Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effects of therapeutic acupuncture on gastric acid secretion on pain relief in chronic duodenal ulcer patients were studied. Ten adult Nigerian patients with clinical, endoscopic as well as radiological evidence of duodenal ulcer constituted the "Ulcer Group." Four other patients who gave history of dyspepsia formed the "Dyspeptic Group." Pentagastrin stimulation test was performed on all subjects pre- and post-acupuncture therapy. The classical Chinese acupuncture loci were employed. The mean Basal Acid Output (BAO) in the duodenal ulcer group was markedly reduced from 4.04 +/- 1.01 mMols/hour to 1.05 +/- 2.5 mMols/hour. The mean Maximal Acid Output (MAO) was lowered from 34.72 +/- 13.81 mMols/hour to 15.34 +/- 4.01 mMols/hour. The difference was statistically significant (P less than 0.001). It is more probable, therefore, that the relief of pain is attributable to the therapeutic inhibition of gastric hyperacidity in our patients. Thus, though pain relief has been previously demonstrated in response to acupuncture, the results of this investigation have gone further to show that acupunture achieves symptomatic relief through therapeutic gastric depression in duodenal ulcer patients.
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PMID:Acupuncture and gastric acid studies. 4 32

Maximal gastric secretion, measured by the histamine-infusion test, was, as expected, significantly greater in a group of 81 patients with duodenal ulcer than in a group of 72 controls. After standardising for the effect of stature on maximal secretion, only 24 of the patients were found to be true hypersecretors. However, maximal secretion in the ulcer group increased with length of history of symptoms, and extrapolation back to zero length of history suggested that there was no significant hypersecretion at that time. These facts support the hypothesis that it is the presence of the ulcer that leads to hypersecretion rather than the converse. Possible mechanisms involved are chronic ingestion of antacids to counter dyspepsia, or gastric distension due to pylorospasm.
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PMID:Hypersecretion and length of history in duodenal ulceration. 4 96

A histalog gastric analysis was done in 20 patients with gastroduodenal disorders and 12 subjects with non-ulcer dyspepsia who were used as controls. Due to overlap of secretory responses its use as a diagnostic tool is limited. About 46% patients with duodenal ulcer exceeded the upper limit of acid secretion of control subjects. Values for stimulated secretion in controls and the patients with gastric ulcer were the same. Endoscopy if possible is the investigation of choice for the diagnosis of gastroduodenal disorders and the secretory studies should be limited to patients under-going surgery for peptic ulceration.
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PMID:Histalog gastric analysis. 9 8

Pepsin 1, the ulcer-associated pepsin, occurred significantly more frequently in the gastric juice of those patients with duodenal ulcer who did not secrete A, B, or H antigens into gastric juice than in those secreting these antigens. This observation may explain the increased proportion of such non-secretors among patients with duodenal ulceration. In patients with gastric ulcer and non-ulcer dyspepsia, and in a miscellaneous group of patients, there was no association of pepsin 1 secretion with secretor status, suggesting that the association noted in duodenal ulceration is an indirect rather than a direct one. No increase of pepsin 1 occurred in group O patients with peptic ulcer, so that the increased proportion of such patients in peptic ulcer does not arise from differences in pepsin 1 secretion.
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PMID:Hereditary aspects of duodenal ulceration: pepsin 1 secretion in relation to ABO blood groups and ABH secretor status. 11 57

Tests of gastric secretion are seldom diagnostic in the investigation of gastric and duodenal ulceration, but they can provide evidence that is helpful in arriving at a diagnosis. Common tests include basal acid output, pentagastrin-stimulated maximal and peak acid output, and the Hollander test. There is some evidence that they may be useful in selecting the type of operation for peptic ulceration. Indications for performing these tests relate to the Zollinger-Ellison syndrome, duodenal ulcer, recurrent dyspepsia after operation for duodenal ulcer, and decisions concerning the choice of operation for peptic ulcer. In order to perform these functions they must be properly conducted and interpreted; they are simply an adjunct to clinical judgement, and complementary to other laboratory tests.
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PMID:Clinical usefulness of gastric acidity studies. 16 33

48 patients with rheumatic diseases underwent long-term treatment with a new antirheumatic compound, tolfenamic acid pINN. The dosage was 2 capsules of 100 mg 3 times daily. At the time of summing-up 9 patients had been treated for one year, 41 for 6 months and 7 had been eliminated after 1 month of treatment, because of side-effects in the form of diarrhoea, dyspepsia, vomiting and 1 ulcer patient got an attack of duodenal ulcer. Of the 41 patients who completed the 6 month trial 33 reported good therapeutic effect. A significant fall in the erythrocyte sedimentation reaction (p less than 0.01) was observed. 19 patients reported side-effects in the trial period, but at the end of the trial only 5 complained of side-effects. In the male patients occasional slight dysuria was the most common side-effect. Of the 9 patients who were treated for one year all reported a good effect from the preparation and none of them complained of side-effects after 1 year of treatment. Apart from eosinophilia in 2 patients, who were eliminated from the trial because of diarrhoea, none of the laboratory values showed any signs of the preparation having any toxic effects.
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PMID:Long-term therapy with tolfenamic acid pINN. A clinical and toxicological study with special reference to clinical and chemical laboratory parameters. 30 10

Many questions regarding duodenitis remain unanswered. However, the evidence suggests that duodenitis is a clinical entity which can give rise to dyspepsia and, on rare occasions, gastrointestinal haemorrhage. Conventional and double contrast radiology has only a small part to play in the diagnosis of duodenitis but is important in helping to exclude other lesions such as duodenal ulcer. Provided care is taken during the fibre-optic visualization of the duodenal bulb, the endoscopic appearances of moderately severe duodenitis correlate well with the histological changes seen. A diagnosis of apparent duodenitis should be confirmed by the histological criteria described. Treatment at present is similar to that of peptic ulcer, with the withdrawal of any predisposing and precipitating factors such as aspirin, alcohol and smoking. Antacids may relieve the symptoms. It is not yet known what effect these measures may have on the duodenitis as opposed to the symptoms of dyspepsia. The H2-receptor antagonist, cimetidine, should be effective in treating duodenitis but double blind clinical and endoscopic studies are required to confirm this. The place of surgery is as yet undefined. With the data at present available, it appears that duodenitis is part of the pathophysiological spectrum of the duodenal ulcer diathesis rather than a separate disease. It may represent both the production and healing phases of duodenal ulceration. In some patients the duodenal mucosa may proceed from normal to duodenitis and then to normal again without the development of frank duodenal ulceration (Figure 4). Prospective studies are required which should include a long-term clinical follow-up of a large number of patients with duodenitis accurately and specifically diagnosed by endoscopy and histopathology.
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PMID:Duodenitis. 36 6

Pirenzepine (PRZ, 75 mg/day for 10 days followed by 50 mg/day for 20 days) was compared with placebo (PL) in the treatment of endoscopically confirmed active gastroduodenitis or duodenal ulcer and with carbenoxolone (CB, 300 mg/day followed by 200 mg/day) in the treatment of gastric ulcer in a 30-day double-blind clinical trial. Ninety-seven of 112 outpatients completed the trial. The results can be summarized as follows: a) Gastroduodenitis. Complete normalization of the endoscopic picture was observed in 61% of the 28 patients on PRZ and in 30% of the 27 on PL. b) Duodenal ulcer. Complete endoscopic healing was observed in 75% of the 12 patients on PRZ and in 44% of the 9 on PL. In both studied PRZ induced improvement in clinical symptoms in more patients than PL. c) Gastric ulcer. PRZ and CB induced complete healing in a similar percentage of patients (64% of 11 and 70% of 10 patients). Better results in dyspepsia were observed in the PRZ group than the CB group. No major side-effects and no pathological changes in blood and urine analyses were observed in PRZ-treated patients.
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PMID:Pirenzepine in the treatment of benign gastroduodenal diseases. A double-blind controlled clinical trial. 39 54

During a 7-year period proximal gastric vagotomy (PGV) was performed in 565 patients. Of these, 210 patients with duodenal ulcer and 14 with dyspepsia without demonstrable ulcer at the time of operation were followed for 5--7 years. Sixty-six percent are symptom-free (Visick I), 23% have no complaints when they take certain dietary measures (Visick II), 3% are improved but still have periods of dyspepsia (Visick III), and 8% are failures because of recurrent ulcer (Visick IV). There were 4 duodenal, 3 pyloric, 5 prepyloric, and 7 lesser-curve gastric recurrences. There were one operative death (0.2%) and one major complication (0.2%). The side effects after PGV are mild, infrequent, and seldom of any significance to the patients. Diarrhoea and dumping are virtually eliminated. Body weight was stable during the whole period of study, and blood chemistry did not disclose any deficiency in haemoglobin, serum iron, or vitamin B12 which might be attributed to PGV. It is concluded that 5--7 years after proximal gastric vagotomy for duodenal ulcer there is a 10% recurrence rate, but the low risk of death and of severe complications and the lack of significant side effects more than outweight the high recurrence rate.
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PMID:A seven-year follow-up of proximal gastric vagotomy. Clinical results. 42 88

Recent studies suggest a normal maximum acid secretion in duodenal ulcer patients with a history of less than three years, but an increase of secretion in those with longer history. The validity of this hypothesis was investigated in groups of patients with operatively verified duodenal ulcer and history for less than 3, 3--6, and 7--10 years. Each group, including 21 men and nine women, was compared to two male and one female group of age-matched controls without dyspepsia. In smaller groups of 16 men it was possible to compare age-matched groups from a population of 376 men with histories for up to 22 years. Finally, 11 men with an ulcer history of less than one year were compared to 11 controls. All subjects had measurements of MAO by the augmented histamine test. MAO was significantly higher in patients with a history less than one year and less than three years, respectively, compared to controls. After correction of MAO for weight or lean body mass the difference remained significant in men, but not in the smaller groups of women. MAO in men with a history of from less than three up to 22 years did not show any maximum. Thus, the study did not support the assumption that gastric hypersecretion is a result of duodenal ulceration.
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PMID:Maximum acid output in duodenal ulcer patients with different length of history and controls without dyspepsia. 60 55


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