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

We have audited the first 3 yr of a new open access gastroscopy service in the Royal Victoria Hospital, Belfast to assess service demands, patient demography and diagnostic trends. Over 3 yr there were 1872 referrals (800 from fundholding general practitioners), 8.8 per cent were non attenders and 5.4 per cent cancelled appointments. Endoscopic diagnostic categories showed no significant change over the 3 yr, 39 per cent non ulcer dyspepsia, 35 per cent gastro-oesophageal reflux disease (GORD), 17 per cent peptic ulcer disease (PUD), 6 per cent GORD and PUD, 1 per cent gastric erosions and 0.8 per cent carcinoma.
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PMID:Open access gastroscopy--3 year experience of a new service. 978 May 59

Since Helicobacter pylori (Hp) was first isolated in 1983, much work has been carried out on the pathogenic effects of this organism. Hp infection is common in humans and currently is the most important etiologic agent in the development of chronic active gastritis, gastric and duodenal ulcers, carcinoma and Malt-lymphoma of the stomach. Moreover Hp infection has also been associated with various extradigestive diseases. At present, a role of Hp infection in dyspepsia is discussed. Dyspepsia is defined by persistence of pain, burning or discomfort localised to the upper abdomen; some authors include in dyspepsia symptoms such as belching, bloating, alitosis, nausea, postprandial repletion, vomiting and regurgitation. In absence of any underlying pathologies, such as peptic ulcer, gastroesophageal reflux, pancreatitis, biliary tract disease or others, dyspepsia is defined as functional or idiopathic dyspepsia. Functional dyspepsia may be distinct in ulcer, reflux or dysmotility-like dyspepsia and unspecified dyspepsia. Hp infection is common in dyspeptic patients and a role of this bacterium has been postulated mostly in ulcer-like dyspepsia. Mechanisms by when Hp induces dyspeptic symptoms are uncertain; bacterial cytotoxins, phlogosis mediators, activity of chronic gastritis Helicobacter-related and host immune response probably play an important role in pathogenesis of functional dyspepsia. However, dyspepsia is not present only in infected patients; therefore other pathogenic factors may be implicated in expression of dyspeptic symptoms in uninfected subjects, such as gastric dysmotility, modifications of gastric output or altered visceral sensibility, psychological factors, gastroesophageal reflux and irritable bowel.
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PMID:[Dyspepsia and Helicobacter pylori]. 1036 46

Diagnosis and treatment of Helicobacter pylori is a crucial point in the management of the different gastroduodenal disorders. Management involves the general practitioner and different specialists such as internists, gastroenterologists and surgeons. Among the most frequent H. pylori-related gastroduodenal disorders of medical interest are some diseases such as dyspepsia and gastroesophageal reflux, where the role of the bacterium is not well defined and therefore the importance H. pylori eradication is still controversial. On the contrary, the relationship of H. pylori and gastric and duodenal peptic ulcer is widely and definitively proven, and there are no doubts regarding the importance of curing the bacterium in these disorders. However, the surgical aspect of peptic ulcer, in particular the relevance and management of its complications, has not been widely investigated so far. In fact, the prevalence of H. pylori in perforated, bleeding and stenotic peptic ulcers seem to be lower that in non-complicated peptic ulcer, and whenever H. pylori eradication virtually prevents the re-bleeding of peptic ulcer in all cases, the effect of curing the bacterium in perforated and stenotic ulcers is still largely unknown. The management of H. pylori infection after gastric surgery is also still controversial. Most studies suggest that H. pylori can persist after gastric surgery whenever its incidence is much lower than that before operation. However it seems most unlikely that the infection plays a major role in the development of ulcer recurrence after gastric surgery or in the induction of gastric carcinoma. In any case, there are no convincing data that its cure may prevent the occurrence of gastric carcinoma following gastrectomy procedures.
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PMID:Management of Helicobacter pylori infection: gastroenterological and surgical perspectives. 1067 4

The composition and in vitro expression of the cag pathogenicity island genes in a group of Helicobacter pylori strains obtained from patients suffering from chronic gastritis-associated dyspepsia (n = 26) or gastric carcinoma (n = 17) were analyzed. No significant difference in the distribution of the 10 studied regions was found between the cases and the controls. Nine strains did not harbor any of the selected regions: eight (30.8%) isolated from patients with gastritis only and one (5.9%) from a patient with gastric carcinoma. No association was found between the number of repeated sequences at the 3' end of the cagA gene or the presence of tyrosine phosphorylation motifs and the clinical origin of the strains. The virB10 homolog gene was the sole gene studied to be significantly expressed more often in cancer strains than in gastritis strains (P = 0.03).
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PMID:Composition and gene expression of the cag pathogenicity island in Helicobacter pylori strains isolated from gastric carcinoma and gastritis patients in Costa Rica. 1117 71

In a review of sixty-four (64) cases of gastric outlet obstruction (G.O.O.) seen at the University of Maiduguri Teaching Hospital between 1991 and 1996, cicatrising chronic duodenal ulcer accounted for 65.7% of cases, followed by antral carcinoma of the stomach 15%, congenital hypertrophic pyloric stenosis 9.4%, carcinoma of the head of pancreas 6% and congenital bands 3%. The usual presentations were forceful vomiting in a patient with background history of dyspepsia of varying duration depending on cause, visible persistalsis, weight loss, abdominal masses and electrolyte imbalances. Diagnoses was easy clinically and confirmed by barium studies and/or gastroduodenoscopy. Treatment offered depended on the cause of gastric outlet obstruction.
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PMID:Gastric outlet obstruction in Maiduguri. 1120 32

Actually is considered that Helicobacter pylori play a major role in the genesis of peptic ulcer. Like in the gastric and duodenal ulcer. When we demonstrate the presence of Helicobacter pylori in the gastric antrum of patients with ulcer they must receive eradication treatment. Another indication for eradication treatment are the patients with malt lymphoma or patients with endoscopical resection of gastric carcinoma. The ideal treatment is the therapy that eradicate 90% of the cases. The most effective are the triple therapies with one proton pump inhibitor with two antibiotics like amoxycillin plus clarithromycin. In Mexico the therapies with metronidazole are not recommended because we have high rates of resistance to this drug 70%. Is not justified to treat patients with non ulcer dyspepsia. We still recommended the schemes of 14 days. A good alternative is the combination of ranitidine bismuth citrate plus two antibiotics. Is possible that in the future we can have a vaccine to eradicate and to prevent the infection.
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PMID:[Treatment of Helicobacter pylori infection. Whom to treat and with what?]. 1146 22

A panel of international gastroenterologists and other specialists convened at a Takeda-sponsored symposium held during the XIIIth International Workshop on Gastroduodenal Pathology and Helicobacter pylori (October 2000, Rome) to discuss clinical management of H. pylori. Topics such as management strategies as alternatives to eradication, long-term outcomes, and the impact of antibiotic resistance to H. pylori were discussed in an interactive session. The panel concluded that 1) patients with ulcer-like or reflux-like dyspepsia do appear to benefit from proton pump inhibitor therapy, 2) eradication of H. pylori may reduce future morbidity and mortality from peptic ulcer disease and gastric carcinoma, outweighing the theoretical risk of developing gastro-oesophageal reflux disease, Barrett's oesophagus, and oesophageal adenocarcinoma, and 3) the epidemiology of resistance to H. pylori, and the impact of the percentage of eradication, should be considered when an eradication regimen is being planned for patients with non-ulcer dyspepsia. Susceptibility testing may be of help in areas where this investigation is cost effective.
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PMID:Key topics in Helicobacter pylori eradication in the management of the dyspeptic patient: a panel discussion. 1168 29

Helicobacter pylori disposes of various virulence factors such as urease, vacuolating cytotoxin and the cag-pathogenicity island which--though not alone, but possibly in conjunction with host-specific factors--may explain the varying course of the infection (asymptomatic, dyspepsia, ulcer, distal gastric carcinoma). Increasing resistance to macrolide antibiotics and the lack of new therapeutic approaches makes treatment of the infection increasingly difficult. The resultant call for a strict indication for treatment is in obvious contrast to the finding that Helicobacter pylori represents the major risk factor for gastric carcinoma and eradication would therefore be absolutely desirable. Increased use of culture and susceptibility testing would be desirable for the purpose of therapy optimization but also for reasons of resistance epidemiology. The indication for diagnostic screening should be guided by the treatment indications as proposed by the guidelines of the Maastricht Consensus Conference 2-2000. In addition--and regardless of clinical picture--therapeutic follow-up primarily relying on non-invasive tests (13C urea breath test, stool antigen test) should be a matter of course.
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PMID:[Helicobacter pylori: virulence factors, resistance and diagnosis]. 1199 60

Helicobacter pylori (H. p.) causes active chronic antrum gastritis in all infected patients. In a relatively small percentage complications of H. p.-gastritis including duodenal ulcer, gastric ulcer, giant fold gastritis, lymphocytic gastritis, autoimmune gastritis, gastric carcinoma and gastric MALT lymphoma may develop. Strongly recommended indications for eradication therapy include gastroduodenal ulcer disease, giant fold gastritis, lymphocytic gastritis, autoimmune gastritis, gastric MALT lymphoma, atrophic gastritis, corpus-predominant gastritis, post gastric cancer resection and patients who are first degree relatives of gastric cancer patients. Eradication therapy is controversial in patients with gastroesophageal reflux disease, functional dyspepsia and in patients in whom treatment with nonsteroidal antiinflammatory drugs (NSAID) or long-term treatment with proton pump inhibitors (PPI) is planned.
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PMID:[Helicobacter pylori infection--clinical aspects and indications for treatment]. 1199 61

Helicobacter pylori is an accepted cause of chronic active gastritis and has a major causative role in peptic ulceration. It is a gastric carcinogen. Its role in non-ulcer dyspepsia (NUD) is less clear; yet 50 per cent of patients with NUD are infected with H pylori. H pylori has been investigated in several other organ systems, but has not been investigated extensively in squamous cell carcinoma of the upper aerodigestive tract, a region which could be directly exposed to the bacterium by gastro-oesophageal reflux (GOR). In this study 61 patients with severe laryngeal dysplasia or frank carcinoma of the head and neck are striated by age, investigated for the presence of antibodies to H pylori and compared to age and sex matched controls. In the age group of 46-61 years, the presence of H pylori antibodies was marginally greater in the experimental (63.0 per cent) than the control group (40.7 per cent) (Pearson Chi square p = 0.055, Fisher 2-sided exact test p = 0.066). When combining this age group with the younger age group and thereby creating two roughly equal groups (n = 31 and n = 30) there was also a statistical trend towards increased positivity in the experimental group. These findings are discussed in the light of other studies with gastro-oesophageal reflux disease (GORD).
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PMID:The prevalence of Helicobacter pylori infection in malignant and premalignant conditions of the head and neck. 1262 84


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