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

Antacids are a useful remedy for the common complaint of indigestion. But if indigestion persists, the patient should seek medical advice and look at whether his or her life-style is contributing. Antacids should be taken in response to symptoms, usually after meals, to react to the surge of acid produced by the body to digest food. Antacids can interfere with drug absorption, so patients on other medications should ask a pharmacist's advice on the timing of their antacid dose. Liquid or soluble preparations act faster than tablets. Take care before recommending an antacid if your patient is: a) pregnant (most over-the-counter antacids are not contraindicated in pregnancy, but it is safest to check with the doctor or pharmacist, particularly for someone in early pregnancy) b)suffering from symptoms which might suggest a more serious, undiagnosed condition, eg cancer. c) already on other medication or on a low-sodium diet.
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PMID:Remedies for common family ailments: 1. Indigestion and heartburn. 868 Jan 51

Solid and papillary neoplasms of the pancreas, a rare tumor usually found in young female patients, seldom presents with metastasis since it is a tumor with low potential for malignancy. The prognosis for this lesion is much more favorable than that for other pancreatic neoplasms. In an attempt to understand the characteristics and prognosis of this lesion, we reviewed twenty cases treated at the Department of Surgery, Severance Hospital, Yonsei University from 1985 to 1994. The mean age of the patients was 25.6 years (range: 13 to 39 years), and 19 (95%) were women. Chief complaints were palpable mass (50%), pain (45%), and indigestion (5%). In laboratory studies, tumor markers, including CEA, CA125, CA19-9, and aFP were studied in eight patients, and found negative. Other laboratory findings were also nonspecific. These tumors may occur anywhere in the pancreas. In our studies, the tumor was most often located in the tail (45%), and the head (40%) of the pancreas. These were treated by distal pancreatectomy and splenectomy (55%), Whipple's operation (20%), pylorus preserving pancreatoduodenectomy (10%), enucleation (10%) or excision (5%). Significant morbidity or mortality was not observed during hospitalization, and no recurrence or malignant degeneration occurred during the mean follow-up period of 4 years (range: 1 month to 9 years). In conclusion, this study has suggested that the patients with a solid and papillary neoplasm of the pancreas have a good prognosis for successful treatment, if the disease is diagnosed early and the tumor is completely resected. A higher index of suspicion, and more aggressive diagnostic workups are needed in dealing with this disease entity.
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PMID:Solid and papillary neoplasms of the pancreas. 871 36

The advent of new diagnostic and therapeutic modalities for Helicobacter pylori allows any physician to offer curative antibiotic regimens to patients with peptic ulcer disease and gastritis. This article describes new management strategies and discusses the advantages of each. In the old strategy, endoscopy was performed on patients with dyspepsia, in the hope of detecting a treatable peptic ulcer. In the new strategy, patients with dyspepsia are investigated with serology to detect those with H. pylori and potentially curable peptic ulcers. Patients with persistent symptoms require a urea breath test and only those who are now H. pylori-negative undergo endoscopy. The cost-effectiveness of these strategies will depend on the expense of each diagnostic test, particularly endoscopy. Whether a noninvasive strategy can be implemented safely may depend also on the incidence of gastric carcinoma in a particular population and the effectiveness of antibacterial therapy at reducing cancer risk.
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PMID:Managing acid peptic disease in the Helicobacter pylori era. 877 10

Gastrointestinal disorders are common in the general population, with annual prevalence figures ranging from 20% for irritable bowel syndrome to over 40% for dyspepsia. Less than one-third of patients consult general practitioners for these problems, and anxiety about serious disease and cancer are as important in the decision to consult as symptom severity. Gastrointestinal disorders have significant socioeconomic effects in the community, and account for 10% of the work of general practitioners in the UK. The health economics implications of management in primary care relate principally to the costs of investigation and therapy, notably antisecretory drugs, endoscopy, radiology and specialist referral. Although guidelines based on evidence and agreed between primary and secondary care physicians offer an attractive approach to rationalizing the use of resources, there is at present little health service research evidence on which to base important decisions. For example, in dyspepsia, the role of Helicobacter pylori identification and eradication in an overall management strategy in primary care has yet to be defined. An exploration of the clinical economics of gastrointestinal disorders in general practice raises a number of research questions, which will require the attention of both generalists and specialists.
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PMID:Clinical economics review: gastrointestinal disease in primary care. 879 45

Hepatoblastoma in adults is a rare malignancy that presents in the epithelial or mixed epithelial-mesenchymal variants. We report two cases, the former representing the epithelial and the latter the mixed type. A 21 year-old woman with epigastric pain had abdominal ultrasound and CT scans showing a large hepatic mass. A right trisegmentectomy was performed. The first and second recurrences were treated by resection. The third recurrence was treated by hepatic transarterial chemo-embolization, systemic chemotherapy and 19 percutaneous alcohol injections. A careful follow up by abdominal ultrasound and CT scans was able to detect the recurrence at an early stage. The patient is well at 151 months. A 39 year-old man with epigastric pain and dyspepsia had upper-GI series and abdominal CT scan showing a left hepatic mass involving the stomach. Liver resection and Billroth II hemigastrectomy were performed. A recurrence involving the left hepatic lobe, the spleen and the remaining stomach occurred 15 months later and the patient died from multi organ failure. Surgery is the treatment of choice of hepatoblastoma in adults. Recurrences can also be treated aggressively by surgical resections if no extrahepatic organs are involved. Other therapeutic modalities can be attempted whenever surgery is not possible.
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PMID:Hepatoblastoma in adult age: a report of two cases. 888 42

Patients with symptoms of GERD and dyspepsia are among the most common consulters in general practice and are different from their counterparts in the community who choose not to consult although they suffer from similar symptoms. They represent a heterogeneous group with considerable symptom overlap. They have a relatively poor quality of life and endoscopic findings can only explain symptoms in about half of these patients. Thus psychosocial factors which could contribute to their morbidity should be explored. While some studies have methodological shortcomings, main findings are that key psychological factors are anxiety, tension, neuroticism, somatization, fears of malignancy, negative assessment of health, depression, a poor social network and less effective coping strategies. Physical illness is likely to bring on psychological distress due to discomfort or threat of ill health. Cognizance of psychosocial factors will facilitate an understanding of the underlying problems and will improve diagnosis and selection of optimal treatment.
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PMID:Psychosocial factors and their role in symptomatic gastroesophageal reflux disease and functional dyspepsia. 889 45

The authors describe 6 children with pancreas ectopy to the gastric wall. Their age was between 8 and 14 years. The main clinical and endoscopic signs were: prolonged pain, dyspepsia and a "polyp" in pyloroantral part of the stomach. In 4 of 6 children the pancreas ectopy to the gastric wall was suspected. All patients had been operated on. The indications for surgery were the following: severe pain with no effect of conservative therapy, suspicion for "polyp" malignancy and ulceration, bleeding. In one patient Bilroth-1 resection has been performed and in 2 cases sectoral dissection of the gastric wall pancreatic ectopy has been done. In 3 patients enucleation of the ectopic pancreas was performed. All patients had ineventful postoperative period. The pancreas ectopy in children is an indication for the surgery because of severe pain and possibility of severe complications. The surgery relieves pain and provides recovery.
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PMID:[Diagnosis and treatment of pancreas ectopy in the gastric wall in children]. 892 67

Helicobacter pylori has been linked with peptic ulcer disease, non-autoimmune gastritis, non peptic ulcer dyspepsia and gastric carcinoma and lymphoma. This study looked at the incidence of H. pylori infection in Ghanaian patients with dyspeptic symptoms referred for upper gastro-intestinal endoscopy and its relationship to various pathologies. Detection was by the CLO urease test. A hundred and thirty (130) patients were studied. 75.4% tested positive for H. pylori infection and the incidence peaks in the 5th decades. While 23.5% H. pylori positive patients had active duodenal or gastric ulcer, 18.8% of H. pylori negative patients also had the ulcer. Out of 43 patients with normal oesophago-gastro-duodenoscopy, 74.4% were H. pylori positive, 66.6% of gastric malignancies tested positive for H. pylori infection. It remains to be confirmed that eradication of H. pylori will relieve the peptic symptoms in affected patients with no ulcer disease.
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PMID:Incidence of Helicobacter pylori infection in Ghanaian patients with dyspeptic symptoms referred for upper gastrointestinal endoscopy. 902 Jun 1

Gastritis is a histopathologic diagnosis, which correlates poorly with both clinical symptoms of non-ulcer dyspepsia and endoscopic abnormalities. Worldwide, most cases of gastritis are due to Helicobacter pylori and are characterized by a diffuse superficial antral gastritis. Chronic inflammatory cells and lymphoid follicles are present in the lamina propria. Neutrophils are present in the surface and pit-lining epithelium. In North America and Western Europe, reactive gastropathy due to duodenal reflux or non-steroidal anti-inflammatory agents is also common. In this condition, there is no increase in inflammatory cells, but the pit-lining cells become hyperplastic, and the pits have a corkscrew appearance. Most examples of multifocal atrophic gastritis are the result of long standing Helicobacter gastritis, although there may be other causes as well. It is characterized by loss of glands in both pyloric and corpus mucosae with intestinal metaplasia of the surface epithelium. A subtype of intestinal metaplasia, in which sulphomucin (large bowel mucin) is present, has been associated with the development of distal gastric cancer. However, this association is relatively weak and is not considered useful for screening purposes. Gastric dysplasia may develop in areas of the stomach affected by intestinal metaplasia. High-grade dysplasia is a significant finding, with up to 60 percent of cases having coincident carcinoma and a further 25 percent of cases likely to develop an invasive malignancy within fifteen months.
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PMID:The morphology of gastritis. 904 89

Helicobacter pylori infection has been associated with chronic atrophic gastritis, a precursor of gastric cancer. We conducted a prospective, case-controlled study to investigate whether H. pylori infection increases the risk of gastric cancer in Korean people with a high risk of gastric cancer. We enrolled 160 gastric cancer patients who were confirmed by endoscopic biopsy during 1994 and 160 age-matched control subjects with non-ulcer dyspepsia were compared to document the relationship between H. pylori infection and gastric cancer. The presence of H. pylori infection was determined by the rapid urease test and/or histology by Wright-Giemsa staining. The overall presence of H. pylori infection was 60% in gastric cancer patients and 51.9% in age-matched control subjects (odds ratio 1.39; 95% confidence interval 0.894-2.17; P = 0.143). Carcinomas of cardia, body and antrum were not associated with H. pylori infection (odds ratio 1.43, 1.69 and 1.29, respectively; 95% confidence interval, 0.271-7.52, 0.787-3.62 and 0.689-2.43, respectively; P = 0.178, 0.177 and 0.642, respectively) nor was the intestinal or diffuse type of cancer (odds ratio 1.39 and 1.40, respectively; 95% confidence interval 0.791-2.45 and 0.681-2.87, respectively; P = 0.250 and 0.835, respectively). Gender was not a risk for gastric cancer. In contrast to previous studies, these results do not provide evidence of H. pylori infection for gastric carcinogenesis in Korea.
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PMID:Helicobacter pylori infection and the risk of gastric cancer among the Korean population. 908 9


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