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

Campylobacter jejuni/coli has recently become recognized as a common bacterial cause of diarrhea. Infection can occur at any age. The usual incubation period of campylobacter enteritis is 2 to 5 days. Fever, diarrhea and abdominal pain are the most common clinical features. The stools frequently contain mucus and, a few days after the onset of symptoms, frank blood. Significant vomiting and dehydration are uncommon. A rapid presumptive laboratory diagnosis may be made during the acute phase of the illness by direct phase-contrast microscopy of stools. Isolation of the organism from stools requires culture in a selective medium containing antibiotics and incubation under reduced oxygen tension at 42 degrees C. The organism persists in the stools of untreated patients for up to 7 weeks following the onset of symptoms. Erythromycin may produce a rapid clinical and bacteriologic cure, and should be used to treat moderately to severely ill patients as well as patients with compromised host defences. The emergence of erythromycin-resistant strains requires close monitoring. The epidemiologic aspects of campylobacter enteritis will be fully understood only when methods become available for differentiating strains of C. jejuni/coli. The historical background and current knowledge of campylobacter enteritis are reviewed in this paper.
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PMID:Campylobacter enteritis. 45 9

On June 7, 1990, food poisoning with main symptoms of abdominal pain and diarrhea occurred in Inuyama City, Aichi Prefecture. From results of bacteriological examination, three kinds of mesophilic Aeromonas spp. were detected from patients, leftover foods, well water, and cookers, one of which was A. hydrophila which was shown to produce haemolysin thought to be the cause of the food poisoning. On the other hand, A. sobria and A. caviae isolated from various materials did not produce haemolysin. The latter two strains of mesophilic Aeromonas spp. did not produce any other enterotoxins. Therefore, it appears that the well water containing A. hydrophila, A. sobria and A. caviae polluted the foods, which then had caused the food poisoning. Of nine strains of A. hydrophila, five do not dissolve sucrose, and these are typed as serogroup O:22 or O:23. The other four strains dissolve sucrose, and these are typed as serogroup O:16. According to the drug sensitivity test, all of these nine strains of A. hydrophila were resistant to Ampicillin, Erythromycin and Cephaloridine.
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PMID:[An outbreak of food poisoning suspected due to Aeromonas and characteristics of the isolated strains]. 129 45

The effects of an antibacterially effective IV dose of erythromycin on gastrointestinal motor activity were investigated in eight normal healthy human volunteers in the fasted state and the fed state. Motor activity was recorded by a multilumen manometric tube. Data were analyzed visually and by a computer method. Blood samples were obtained for erythromycin and motilin assays. In the gastric antrum, erythromycin significantly increased the total duration, amplitude, and area under contractions from 0 to 60 minutes and frequency of contractions from 0 to 30 minutes from the start of its infusion in the fasted state. A similar response in the fed state occurred mostly from 0 to 30 minutes after the start of erythromycin infusion. By contrast, erythromycin inhibited the frequency and decreased the duration of small intestinal contractions in the fed state but had no effect in the fasted state. The gastric motor response was related to the plasma concentration of erythromycin, but not to plasma motilin. Erythromycin significantly shortened the duration of migrating motor complex disruption by a meal. Erythromycin also induced symptoms of upper abdominal pain, bloating, and nausea. Abdominal pain was related to strong antral contractions in both fasted and fed states; bloating occurred only in the fed state. Nausea occurred in both fasted and fed states, but it was not related to any specific pattern of motor activity. It is concluded that the strong antral contractions induced by erythromycin may accelerate the rate of gastric emptying, but they may also be responsible for causing the sensations of upper abdominal pain and bloating. The motor response to erythromycin is less during the fed than during the fasted state. The strong antral contractions induced by erythromycin are not mediated by the release of motilin.
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PMID:Gastrointestinal motor effects of erythromycin in humans. 195 15

Erythromycin base and its salts are frequently used in clinical practice. The most frequent side effects of oral erythromycin preparations are gastrointestinal. Various salts and enteric coatings have been developed without adequate comparison in regard to gastrointestinal side effects. The overall incidence of gastrointestinal side effects (abdominal pain and cramps, nausea, vomiting, diarrhea, and gas) of two common erythromycin base formulations, Erythromycin Base Filmtab (Abbott), a nonenteric-coated base tablet, and Eryc (Parke-Davis), a pelletized, encapsulated, enteric-coated base capsule, were compared in 368 adults at two dosage levels (1 g/d and 2 g/d). Minimal differences were found when target symptoms were compared by preparation coating. In contrast, subjects receiving erythromycin at the 2-g/d dosage level reported higher incidence rates for each of the target symptoms, regardless of product coating, than did those patients treated at the 1-g/d dosage level. Enteric coating of erythromycin base offers little protection from the common dose-related gastrointestinal adverse effects of oral erythromycin.
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PMID:Prospective comparison of patient tolerance to enteric-coated vs nonenteric-coated erythromycin. 224 43

Campylobacter enteritis appears to be a frequent cause of bacterial diarrhoea, especially among children. The species isolated in our study are C. jejuni and C. coli. The clinical characteristics are acute diarrhoea (sometimes with blood) and abdominal pain. The evolution is usually favorable without treatment. In serious and prolonged cases, the treatment is based on Erythromycin which was active against all the strains.
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PMID:[Enteritis caused by enteropathogenic Campylobacter. Preliminary study (January 1988 to June 1989)]. 248 3

The bacteriologic and clinical effects of early antibiotic treatment of Campylobacter jejuni enteritis were studied. Erythromycin rapidly eliminated C. jejuni from stools, whereas trimethoprim-sulfamethoxazole did not. Despite its bacteriologic effectiveness, erythromycin did not reduce the duration or severity of diarrhea, abdominal pain, or other symptoms.
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PMID:Early treatment of Campylobacter jejuni enteritis. 281 11

Campylobacter jejuni is now recognized as one of the most common causes of human infectious diarrhea. Avian species and mammals are the chief reservoirs, although the organism has been isolated from contaminated drinking water and unpasteurized milk. Transmission usually occurs by the fecal-oral route through ingestion of contaminated food or water or by direct contact with feces of infected humans or animals. Persons affected have abdominal pain, watery or bloody diarrhea, fever, and constitutional symptoms. Diagnosis is established by demonstrating the organism in Gram stains of stool or by stool or blood culture. Erythromycin is the drug of choice if specific therapy is needed.
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PMID:Campylobacter-caused diarrhea. Who is at risk? What to watch for. 670 38

Campylobacter jejuni (previously called "related vibrio") has recently become recognized as an important cause of acute diarrhoeal disease in many countries. As with other intestinal pathogens, the clinical picture of C. jejuni infection varies from symptomless excretion to severe disease. The incubation period averages two to five days. Fever, abdominal pain and bloody diarrhoea are the usual symptoms of campylobacter enteritis. Although it is normally a self-limiting disease, complications such as cholecystitis, peritonitis, septicaemia and meningitis occasionally arise. The small intestine is thought to be the main site of infection, but the colon is also regularly involved. The disease might be more accurately described as an enterocolitis. Campylobacters, like salmonellae and yersiniae, are thought to be pathogenic by virtue of their invasive ability. Chemotherapy is usually effective. Erythromycin is commonly used for patients ill enough to require specific treatment. Although the infection can be transmitted from person to person, it is mainly a zoonosis with many possible routes of infection. Poultry is a potential source of infection, dogs may also transmit the disease and there have been major outbreaks of campylobacter enteritis from the consumption of untreated or inadequately treated milk and water. Further epidemiological work is hampered by the lack of suitable typing techniques.
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PMID:Campylobacter Enteritis. 710 20

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

To evaluate the effects of erythromycin on antroduodenal motility in children with chronic functional gastrointestinal symptoms, we studied 35 consecutive subjects referred for diagnostic motility studies. We recorded fasting motility for > 4 hr, then infused in random order either 1 or 3 mg/kg erythromycin intravenously over 1 hr and continued the study for another hour. Erythromycin induced phase III in 18 of 20 children who had phase III during fasting compared to only one of 15 who did not (P < 0.001). The antral motility index increased after erythromycin (1596 +/- 323 vs 436 +/- 242 mm Hg/30 min before erythromycin, P < 0.005) but the duodenal motility index did not change. The antral motility index was greater in children receiving 3 mg/kg than in those receiving 1 mg/kg (1968 +/- 391 vs 1226 +/- 285 mm Hg/30 min, P < 0.01), but duodenal motility indices did not differ. Only one child receiving the lower dose erythromycin complained of abdominal pain, nausea, or vomiting vs 9 of 19 the children receiving the higher dose (P < 0.02). In summary, in children with chronic functional gastrointestinal disorders, erythromycin rarely induced phase III in patients who did not have it during fasting. When different doses erythromycin are compared, 1 and 3 mg/kg are equally efficacious in inducing phase III episodes; the lower dose is associated with fewer side effects and the higher dose produces a higher antral motility index.
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PMID:Effect of erythromycin on antroduodenal motility in children with chronic functional gastrointestinal symptoms. 802 49


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