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

In the adult, the irritable bowel syndrome is characterized by intestinal transit disorders associated or not with chronic abdominal pain. Two different forms can be seen: in one, pain and constipation are predominant, while in the other, pain and diarrhea alternate. The second form is encountered with predilection in the child. Various terms can be used to name the syndrome including colitis, non specific or benign colitis, irritable bowel syndrome in the child, infantile diarrhea, and others, all of which attests to our ignorance of the pathophysiology of this disorder. This syndrome is by far the most frequent cause of chronic or recurrent diarrhea in the child. Before the age of 3 or 4 years, the principal syndrome is diarrhea, which usually appears before the age of 6 months. Onset is generally brutal, as in acute enteritis or an extradigestive infection (ENT...) but persists, or else, more often, the syndrome appears insidiously over several days. The child has soft or liquid stools of fetid odor in most cases, very rarely sourish, inhomogeneous and in which intact aliments can be found. Stools are often associated with mucous discharge, rarely with blood, and do not contain any pus. Stools are not fatty but occasionally they are sticky and adhere to the pot. During the day, stools change from well formed in the morning to soft in the evening. Their frequency varies from one day to another as well as during a given 24 hour period, ranging from one or two to 10 per day.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Irritable bowel syndrome in children]. 221 Jan 87

Unlike the proven causal association between oral contraceptive (OC) use and hepatic cell adenoma, the link between OCs and hepatocellular carcinoma remains speculative. The case history of a 53-year-old US woman suggests, however, that hepatic cell adenomas may transform into hepatocellular carcinoma. The patient, who had used Ovral continuously since 1966, presented in 1985 with vague abdominal pain and a palpable right upper quadrant mass. Computed tomography revealed a 12 x 8 cm mass in the right hepatic lobe and 2 small lesions in the left lobe. Serum alpha-fetoprotein and ferritin levels were normal and tests for hepatitis B were negative. A needle biopsy of the right lobe mass indicated benign hepatic adenoma. OC use was discontinued and the patient was examined at bimonthly intervals. Although she continued to report vague pain, there were no significant changes in radiologic findings or levels of alpha-fetoprotein over the next 18 months. At the 18-month follow-up visit, the alpha-fetoprotein level showed an increase to 227 mcg/L and had risen to 2300 mcg/L by the 30-month follow-up visit. At this time, computed tomography showed slight enlargement of the right lobe mass and inhomogeneity, while biopsy revealed sclerosing hepatocellular carcinoma. This is the 3rd case reported in the literature in which there is evidence of a transformation of hepatic cell adenomas into hepatocellular carcinoma in longterm OC users. Thus, the premalignant potential of hepatic cell carcinomas in OC users should be considered by physicians who follow such cases.
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PMID:Transformation of hepatic cell adenoma to hepatocellular carcinoma due to oral contraceptive use. 253 93

To further understand the pathophysiology of arterial diseases induced by oral contraceptives (OCs), a case report is presented of a young woman who died of extensive visceral artery thrombosis. The possible role of estrogens and progestogens and of cigarette smoking as the predisposing factors in this patient are discussed. A 26-year-old woman, who complained of progressive abdominal pain and whose past medical and surgical history was negative, was admitted to the general surgery service. She was the mother of 1 child and had had 2 previous spontaneous abortions. She had received ethinyl estradiol 35 mcg with norethindrone 500 mcg and 1000 mcg for 3 months, but because of a problem with breakthrough bleeding the medication was changed to mestranol 50 mcg with norethindrone 1000 mcg. She had been taking Ortho-Novum 1/50 for 2 1/2 years. She had smoked 25-35 cigarettes daily for about 10 years but denied use of alcohol or other drugs. She was not known to be diabetic, hypertensive, or dyslipidemic, and had no history of atherosclerosis in her family. For 7 months prior to her admission, the patient complained of abdominal pain, which progressively increased in intensity and duration, interrupted by periods of well-being. The patient reported 2 recent, isolated episodes of mild proctalgia but no tenesmus or melena. There had been no fever, but the patient had been anorexic for the past 2 weeks and reported losing 10 kg in the past month. She had no complaints apart from those related to the gastrointestinal system. At an emergency laparotomy, gangrenous acalculous cholecystitis and infarction of the terminal ileum were discovered. A cholecystectomy with resection of the terminal ileum and the right colon was performed. An end-to-end primary anastomosis was performed. On exploration of the superior mesenteric artery, a thrombus was discovered at its origin. As a transverse arteriotomy showed a good retrograde flow, a thrombectomy was performed. There appeared to be an unsatisfactory antegrade flow. The superior mesenteric artery then was transposed in an end-to-end fashion on the abdominal aorta. An immediate postoperative arteriogram showed thrombosis of the celiac axis at its origin. Revascularization failed to improve the condition of the intestine. The patient died. The intent of this case report is to emphasize that the association between smoking and oral contraceptives can cause cardiovascular disease in young women, and a failure to recognize this association can result in delayed diagnosis and worsen the prognosis.
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PMID:Intimal hyperplasia and thrombosis of the visceral arteries in a young woman: possible relation with oral contraceptives and smoking. 337 98

A case of mesenteric vascular occlusion is detailed. The 30-year-old female had abdominal pain, bloody diarrhea, and small bowel changes seen on x-ray. She had begun taking the oral contraceptive Ovral (.5 mg norgestrel, .05 mg ethinyl estradiol) 3 years prior to hospital admission. Symptoms began to disappear when her oral contraception was discontinued on the ninth hospital day. Over the next 5 days abdominal signs and symptons subsided progressively. A follow-up small bowel series showed complete disappearance of previous abnormalities. In the differential diagnosis of acute abdominal pain progressing to bloody diarrhea, especially in young women or oral therapy, acute vascular insult with small bowel ischemia must be considered.
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PMID:Reversible mesenteric vascular occlusion associated with oral contraceptives. 470 Oct 37

An obese 28-year old woman presented at the Royal Victoria Hospital on February 23, 1978 because of upper abdominal pain of 2 days duration. The patient had previously given birth 10 years ago and had since been taking an oral contraceptive (OC) containing 0.25 mg d-norgestrel and 0.05 mg ethinyl estradiol (Ovral). She had iron deficiency anemia at age 12, smoked 3 packs of cigarettes/week, rarely consumed alcoholic beverages and was not under any medication. Physical and laboratory examinations revealed a large liver tumor. Angiography and needle biopsy confirmed the diagnosis of hepatocellular adenoma (HCA). Resection was not indicated because of the size of the tumor. OCs were discontinued. Tubal ligation was performed 2 months later as the patient desired no further pregnancies. Complete regression of the tumor over a 12-month period was confirmed by subsequent scintiscans. This case shows that even large HCAs can regress completely with no therapy other than OC withdrawal, confirming the suggestions of others that simple observation after OC withdrawal may be preferable to resection in minimally symptomatic HCAs. A frequent histologic finding both in OC-associated HCA and in normal liver surrounding HCAs is marked sinusoidal dilatation, which suggests a general effect of estrogen therapy. Further studies should be done to determine the mechanisms by which OCs produce these changes and to define their clinical importance. The role of radionuclide imaging techniques, percutaneous liver biopsy, and angiography in the diagnosis of HCAs are very briefly described.
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PMID:Complete regression of hepatocellular adenoma after withdrawal of oral contraceptives. 627 17

This paper reports the case of a 30-year old woman, para 2, with mesenteric venous occlusion associated with inadvertent oral contraceptive (OC) use during pregnancy. The patient presented with vomiting, diffuse abdominal pain, and dysuria. Despite a 4 month history of amenorrhea, the patient continued OC use (Ovral)(. Ultrasonography revealed a fetus of 14 weeks gestation. Despite treatment, the patient's condition deteriorated and thrombotic occlusion of the mesenteric veins with hemorrhagic infarction of the intestine was noted. A resection of the damaged small bowel was performed, followed by an end to end enteroenterostomy. It is suggested that the hypercoagulable state normally found during pregnancy was aggravated in this case by the hormonal intake. In addition to OC use, this patient had another risk factor for mesenteric venous thrombosis: heavy cigarette smoking. The risk of venous thromboembolic disease associated with OC use declines within 1 month to the level found among nonusers of OCs. Thus, patients at risk of this condition (those who suffer from collagen disease or are obese and heavy smokers) should be advised to avoid pregnancy in the 1st month after OC discontinuance.
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PMID:Mesenteric vein thrombosis associated with oral contraceptive administration during pregnancy. 652 63

A case study of a woman taking Ortho-Novin (2 mg norethisterone and .1 mg mestranol) who presented with what was eventually diagnosed as a rare complication called mesenteric vein thrombosis is presented. Her complaints were of acute or chronic abdominal pain. Coagulation studies were performed and gave the folowing results: prothrombin time, 13.5 seconds, fibrinogen 500 mg percent, fibrin degradation products 60-80 mcg/ml, factor V 120%, factor VII 180%, factor VII 380%, factor X 200%, and an activated PTT of 21 seconds with no significant change in fibrinolytic activity. At laparotomy it was discovered that she had almost total small bowel infarction, and end-to-end anastomosis was performed. For nutritional supplementation after the almost complete resection of her bowel, shunts were inserted to assure intravenous infusion of adequate calories, trace elements, and vitamins. A doctor whose patient presents with abdominal symptoms and in on oral contraception and shows similar coagulation-study results should consider that she may be suffering from the small, small bowel syndrome.
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PMID:The pill, mesenteric vein thrombosis and the short, short bowel syndrome. 738 23

Progestin only birth control pills appeared on the US market in 1973. As there is no estrogen in these mini pills, they may have fewer dangerous side effects than the combined pills. Some clinics suggest mini pills for women who suffer from estrogen excess side effects. The 3 mini pills available in the U.S. are called Micronor, NOR-QD, and Ovrette. Instructions are presented for patients who are interested in using mini pills. The mini pills most likely work by affecting a women's fertility in several ways: act as a messenger to the woman's ovaries and uterus to prevent the release of an egg; thicken the mucous on the cervix, making it difficult for the sperm to "get through" the cervix and reach the egg; and change the lining of the uterus so that it may not develop properly for the fertilized egg to grow. The mini pills can be 97% effective is used perfectly. The mini pills are only effective for as long as a woman takes them. A woman must take a pill every day to prevent pregnancy. A woman should not use the mini pill if she has or ever has had any of these problems: blood clotting problems in veins; stroke; cancer of the breast or reproductive parts of the body; suspected pregnancy, current pregnancy; and undiagnosed, abnormal genital bleeding. Possible benefits for a woman using mini pills include: an effective method of birth control; a method for nursing mothers since it does not seem to affect the amount of their breast milk; and a possible reduction in premenstrual cramps. Possible risks for a woman using mini pills include: irregular periods; and a less effective method if the patient does not take a pill every day. The danger signals to look for are abdominal pain, chest pain, headaches, eye problems, and severe leg pain. A patient should revisit a clinic in the following situations: has not had a period within 45 days of the last period; severe abdominal pains while taking mini pills; experiences a warning signal; any time one thinks the pills are causing trouble; and once a year for a pap smear, breast examination, and laboratory tests.
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PMID:How to use mini-pills: helpful patient instructions. 1226 79

A study of 2 low-dose oral contraceptives, Loestrin and Nordette, was conducted in association with the National Family Planning Board in Kota Bharu, Kelantan, West Malaysia, to determine differences in continuation rates and reasons for discontinuation. This report includes analysis of 96 women, 91.7% of whom were interval patients, randomly allocated to 1 of the above OCs between December 1979 and January 1981. Follow-up visits were scheduled at 1, 3 and 6 months after admission with symptom grids completed during the 1st, 3rd, and 6th cycles. The continuation rates at 6 months were 85.9 and 89.8 for Loestrin and Nordette, respectively. The corresponding follow-up rates were 73.9 and 68.3. The side effect reported most often among both groups was breakthrough bleeding (BTB). In addition, the proportion of Loestrin users who reported BTB at least once during the study was significantly higher than the proportion of Nordette users (38.3% versus 18.4%, p 0.05). Other symptoms reported were nausea, headaches, intestinal problems, and abdominal pain. No accidental pregancies were reported during this study. There were a total of 6 (11.8%) discontinuations in the Loestrin group and 4 (8.9%) in the Nordette group.
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PMID:A comparative study of Loestrin versus Nordette in Kelantan, West Malaysia. 1226 18

Fertility control by cyclic norethindrone (Norlutin), 17 alpha-ethinyl 19-nortestosterone, plus .06 mg 3-methoxy ethinyl estradiol (Ortho-Novum) was studied in 364 women over a period of 32 months for a total of 6062 cycles. No patient who followed the instructions became pregnant. 37 patients stopped the medication for various reasons. The interval between stopping medication and becoming pregnant averaged 1.6 months. 13 of these pregnancies occurred after 11-15 cycles of treatment. Children born to these mothers were normal with no virilization observed. Findings from all Papanicolaou smears and cervical biopsies were normal. The desirable effects of diminishing the menstrual flow, reducing dysmenorrhea and regulating the menstrual cycle, plus the all-important one of contraception, far outweighed minimal and infrequent undesirable side effects (in order of frequence: chloasma, hot flashes, headache, nausea, acne, abdominal pain, dizziness and urticaria). In only 4.8% of the total 6062 cycles was some complaint made.
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PMID:Long-term administration of norethindrone in fertility control. 1227 4


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