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)

A case of gold associated enterocolitis is described. A review of all 27 previously reported cases revealed that the syndrome induced has common characteristics. The reaction occurs within three months of instituting gold therapy, is characterised by profuse diarrhoea and vomiting with abdominal pain, fever, and sometimes eosinophilia. Petechial changes are prominent on endoscopy and the endoscopic and histological features of the gut lesion do not resemble inflammatory bowel disease. The overall mortality is 26% but has decreased in recent years. There is no specific therapy but in severe cases diversional surgery may be justified.
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PMID:Gold induced enterocolitis. 308 25

The results of cholecystectomy in terms of symptomatic improvement were prospectively evaluated in 124 unselected gall stone patients interviewed before and two years after elective surgery. Indications for cholecystectomy were biliary pain (n = 65), previous complications of gall stone disease (n = 52), and flatulent dyspepsia (n = 7). At two years 93 patients could be re-evaluated, of whom only 49 (53%) were completely symptom free. Postcholecystectomy symptoms occurring in the remaining 44 patients were mainly flatulent dyspepsia (which had relapsed in 22 of 46 patients who suffered it preoperatively), dull abdominal pain or diarrhoea. Incisional hernia was present in five patients and one had recurrence of pain because of retained common bile duct stones. Symptomatic cures after cholecystectomy decreased with the duration of the preoperative history. The results reconfirm that cholecystectomy eradicates specific symptoms and complications of gall stone disease, but they also show that nearly one half of operated patients are dissatisfied with the procedure because of mild but distressing 'postcholecystectomy' symptoms. These are probably caused by previously undiagnosed functional gut disease associated with, but unrelated to, gall stones. A systemic approach to multisymptomatic patients with gall stones is recommended.
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PMID:Postcholecystectomy symptoms. A prospective study of gall stone patients before and two years after surgery. 342 78

Nine cases of Crohn's disease from the Department of Medicine, Singapore General Hospital were collected over a duration of 9 years (1978-1986). Male (5): Female (4) ratio was nearly equal. Predominantly young people (mean age 30.5 year, range 12-59 year) from all races in Singapore were affected. Presentation could be acute (1), subacute (2), or chronic (6). The commonest symptoms were abdominal pain (8) diarrhoea (6) and weight loss (6). Three patients had a palpable right iliac fossa mass, 3 had definite malabsorption from ileal disease and 1 had perianal involvement leading to an anal stricture. The only extraintestinal manifestations of disease were clubbing and sacroiliatis. Haematological (haemoglobin, total white count, erythrocyte sedimentation rate) and biochemical (albumin) parameters generally reflected the degree of activity and chronicity of disease prior to presentation. The diagnosis and assessment of disease sites were based on a combination of radiological, endoscopic, operative and histological criteria. Ileal disease (4) per se was commonest followed by ileocolic disease (3) and colonic disease (2). Medical treatment consisted of sulphasalazine +/- steroids in all patients. Azathioprine and metronidazole were used for steroid sparing and perianal disease respectively. Laparotomy was performed in 2 patients. Six patients were well with infrequent (less than or equal to 2 times/year) or no relapses during follow up. Of the remaining three, 2 had either chronically active disease or frequent relapses (greater than 2 times/year) and one severe recurrent disease despite repeated gut resection.
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PMID:Crohn's disease--a diagnostic rarity in Singapore. 343 15

Eight cases of abdominal tuberculosis from the Department of Medicine, Singapore General Hospital are reported to illustrate the varied clinical manifestations of the disease. Presentation ranged from asymptomatic hepatomegaly to acute abdomen (intestinal obstruction/perforation). Chronic non-specific symptomatology (fever, weight loss, abdominal pain, diarrhoea, jaundice) was commonest. There were three patients with hepatic tuberculosis, two with tuberculous mesenteric lymphadenitis and three with intestinal tuberculosis, two of whom had concomitant tuberculous peritonitis. Only three patients had coexisting pulmonary tuberculosis. The diagnosis was unsuspected at presentation in four patients. Initial provisional diagnoses included typhoid, abdominal lymphoma, hepatic malignancy, chronic hepatitis and iatrogenic gut perforation. All patients responded totally to conventional antituberculous therapy.
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PMID:The varied manifestations of abdominal tuberculosis. 343 16

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

The currently recognized toxic effects of quinine in humans are identified and the problems of management of overdosage of quinine are discussed. Quinine, available therapeutically as sulphate or hydrochloride salts, also is widely used in tonic water, and there are several case reports of allergic reactions to the drug when a patient has consumed the drug in this way. Another unintentional source of poisoning is its use as an adulterant in heroin for "street" use. This appears to be a problem in the US. Quinine, termed a "general protoplasmic poison" is toxic to many bacteria, yeasts, and trypanosomes, as well as to malarial plasmodia. Quinine has local anesthetic action but also is an irritant. The irritant effects may be responsible in part for the nausea associated with its clinical use. In addition it has a mild antipyretic effect. Several features are common to both an acute single overdose in self-poisoning and accumulation of quinine during therapy for malaria: together they are termed cinchonism. Auditory symptoms, gastrointestinal disturbances, vasodilatation, sweating, and headache occur with moderately elevated plasma quinine concentration. As these rise, increasingly severe visual disturbances and then cardiac and neurologic features occur. Mild nausea may be the only symptom, but with large overdoses profuse vomiting, abdominal pain, and diarrhea may occur. These result from a combination of the local irritant effect of quinine on the gut and the central effects of quinine on the chemoreceptor trigger zone. Vasodilatation and sweating are well recognized, and tinnitus is common. Visual symptoms usually are delayed, and blindness may not be discovered for a day or more. Aspirin-sensitive patients, and others, may develop angioedema by nonimmunological mechanisms in response to drugs, and quinine has been reported to produce pseudo-allergic reactions in aspirin-sensitive patients. Quinine also can cause drug-induced thrombocytopenia and purpura. In patients suffering with malaria due to "Plasmodium falciparum," anemia and acute intravascular hemolysis with renal failure are recognized complications. There appears to be little evidence in the literature in support of the folk tradition of quinine as an inducer of abortion. Quinine is known to cause deterioration in patients with myasthenia gravis and erythema multiforme, to stimulate insulin release in patients receiving treatment for falicparum malaria, and to be responsible at times for ataxia following moderate overdosage. Clinically, quinine poisoning is observed in 3 situations: self-poisoning; accidentally; and following use of quinine in excessive doses in the hope of achieving abortion. Treatment courses are reviewed.
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PMID:Quinine toxicity. 354 70

The records of 128 patients operated on for adhesive complete mechanical obstruction of the small intestine were retrospectively reviewed. The gut proved to be strangulated in 53 cases, irreversibly in 16 and reversibly in 37, while 75 patients had simple obstruction (12, 29 and 59%). Continuous abdominal pain was more common in strangulation than in simple obstruction and leukocytosis was most common in irreversible strangulation (both differences significant). But no preoperative clinical parameter was specific for strangulation obstruction. Preoperative hospital stay greater than 25 hours was significantly more common in irreversible strangulation obstruction than in the other groups. Strangulation was preoperatively recognized in only 25% of the cases. The overall mortality rate was 5.5%, but with no statistical intergroup difference, possibly because so few patients died. The study showed that strangulation usually is unrecognized preoperatively, and that early operation is essential for obstruction due to intestinal strangulation. Early surgery is therefore indicated in most cases clinically diagnosed as intestinal obstruction.
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PMID:Intestinal obstruction with strangulation of the small bowel. 363 May 29

We report the clinical and intestinal manometric findings in a group of 42 patients with chronic idiopathic intestinal pseudo-obstruction evaluated at the Mayo Clinic. The main clinical manifestations in these patients were nausea and vomiting (83%), abdominal pain (74%), distension (57%), constipation (36%), diarrhoea (29%), and urinary symptoms (17%). These symptoms preceded surgery in all patients. Air fluid levels or distended bowel loops occurred in 57% and a dilated bladder or urinary excretory pathway in 17%. All patients showed intestinal manometric abnormalities none of which are seen in healthy individuals: aberrant configuration or propagation of interdigestive motor complexes in 25 patients; bursts (greater than 2 min duration) of non-propagated phasic pressure activity in fasting and/or fed state in 30 patients; sustained incoordinated fasting pressure activity in 15 patients; and inability of an ingested meal to convert fasting into fed pattern in 28 patients. We conclude that qualitative analysis of intestinal manometry provides evidence of gut dysmotility in patients with the clinical syndrome of chronic intestinal pseudo-obstruction. These abnormalities of motility can help to establish the correct diagnosis.
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PMID:Chronic idiopathic intestinal pseudo-obstruction: clinical and intestinal manometric findings. 381 84

In a bilateral nephrectomized woman undergoing continuous ambulatory peritoneal dialysis, angiotensin I instilled intraperitoneally with the dialysis fluid prevented the fall in systemic blood pressure at peritoneal dialysis and elevated, in high doses, the systemic blood pressure in a dose-dependent manner over the whole observation period. The blood pressure lowering effect could be completely reversed by infusion of the angiotensin II receptor antagonist, saralasin. However, some side effects observed, like increased motility of gut, diarrhea and abdominal pain probably will limit the application of the drug in clinical routine.
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PMID:Angiotensin I in peritoneal dialysis fluid improved hypotension: a case report. 382 82

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


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