold hands or blackouts. Attention is drawn to this distinctive combination in young women of slow total gut transit time and a colon of normal width on barium enema, associated with abdominal, anorectal, gynaecological and somatic symptoms, as a disorder which can be disabling and particularly difficult to treat.
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PMID:Severe chronic constipation of young women: 'idiopathic slow transit constipation'. 394 36

Sorbitol is a commonly used sugar substitute in "sugar-free" food products. Although sorbitol intolerance manifested by abdominal pain, bloating, and diarrhea has been observed in children, it has not been well documented in adults. Forty-two healthy adults (23 whites, 19 nonwhites) participated in this study. After ingestion of 10 g of sorbitol solution, end expiratory breath samples were collected at 15-min intervals for 4 h and analyzed for H2 concentration. Clinical sorbitol intolerance was detected in 43% of the whites and 55% of the nonwhites, the difference not being statistically significant. However, severe clinical sorbitol intolerance was significantly more prevalent in nonwhites (32%) as compared to whites (4%). There was a good correlation between the severity of symptoms and the amount of hydrogen exhaled. Dietetic foods, many of them containing sorbitol, are very popular with diabetics and "weight watchers." Based on our observations, we believe that a large number of adults could be suffering from sorbitol-induced nonspecific abdominal symptoms and diarrhea. These symptoms could lead to an extensive diagnostic work-up and lifelong diagnosis of irritable bowel syndrome.
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PMID:Sorbitol intolerance in adults. 403 46

147 Mexican women, of low socioeconomic level, who had aborted spontaneously and desired pregnancy, were subjected to trial of placebo oral contraceptive. In 424 months there were 72 pregnancies, a Pearl index of 203.8 pregnancies per 100 couple-years. Menstrual cycles lasted 21-24 days in 30 women (9.8%), 25-35 days in 235 (76.8%), and 36-59 days in 38 (12.4%). 18 cycles (5.8%) were marked by intermenstrual bleeding. Incidence of 31 side effects is listed. Most common were: decreased libido 125 months (29.5%), headache 66 (15.6%), lower abdominal pain and bloating 58 (13.7%), dizziness 47 (11.1%). Common complaints were nervousness, increased libido, dysmenorrhea, nausea, epigastric pain, leg pain, leukorrhea, somnolence. Oral contraceptive-like side effects reported in fewer than 1% of months included acne, mastalgia, increased appetite, weight gain, painful varicose veins. Nausea (here 4.2% of months) was the only side effect with markedly different incidence from other studies with active oral contraceptives.
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PMID:Incidence of side effects with contraceptive placebo. 535 96

1422 faecal samples sent by general practitioners for routine parasitological examination were surveyed in 3 months. Of the 10.8% short-listed for special examination for cryptosporidium oocysts, 14 (9.1%) were positive. Charcot-Leyden crystals were not associated with cryptosporidiosis. All 14 patients had symptoms of gastrointestinal infection, which seemed to be related to a trip abroad. The incubation period varied between 4 and 12 days. Clinically cryptosporidiosis could not be distinguished from giardiasis, but its duration was shorter (median 10 days), strong abdominal pain and cramps were commoner, and bloating, anorexia, and weakness were less common. The disease can be diagnosed by identification of oocysts in faecal samples that have undergone formalin-ether concentration. There is no specific treatment for it, and recovery is spontaneous.
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PMID:Cryptosporidium: a frequent finding in patients with gastrointestinal symptoms. 613 70

The effectiveness of a new calmodulin-independent spasmolytic, tiropramide hydrochloride, and octylonium bromide, an antispasmodic calmodulin-antagonist drug, was compared in a controlled trial performed in 60 patients with irritable bowel syndrome with spastic pattern. The effect of treatments was assessed according to the score reduction of following symptoms: abdominal pain, constipation, bloating and dyspepsia. Tiropramide hydrochloride administered at the daily dose of 300 mg for 30 days induced a faster and higher improvement than that observed during the administration of 120 mg daily of octylonium bromide. On 3rd and 5th day, treatment with tiropramide induced the relief of abdominal pain in a significantly greater percentage of patients (p less than 0.05). Besides, in the group of subjects treated with this drug the "pain" score was more markedly decreased. Furthermore, at the end of the study 88% of subjects treated with tiropramide and 47% with octylonium bromide had normal bowel habits. This difference was statistically significant (p less than 0.05). Both treatments are effective in reducing dyspeptic symptoms and bloating. We can conclude that tiropramide--having a significant antispasmodic effect combined with a regulating effect on bowel habits--besides eliminating spasm, would act by synchronizing and therefore normalizing the intestinal motility.
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PMID:[Controlled clinical study on the efficacy of tiropramide hydrochloride in the treatment of irritable colon: comparison with octylonium bromide]. 636 85

Crohn's disease of the stomach and duodenum is uncommon and difficult to diagnose. This study reviews 23 patients with this condition seen at the Toronto General Hospital between 1970 and 1981. In 12 patients the major symptoms were due to coexisting lower intestinal Crohn's disease (primarily distal disease). Diarrhea and crampy abdominal pain were the primary presenting complaints. None had obstructive symptoms. Nine of the 12 were treated medically, 7 with success; 1 required surgical intervention and 1 continued to have pain but no evidence of ulceration. In the remaining 11 patients, the major symptoms were due to their gastroduodenal Crohn's disease (primarily proximal disease) even though 10 had coexisting disease of the intestine. Their symptoms included postprandial vomiting, upper intestinal bloating, hematemesis and epigastric pain. Only one patient was successfully treated medically; the others required surgical intervention. At the time of writing, 9 of the 11 patients had no symptoms. The authors conclude that response to medical therapy occurs only in patients whose gastroduodenal disease is relatively mild and whose symptoms come from distal intestinal disease. In contrast, patients whose main symptoms are from gastroduodenal involvement usually require surgical treatment. Vagotomy with gastroenterostomy is the procedure of choice.
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PMID:Gastroduodenal Crohn's disease: diagnosis and selection of treatment. 686 Oct 31

A tracer condition, to be used for clinical epidemiologic examination of psychosociogenic illness, must be common and clearly identifiable, distinguishable from concomitant physical problems, and found in general care. These criteria are met by couvade syndrome, the seeking of care for pregnancy-related symptoms by the mates of expectant women. Records of the mates of 267 postpartum women, representing a systemic sample of all births in a health maintenance organization of 36,000, were rated for the presence of nausea, vomiting, anorexia, abdominal pain, abdominal bloating, and other symptoms. Each patient was his own control. Sixty men (225 of 1000) sought care for couvade syndrome; they had a twofold increase in visits (p less than 0.001); had four times more symptoms than during control periods (p less than 0.001); and received twice as many prescriptions for medication as the men without this syndrome (p less than 0.05). The health care providers did not tend to recognize the "expectant" status of these patients or note the presence of the syndrome.
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PMID:The couvade syndrome: an epidemiologic study. 719 85

Treatment of chronic intestinal pseudoobstruction with prokinetic agents has been disappointing. Our study was designed to determine if octreotide and erythromycin would provide sustained relief from nausea, abdominal pain, and bloating in pseudoobstruction. Using gastrointestinal manometry, quantitative parameters of the activity front of the migrating motor complex at baseline and after prokinetic therapy with erythromycin and octreotide were determined in 14 patients with intestinal pseudoobstruction who had nausea, abdominal pain, and bloating. Patients were treated with erythromycin and octreotide for 20-33 weeks. Octreotide increased the frequency, duration, and motility index of activity fronts (AFs) from 1.2 +/- 0.3 AFs/4 hr, 2.7 +/- 0.7 min, and 85 +/- 23 min mm Hg to 4.1 +/- 0.8 AFs/4 hr, 5.5 +/- 0.7 min, and 152 +/- 24 min mm Hg, respectively (P < 0.05). Antral activity was decreased from 63 +/- 14 to 23 +/- 8% by octreotide (P < 0.05). Erythromycin induced antral activity; however, small intestinal motor activity was suppressed. While on erythromycin and octreotide, five patients had long-term improvement of nausea and abdominal pain. All responders had at least 5 AFs/4 hr induced by octreotide. We conclude that octreotide and erythromycin relieve abdominal pain and nausea in pseudoobstruction. Patients who have at least 5 AFs/4 hr after octreotide administration are most likely to clinically respond.
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PMID:Effect of octreotide and erythromycin on idiopathic and scleroderma-associated intestinal pseudoobstruction. 755 39


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