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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Behavioral research in gastroenterology has grown exponentially over the last decade. Controlled studies demonstrate that psychotherapy, stress management, and hypnosis are effective for irritable bowel syndrome; and behavioral treatments are preferred over medical management for some types of fecal incontinence and vomiting. For peptic ulcer disease, interest in behavioral treatments has declined. However, a new syndrome, functional dyspepsia, is now recognized, in which ulcerlike symptoms occur without ulcer and frequently in association with psychological symptoms. For inflammatory bowel disease, stress management training has produced inconsistent outcomes. Newly recognized disorders for which behavioral treatments are needed include constipation associated with inability to relax the pelvic floor muscles during defecation, functional rectal pain (proctalgia), noncardiac chest pain, and aerophagia (excessive air swallowing).
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PMID:Behavioral medicine approaches to gastrointestinal disorders. 150 8

Gastrointestinal bloating is a common complaint met within the general practitioner's office. The most important cause of this symptom is an increase in the volume of gas in the gastrointestinal tract. Differential diagnoses include aerophagia, ingestion of gas-producing foods, gastric hypersecretion, bacterial overgrowth in the small intestine, disordered gastrointestinal transit, malabsorption or maldigestion of carbohydrates. In addition, nonulcer dyspepsia and the irritable bowel syndrome must be excluded. The diagnosis is based on a history of eructation, heart burn, flatulence and diarrhea, dietary habits, physical examination, laboratory analysis and apparative diagnostic measures. Therapy depends on the underlying cause of the disease.
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PMID:[Meteorism]. 191 70

'Acid-related disorders' is a term used to describe a whole range of conditions from the Zollinger-Ellison syndrome, where acid is entirely responsible for the problems, to aerophagia and motility-type non-ulcer dyspepsia, where acid plays little if any role in the dyspeptic symptoms. Careful evaluation of the patient's symptoms is required to establish the basis for the dyspepsia and from that, careful selection can be made for any investigations that might be needed. These symptoms are the basis for advising on the most effective management--but as many doctors and patients erroneously attribute dyspepsia solely to acid, it is all too easy for inappropriate treatment to be offered. Acid is not the only cause of dyspeptic symptoms. Dyspepsia is a very common complaint with many causes. Acid and pepsin are often held responsible for these symptoms, by both the medical profession and the lay public. The term, 'acid-related disorders' is used to embrace this wide variety of conditions in which acid may play a part. However, in spite of current folklore, it is a spectrum of conditions ranging from situations where acid is crucial to conditions where acid may play little part.
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PMID:Acid-related disorders: what are they? 324 3

The aim of this study was to describe the clinical features of patients with chronic unexplained dyspepsia and compare the symptoms with peptic ulcer and biliary pain, and determine the prevalence of symptoms that may indicate psychoneurotic traits and measure chronic illness behaviour (days lost from work and doctor visits). Studied were: 113 patients with essential dyspepsia, defined as endoscopically confirmed non-ulcer dyspepsia where gallstones, the irritable bowel syndrome and gastro-esophageal reflux have been excluded and there is no ascertainable cause for the dyspepsia; 55 patients with dyspepsia and peptic ulceration at endoscopy; and 53 patients with diagnosed biliary pain and cholelithiasis, proven at cholecystectomy. All patients completed a detailed structured history questionnaire in the presence of one investigator. More patients with peptic ulcer than with essential dyspepsia experienced night pain, pain relieved by food, and vomiting, while more patients with essential dyspepsia than with cholelithiasis experienced epigastric pain, lack of radiation of pain, continuous pain, mild to moderate pain, pain before meals, pain relieved by food and antacids, pain aggravated by food and alcohol, and an absence of vomiting (all p less than 0.01). Symptoms suggesting psychoneurosis, aerophagy symptoms, and chronic illness behaviour were similar in all groups. We conclude that certain symptoms may be of value in diagnosing the underlying cause of dyspepsia.
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PMID:Comparison of the clinical features and illness behaviour of patients presenting with dyspepsia of unknown cause (essential dyspepsia) and organic disease. 346 12

Non-ulcer dyspepsia (NUD) is defined as dyspepsia in which investigation shows no evidence of focal gastroduodenal disease or oesophagitis. The aim of the present study was to determine the proportion of NUD patients with other identifiable diseases. We interviewed 327 consecutive patients who had at least 1 month of dyspepsia before a panendoscopy that showed no evidence of oesophagitis, malignancy, or peptic ulcer. Symptoms were assessed by a structured history questionnaire. The existence of gallstones was excluded radiologically. Of the subjects studied, 75 (23%) had irritable bowel syndrome and 71 (22%) gastro-oesophageal reflux, whereas 63 (19%) had both, 25 (8%) had aerophagy, and 14 (4%) had gallstones. Of the remaining 79 patients (24%) 6 had duodenitis and 10 gastritis, whereas 1 had both. Sixty-two subjects (19%) had entirely normal endoscopic results and no ascertainable cause of their dyspepsia (termed provisionally essential dyspepsia). It is concluded that, whereas three-quarters of NUD patients have diseases that fall into other diagnostic categories, nearly one-quarter have essential dyspepsia.
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PMID:The association between non-ulcer dyspepsia and other gastrointestinal disorders. 404 40

One third to one half of cases of dyspepsia remain unexplained. The cause of nonulcer dyspepsia is unknown, but aerophagia, esophageal dysfunction, pyloroduodenal dysmotility and the irritable bowel syndrome may be important factors in some patients. The symptoms are often affected by diet and emotion. History-taking and endoscopy are the most discriminating diagnostic tests. Unexplained dyspepsia tends to be a lifelong disease with few, if any, sequelae. Nevertheless, reassurance and treatment with a placebo, such as an antacid or simethicone, provide effective and safe relief for many patients.
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PMID:Nonulcer dyspepsia. 636 98

A depressed patient on tricyclic antidepressants developed acute flatulent abdominal distention. Aerophagia, commonly associated with complaints of abdominal distention, indigestion, and colic, is common in depressive states. This case report explores the relationships between depression, tricyclic antidepressants, and gastrointestinal function.
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PMID:Aerophagia and depression: case report. 664 1

Our objective was to obtain national data of the estimated prevalence, sociodemographic relationships, and health impact of persons with functional gastrointestinal disorders. We surveyed a stratified probability random sample of U.S. householders selected from a data base of a national market firm (National Family Opinion, Inc.). Questions were asked about bowel symptoms, sociodemographic associations, work absenteeism, and physician visits. The sampling frame was constructed to be demographically similar to the U.S. householder population based on geographic region, age of householder, population density, household income, and household size. Of 8250 mailings, 5430 were returned suitable for analysis (66% response). The survey assessed the prevalence of 20 functional gastrointestinal syndromes based on fulfillment of multinational diagnostic (Rome) criteria. Additional variables studied included: demographic status, work absenteeism, health care use, employment status, family income, geographic area of residence, population density, and number of persons in household. For this sample, 69% reported having at least one of 20 functional gastrointestinal syndromes in the previous three months. The symptoms were attributed to four major anatomic regions: esophageal (42%), gastroduodenal (26%), bowel (44%), and anorectal (26%), with considerable overlap. Females reported greater frequencies of globus, functional dysphagia, irritable bowel syndrome, functional constipation, functional abdominal pain, functional biliary pain and dyschezia; males reported greater frequencies of aerophagia and functional bloating. Symptom reporting, except for incontinence, declines with age, and low income is associated with greater symptom reporting. The rate of work/school absenteeism and physician visits is increased for those having a functional gastrointestinal disorder. Furthermore, the greatest rates are associated with those having gross fecal incontinence and certain more painful functional gastrointestinal disorders such as chronic abdominal pain, biliary pain, functional dyspepsia and IBS. Preliminary information on the prevalence, socio-demographic features and health impact is provided for persons who fulfill diagnostic criteria for functional gastrointestinal disorders.
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PMID:U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. 835 66

One hundred and fourty four patients with non-ulcer dyspepsia (NUD), as defined by the working party of AGA in 1987, (67 men and 77 women, 16-76 years, mean age 42.9 +/- 1.2 years) and 34 asymptomatic controls (25 men and 9 women, 17-75 years, mean age 50.6 +/- 2.4 years) parameters of gastrophysiological function (gastric acid secretion, postprandial gastric emptying-acetaminophen method, serum gastrin levels and cutaneous electrogastrography (EGG)) and the prevalence of Helicobacter pylori (Hp) (histological and urease test of biopsy specimens) were investigated. Based on symptom patterns, there were 68 patients with dysmotility-like dyspepsia, 27 with ulcer-like dyspepsia, 17 with reflux-like dyspepsia, 6 with aerophagia and the 26 with nonspecific or idiopathic dyspepsia. The age distribution of NUD was predominant in the fourth decade, and the sex distribution was not significantly different. In general, hypersecretion of gastric acid and hypergastrinemia were rare in NUD patients. There was no significant difference in gastric acid secretion, basal and food stimulated serum gastrin levels and prevalence of Hp between the two groups. But 51 of 144 NUD patients (41.1%) had delayed gastric emptying (p < 0.05) compared to controls. Indeed gastric emptying was markedly prolonged in patients with dysmotility-like (58.1%) and reflux-like (42.9%) dyspepsia. On EGG, about a half of NUD patients showed evidence of bradygastria or tachygastria, in particular in the postprandial state, which was related to delayed gastric emptying. By chronic administration of cisapride, score of symptoms was significantly decreased and postprandial gastric emptying was significantly accelerated in delayed gastric emptying cases. We conclude that in NUD patients, in particular those with dysmotility-like dyspepsia, tests of postprandial gastric emptying and/or EGG are useful for investigation of gastric motor disorder and therapeutic effects of several prokinetic drugs clinically.
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PMID:[Investigation of gastric function and prevalence of Helicobacter pylori in non-ulcer dyspepsia]. 849 67

Many patients with liver cirrhosis have dyspeptic complaints. Peptic ulcer, gallstones and oesophagitis are the most common causes of dyspepsia. Functional dyspepsia is infrequently investigated in liver cirrhosis. Sixty-two patients with liver cirrhosis and dyspepsia were submitted to endoscopic and sonographic investigation. In 28 of them no organic finding was detected. These cases were considered as having functional dyspepsia. 36% were of dysmotility-like type, 28% were ulcer- and reflux-like, each, and 7% were of idiopathic type. Aerophagia could not be taken in consideration as functional dyspepsia, due to portal hypertension. In comparison with a group of 30 patients with functional dyspepsia without liver cirrhosis, functional dyspepsia in liver cirrhosis is more frequent in men than in women and occurs about a decade later. In 12 subjects the gastric emptying of a semifluid meal estimated by sonography was normal. Functional dyspepsia is a reality in liver cirrhosis. Gastric emptying seems not to have a major role in the etiopathogenesis of such complaints.
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PMID:[Functional dyspepsia in liver cirrhosis]. 896 53


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