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

Twenty patients underwent placement of a jejunal catheter for early postoperative feeding at the time of upper abdominal operations, and a control group of 11 patients underwent operative procedures of similar magnitude without jejunostomy. Advancement of the rate of feeding to target intake over 6 to 7 days was attempted. Complications from the feeding led to cessation or curtailment of intake in 65 percent of the patients. Specific complications included abdominal pain and distention, diarrhea, and retrograde reflux of the feeding into the stomach. No statistically significant difference in nitrogen balance was demonstrated between the fed and unfed groups, presumably due to the limitations of nutrient delivery or absorption in the fed groups or elevated breath hydrogen excretion in patients with abdominal pain and distention suggests that the nature of the nutrients, particularly complex carbohydrates, is a factor in the development of feeding complications. Caution must be exercised in advancing the rate of postoperative jejunal feeding.
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PMID:Limited efficacy of early postoperative jejunal feeding. 392

Gas-fluid levels in the colon observed in radiographs are abnormal and usually indicate serious gastrointestinal disease. Colonic gas-fluid levels associated with concurrent abdominal pain and malabsorption of lactose, documented by lactose breath hydrogen testing, were observed in five children. Incomplete lactose absorption is a relatively benign condition that can be added to the differential diagnosis of gas-fluid levels in the colon and may account for some cases of spontaneous resolution of clinical and radiologic signs in children presenting with acute recurrent abdominal pain.
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PMID:Roentgenographic observation of gas-fluid levels in the colon of children with abdominal pain and malabsorption of lactose. 399 35

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

In 1983, 949 cases of acute non-fatal illness consisting of headache, dizziness, blurred vision, abdominal pain, myalgia, and fainting occurred in the West Bank. Physical examination and biochemical tests were otherwise normal. There was no common exposure to food, drink, or agricultural chemicals among those affected. No toxins were consistently present in patients' blood or urine. Hydrogen sulphide gas was detected in low concentrations (40 parts per billion) at the site of the first outbreak. No other environmental toxins were found. The illness was thus of psychological origin and possibly triggered by the smell of hydrogen sulphide.
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PMID:The Arjenyattah epidemic. Home interview data and toxicological aspects. 614 May 60

Unsuspected bacterial contamination of the small intestine was indicated by breath hydrogen testing in nine patients aged 2 to 34 months during physical examinations for chronic diarrhea and abdominal pain. Elevated bacterial counts of questionable significance were found in duodenal aspirates before and after antibiotic treatment. There was no evidence of bile salt deconjugation or structural changes in the small intestine by light or electron microscopy. This may indicate that the site of colonization is distal to the biopsy site. Breath testing indicated lactose malabsorption in all patients, and four of five patients tested also malabsorbed sucrose. Duodenal disaccharidase levels in all patients were within the normal ranges, but in eight patients the lactase-sucrase ratio was greatly elevated (0.80 +/- 0.36; normal less than 0.45). Dietary restriction alone did not cause complete cessation of symptoms, whereas all patients responded dramatically to oral antibiotic therapy. When patients were well, the lactase-sucrase ratio had returned to normal in those tested, and all nine had normal lactose and lactulose breath hydrogen tests. Unsuspected bacterial contamination of the small intestine, which is easily detected using the breath hydrogen test, may be more commonly associated with chronic diarrhea in children than has been previously realized. In such cases, therapy should be directed at removing the contamination.
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PMID:Bacterial contamination of the small intestine as an important cause of chronic diarrhea and abdominal pain: diagnosis by breath hydrogen test. 643 89

Excretion of hydrogen in breath commonly persists despite an overnight fast. Although elevation of hydrogen concentration above the fasting value after administration of a test sugar is evidence of malabsorption, the significance of the fasting value itself is unknown. We determined the normal limits of fasting breath hydrogen in healthy children and adults, and in patients with chronic diarrhea or recurrent abdominal pain. Fasting breath hydrogen in 221 healthy children and 9 healthy adults averaged 7.1 +/- 5.0 parts per million (mean +/- SD), exceeding 30 parts per million in less than 1%. No value exceed 42 parts per million. In 73 patients with recurrent abdominal pain and 76 patients with chronic diarrhea, fasting breath hydrogen was less than 42 parts per million in 97% and 83%, respectively. History and laboratory data were reviewed in the 15 patients where fasting breath hydrogen exceeded 42 parts per million. Seven had documented small bowel bacterial overgrowth and an additional 3 patients had radiographic evidence of intestinal stasis. Using test dinner meals, we prospectively evaluated the effect of previously ingested foods containing complex carbohydrates on fasting breath hydrogen. Dinner meals consisting of rice, wheat, or beans influenced fasting breath hydrogen values, but did not result in elevated fasting breath hydrogen in healthy individuals. Rice bread resulted in uniformly low fasting breath hydrogen values in healthy subjects (2.0 +/- 2.5 parts per million), but fasting breath hydrogen remained elevated in patients with bacterial overgrowth. Our studies indicate that conditions for measurement of the fasting breath hydrogen value may be standardized to improve discrimination between normal and abnormal values.
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PMID:Fasting breath hydrogen concentration: normal values and clinical application. 648

The aim of this study was to determine the incidence of lactose malabsorption in healthy, adult Australian Aborigines. Malabsorption of lactose was measured in 45 full blooded Aboriginal subjects and 37 nonAboriginal multiracial controls using the breath hydrogen method. 84% of the Aboriginal subjects were found to be lactose malabsorbers and 64% developed abdominal pain or diarrhea. In the control subjects, 20% were found to be lactose malabsorbers and all of these developed symptoms of diarrhea. The results provide strong evidence that Australian Aborigines, in common with most human adults, are lactase deficient.
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PMID:Lactose malabsorption in Australian Aborigines. 682 86

Eighty-one breath hydrogen tests were performed in 72 children who were investigated either because of chronic diarrhoea or recurrent abdominal pain, or because they were relatives of patients with congenital sucrase-isomaltase deficiency. The results of tests on 16 patients were positive (sucrase-isomaltase deficiency, seven patients; secondary sucrose malabsorption, nine patients). Hydrogen production was higher in patients with sucrase-isomaltase deficiency (mean, 96 ppm; range, 20 ppm to 432ppm) than in those with secondary sucrose malabsorption (mean, 21 ppm; range, 12ppm to 51ppm). All patients with positive test results responded to sucrose restriction, and those with secondary malabsorption subsequently became well. The breath hydrogen test is a sensitive, non-invasive method for detecting sucrose malabsorption, whether due to a primary deficiency or secondary to other bowel disorders. Guidelines for improving the accuracy and reproducibility of the breath hydrogen test are discussed.
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PMID:Detection of primary and secondary sucrose malabsorption in children by means of the breath hydrogen technique. 686 23

Lactose breath hydrogen tests were given to 70 children and adolescents with chronic ulcerative colitis and Crohn's disease in order to determine the prevalence of lactose malabsorption in childhood inflammatory bowel disease. Twenty-nine percent of these patients demonstrated lactose malabsorption; the majority of these children (70%) experienced gastro-intestinal symptoms during the test. The prevalence was not significantly different whether the diagnosis was ulcerative colitis or Crohn's disease. With the exception of those with diffuse small bowel disease, the location of intestinal involvement with Crohn's disease and the severity of clinical symptoms did not affect lactose malabsorption. Lactose malabsorption was not more frequent in patients with inflammatory bowel disease than in a group of children with recurrent abdominal pain and normal gastrointestinal x-rays, although significant differences in the prevalence of lactose malabsorption were observed in relation to ethnic background. Milk incubated with commercially available yeast lactase (lactAid, Surgarlo Co., Atlantic City, N.J.) for greater than 24 h prevented an increase in breath hydrogen when administered to 6 patients previously shown to have lactose malabsorption.
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PMID:Lactose malabsorption in children and adolescents with inflammatory bowel disease. 689 2

In order to evaluate the role of lactose malabsorption in children with recurrent abdominal pain, we performed a prospective controlled double-blinded study in 40 children with RAP of at least three months' duration. Children were studied for lactose malabsorption by breath hydrogen determinations after ingestion of lactose (2 gm/kg of body weight; maximum 50 gm). Lactose malabsorbers were retested with 12.5 gm lactose; lactose absorbers were retested with lactose for ability to produce hydrogen. All children underwent a dietary trial which included two lactose elimination periods. Although 12 children (30%) were lactose malabsorbers, only three malabsorbed part of the smaller, more physiologic, lactose load. Improvement rates of lactose malabsorbers and absorbers during lactose elimination were not significantly different as judged by their physicians and as determined by a 50% or more decrease in pain frequency. These results suggest that lactose malabsorption is of little importance in children with RAP.
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PMID:Lactose malabsorption in recurrent abdominal pain of childhood. 705 18


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