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 irritable bowel syndrome (IBS), motility disturbances occur from the upper gastrointestinal tract to the distal colon, where regulatory peptides have a wide-spread distribution. Studies on basal and postprandial plasma levels of different gut hormones show that VIP, CCK, and motilin may be closely related to the symptoms including abdominal pain, diarrhea and constipation. In addition, peptide YY and NPY have effects on absorption in the intestine, and some opioid peptides exert actions on colonic motility in IBS patients. Recent studies revealed that gall bladder in IBS has an abnormal sensitivity to CCK-8, indicating that IBS patients has an generalized abnormality of the smooth muscle of the digestive tract. Gut hormones, which act as hormones, neurotransmitters and neuromodulators depending on their releasing site, may therefore play an important role in IBS patients.
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PMID:[Role of gut hormones in irritable bowel syndrome]. 128 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

To determine if carbohydrates perfused into the ileum affect gastric emptying and circulating levels of gastrointestinal hormones, 18 healthy subjects were intubated with an oroileal tube. A 400-cal (60% carbohydrate, 20% protein, 20% fat) homogenized meal labeled with 111In-DTPA was then infused into the stomach over 10 min. Simultaneously, a test solution of normal saline (n = 6) or 12.5 (n = 4), 25 (n = 4), 50 (n = 2), or 100 (n = 2) mg/min of carbohydrates (75% rice starch, 25% glucose) containing a nonabsorbable marker, polyethylene glycol, was continuously perfused into the terminal ileum at 3 ml/min for 7 h. In one-half of the subjects the perfusate contained an amylase inhibitor (3.3 mg/ml) that reduced starch digestion and carbohydrate absorption. Gastric emptying was measured by a dual-headed gamma-camera. Plasma concentrations of hormones and the amount of carbohydrates passing the ileum were measured every 10 min. The amylase inhibitor significantly reduced the absorption of complex carbohydrates from the terminal ileum (p less than 0.05). Gastric emptying was significantly slowed by ileal perfusion of carbohydrates (p less than 0.01). This effect was enhanced by the amylase inhibitor (p = 0.06). Plasma concentrations of C-peptide, glucagon, motilin, gastrin, and human pancreatic polypeptide were not related to gastric emptying or ileal perfusates, but decreased concentrations of gastric inhibitory polypeptide and neurotensin and increased concentrations of peptide YY were significantly associated (p less than 0.05) with slowing of gastric emptying. Perfusing carbohydrates into the ileum was associated with nausea, abdominal pain, and vomiting, but we could detect no direct relationship between the onset of these symptoms and gastric emptying. Slowing of gastric emptying of a homogenized mixed meal by the entry of complex carbohydrates into the ileum may be partly mediated by peptide YY or nonvagally mediated neural mechanisms.
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PMID:Effect of ileal perfusion of carbohydrates and amylase inhibitor on gastrointestinal hormones and emptying. 246 4

In 16 consecutive patients with systemic mastocytosis, we prospectively evaluated a variety of gastrointestinal functions and examined how they relate to the occurrence of gastrointestinal symptoms. Nine patients had either a duodenal ulcer or duodenitis. Hypersecretion of gastric acid was present in 6 patients, and in these patients the mean basal acid output was 20.7 +/- 4.1 mEq/h (range 14-39 mEq/h). Impaired small intestinal absorption occurred in 5 patients, although this was usually mild. The mean fractional emptying rate of liquids for all patients (14.7% +/- 2.3% per minute) did not differ from that for controls (10.7% +/- 0.6% per minute). Mean mouth-to-cecum transit time measured by breath hydrogen testing was the same among patients (87.7 +/- 6.7 min) and controls (86.7 +/- 8.0 min). Plasma histamine concentrations were increased in all patients (mean 1886 pg/ml, range 480-7450) and correlated with the basal acid output (r = 0.64, p less than 0.02) but not maximal acid output or the presence or absence of pain or diarrhea. Mean fasting plasma concentrations of motilin, substance P, and neurotensin from 6 patients did not differ significantly from controls, whereas gastrin and vasoactive intestinal peptide were significantly less than in controls (p less than 0.01). Gastrointestinal symptoms, consisting of abdominal pain or diarrhea, occurred in 80% of patients. Abdominal pain classified as dyspeptic was usually associated with acid-peptic disease of the duodenum and hypersecretion of gastric acid, whereas abdominal pain of a nondyspeptic character was not. Only in those cases of diarrhea consisting of greater than 200 g stool/day was gastric acid hypersecretion frequently found. Neither fecal urgency nor nondyspeptic pain could be accounted for by alterations of gastrointestinal transit. These results demonstrate that gastrointestinal symptoms, peptic disease, and mild malabsorption are much more common than described previously in patients with systemic mastocytosis. Furthermore, the results provide no evidence for the contention that altered gastrointestinal transit is involved in the pathogenesis of these symptoms.
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PMID:Gastrointestinal dysfunction in systemic mastocytosis. A prospective study. 339 14

Disturbances in gut motor activity have been proposed as a characteristic phenomenon in patients with irritable bowel syndrome (IBS). The symptoms are often associated with food intake. Several neuropeptides have a stimulatory or inhibitory effect on intestinal smooth muscle contraction. Studies on basal and postprandial plasma levels of different neuropeptides have therefore been performed in patients with IBS and been compared with those of a control group. In the whole group of IBS patients no typical gut hormone profile was found in plasma. When the IBS patients were divided into subgroups based on the predominant syndrome changes in the plasma levels of gastrin, motilin and pancreatic polypeptide (PP) were seen. In diarrhoea fasting levels of motilin and PP and postprandial level of PP were increased. In constipated patients fasting levels of gastrin and motilin and postprandial levels of gastrin, motilin and PP were decreased. Fasting and postprandial levels of gastrin were also decreased in patients with predominantly abdominal pain.
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PMID:Are gut peptides responsible for the irritable bowel syndrome (IBS)? 347 12

Gastrointestinal disorders including abdominal pain, abdominal distention, ileus, and constipation are common after spinal cord injury. In physiologic studies of patients with spinal cord injury, slow gastric emptying, ileal dilation, and abnormal rectosigmoid motility have been found. However, it is not yet known whether abnormal gut hormone release is important in the development of these abnormalities. In healthy volunteers, there are postprandial increases in plasma peptide YY and motilin levels, which appear related to neural mechanisms. We hypothesized that abdominal sympathetic pathways provide tonic inhibition of peptide YY and motilin release and that postprandial increases in these gut hormones are mediated through spinal pathways. Fasting serum was obtained from normal volunteers, paraplegic patients, and tetraplegic patients. In studies in which patients were fed, serum was obtained from normal volunteers, paraplegic patients, and tetraplegic patients before and at 30-min intervals after a 280 kcal meal. Serum motilin and peptide YY levels were measured by radioimmunoassays. In fasting studies, there was a trend (P = 0.23) toward increased fasting serum motilin in paraplegic patients, and this result did not support tonic inhibition of motilin release. Fasting peptide YY levels were not increased in spinal cord injury patients, which did not support tonic inhibition of peptide YY release. In fed studies, there were strong trends toward postprandial increases in serum peptide YY in volunteers and paraplegic patients and a significant postprandial rise in serum peptide YY in tetraplegic patients (P = 0.04). This was evidence against involvement of spinal pathways in postprandial release of peptide YY.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Gut hormone release in patients after spinal cord injury. 757 9

The aim of this study was to compare serum motilin levels in children with and without recurrent abdominal pain, based on the assumption that recurrent abdominal pain in children is a gut motility disorder. In this controlled study, 19 children between 6 and 15 years of age with recurrent non-organic abdominal pain and 20 control children between 6 and 15 years of age without abdominal pain or other functional somatic complaints were evaluated. No statistical significant difference was found in serum motilin levels between children with and without abdominal pain. Median difference between the groups was 11 pmol/l (95% confidence limits of median difference -9 to +33). This investigation could not support the assumption that motilin might be a pathogenic factor in children with recurrent abdominal pain. It is suggested, however, that future research should compare serum motilin levels during and between attacks of pain.
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PMID:Motilin in children with recurrent abdominal pain: a controlled study. 808 35

The effects of octreotide on six normal subjects and five patients with scleroderma were investigated. Changes in intestinal motility and in plasma motilin were examined after a single injection of octreotide. Octreotide stimulated intense intestinal motor activity in normal subjects. Motility patterns in the scleroderma patients were chaotic and non-propagative, but, after octreotide was given, became well coordinated, aborally directed, and nearly as intense as in normal volunteers. Clinical responses and changes in breath hydrogen were also evaluated in the five scleroderma patients who had further treatment with octreotide at a dose of 50 micrograms/day subcutaneously for three weeks. A reduction in symptoms of abdominal pain, nausea, vomiting, and bloating was seen. Additionally, there was an improvement in bacterial overgrowth as objectively measured by breath hydrogen testing. The effects of octreotide (100 micrograms/day subcutaneously) on the perception of rectal distension were investigated in a double blind, placebo controlled study in healthy volunteers. Octreotide was shown to reduce the perception of rectal distension without affecting motor pathways or local rectal reflexes. This enhanced tolerance to volume distension seems to result from inhibition of sensory afferent pathways as shown by electroencephalographic studies showing diminished evoked spinal and cortical potentials after octreotide. In irritable bowel syndrome patients with rectal urgency, octreotide reduces rectal pressures and perception after rectal distension to near normal values.
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PMID:Octreotide in gastrointestinal motility disorders. 820 95

Hepatic porphyrias are characterized by neurological symptoms manifested by abdominal pain, neuropathies and mental aberrations. Porphyrins are ubiquitous and essential biochemical constituents of living beings acting as mediators of oxidation reaction in the metabolism of the steroid, drugs, environmental chemicals or as a mean of exchanging gases, such as oxygen and carbon dioxide between the environment and the tissue of the body using endogenous polypeptide properties. The different porphyrins arising from the arrangement of normal heme synthesis are characterized by an accumulation and excretion of specific intermediate porphyrins and/or of precursors exerting toxic effect, initiating cascades of generations of polypeptides, neurotransmitters and gut-brain axis peptide responsible for the symptoms of clinical status. We studied polypeptide levels in 27 patients (19 females, 8 males) presenting acute attack of hepatic porphyria: 2 with ALA dehydratase-deficient porphyria; 9 with acute intermittent porphyria; 12 with porphyria cutanea tarda and 4 with variegate porphyria. During acute attacks of porphyria, polypeptides were found to be constantly increased: vasoactive intestinal polypeptide (VIP); neurotensin (NT); substance P; pancreatic polypeptide; gastrin-releasing peptide; gastrin and motilin. Administration of the somatostatin (antagonizing polypeptide), which was undetectable or low before treatment, apparently alleviated the acute symptomatology. Elevated levels of polypeptides, at least partly, contribute to appearance of acute symptoms in porphyria patients.
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PMID:Polypeptide levels increase during acute onset of hepatic porphyrias. 907 85

The actions of trimebutine [3,4,5-trimethoxybenzoic acid 2-(dimethylamino)-2-phenylbutylester] on the gastrointestinal tract are mediated via (i) an agonist effect on peripheral mu, kappa and delta opiate receptors and (ii) release of gastrointestinal peptides such as motilin and modulation of the release of other peptides, including vasoactive intestinal peptide, gastrin and glucagon. Trimebutine accelerates gastric emptying, induces premature phase III of the migrating motor complex in the intestine and modulates the contractile activity of the colon. Recently, trimebutine has also been shown to decrease reflexes induced by distension of the gut lumen in animals and it may therefore modulate visceral sensitivity. Clinically, trimebutine has proved to be effective in the treatment of both acute and chronic abdominal pain in patients with functional bowel disorders, especially irritable bowel syndrome, at doses ranging from 300 to 600 mg/day. It is also effective in children presenting with abdominal pain.
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PMID:Trimebutine: mechanism of action, effects on gastrointestinal function and clinical results. 936 86


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