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)

A questionnaire has been completed by 99 patients referred for investigation of symptoms after gastric operations. The replies were analysed in an attempt to distinguish patients with a recurrent peptic ulcer from those with no recurrent ulcer. All cases were investigated by barium meal, endoscopy, and oral cholecystography. All recurrent ulcers were confirmed by reoperation and patients with gastric carcinoma, gallstones, or symptomatic hiatus hernia were excluded. The study was retrospective in 40 patients in whom the diagnosis was already confirmed when the questionnaire was analysed and prospective in 59 in whom the diagnosis was originally unknown. The replies were analysed with (a) a small computer using Bayes' theorem, (b) weighted tables, and (c) a discriminant analysis. The computer prediction of the prospective data was 85% accurate. The results of simpler methods were almost as good as the computer prediction, and questions related only to the severity of pain and vomiting accurately distinguished recurrent ulcer from other causes of dyspepsia in 81% of patients.
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PMID:A symptomatic discriminant to identify recurrent ulcer in patients with dysperpsia after gastric surgery. 5 52

In a study, partly retrospective and partly prospective, there were 29 infants who had sliding hiatal hernia: their principal clinical features, the diagnostic criteria, treatment and cure rate were similar to those of other series. The study highlights associated duodenal anomalies which seem to influence the radiological but not the clinical cure rate. The findings can be contrasted with those in adults who have duodenal abnormalities with sliding hiatal hernias in that 21 out of 29 infants with sliding hiatal hernia had a normal duodenal loop. Severe dyspepsia, with malnutrition initially, did not have any influence on physical development in 27 out of 29 patients.
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PMID:The significance of abnormal duodenal loop on radiological and clinical cure in infants with sliding hiatal hernia. 89 55

A sliding hiatus hernia is a common radiological finding and is not always relevant to the patient's symptoms. The possibility of an alternative explantation for the complaint of retrosternal pain or dyspepsia should always be considered, and when anaemia is present the site of occult blood loss is often lower in the gastrointestinal tract. The majority of patient's with symptomatic gastro-oesophageal reflux can be controlled with medical measures. Surgical intervention in cases of uncomplicated hiatus hernia should be recommended only after careful preoperative assessment and even then a satisfactory result cannot be absolutely guaranteed.
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PMID:Common gastroenterological problems. II.--Sliding hiatus hernia. 107 40

Measurements of the lower oesophageal sphincter pressure and gastric secretion were made in patients with dyspepsia but no reflux and in patients with a hiatus hernia and reflux in response to a near maximal dose of pentagastrin. Patients with hiatus hernia had lower resting sphincter pressures than those with dyspepsia. The magnitude of the pressure rise following pentagastrin was related to the resting tone of the sphincter. However, in terms of percentage increase over resting sphincteric pressure, patients with dyspepsia and patients with a hiatus hernia had similar response.
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PMID:The response of the lower oesophageal sphincter to maximal doses of pentagastrin. 111 68

This study has investigated the possible association between duodenogastric reflux, gastritis, and symptoms in 35 patients with or without dyspepsia one to 15 years after gastric surgery. Five patients were excluded because of biliary disease, hiatus hernia, or recurrent ulceration. The remaining 30 were assessed by a symptomatic score, measurement, of bilirubin and sodium concentrations in samples of fasting gastric juice, endoscopy, gastric biopsy, and the presence of radiological reflux. In 15 patients with a symptom score of less than the median, gastric bilirubin levels were less than 1 mg/100 ml in 80%; severe endoscopic changes were seen in only one patient and reflux was not observed. In contrast, in patients with a symptom score in excess of the median fluoroscopic and biochemical reflux was seen in 69 and 80% respectively and severe mucosal hyperaemia in half. There was a significant correlation between symptoms, gastric hyperaemia, and duodenal reflus ( P smaller than 0-02).
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PMID:Duodenogastric reflux: a cause of gastric mucosal hyperaemia and symptoms after operations for peptic ulceration. 114 Jun 22

We describe the clinical features and therapeutic outcome in 49 patients in whom benign gastric ulceration of an hiatal hernia was demonstrated endoscopically. Hiatal hernia ulcers accounted for 10% of all benign gastric ulcers. The typical patient was an elderly female with a history of dyspepsia who was receiving non-steroidal anti-inflammatory drugs. Twenty-seven (55%) patients had evidence of haemorrhage (acute in 15; chronic in 12) from the hiatal hernial ulcer at presentation. In 16 (33%) patients, symptoms attributable to haemorrhage constituted the sole clinical evidence of the hiatal hernial ulcer. Acute haemorrhage from hiatal hernial ulcers was associated with non-steroidal anti-inflammatory drug (NSAID) treatment (P less than 0.05). Chronic blood loss from hiatal hernial ulcers was associated with female gender (P less than 0.005) but not with NSAID treatment. Hiatal hernial ulcers healed slowly in response to medical treatment with H2-receptor antagonists (median time to healing 12 weeks). Surgical treatment may be the therapy of choice for hiatal hernial ulcers because of the high complication rate, poor response to medical therapy, and the apparent predominance of mechanical aetiological factors.
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PMID:Hiatal hernial ulcers: clinical features and follow-up. 168 55

The indications for and findings in 431 consecutive patients who had upper gastrointestinal endoscopy in Zaria from June 1978 to August 1982 are reviewed. The major indications were dyspepsia (78.1%), upper gastro-intestinal bleeding (12.1%) and portal hypertension (4.2%). Other indications were persistent vomiting, dysphagia and abdominal masses. The mean age of the patients was 32 years. The male: female ratio (3:1) was not different from that in the hospital population. There were no abnormal findings in 32.7%. 26.6% had duodenal ulcers. Duodenitis was noted in 24.8%, oesophageal varices in 6.3%, gastritis in 6.3% and hiatus hernia in 4.6%. In those who presented with upper-gastrointestinal haemorrhage, oesophageal varices (34.6%) and peptic ulcer (17.3%) were the commonest findings. Complication seen commonly were soreness in the throat and thrombophlebitis at the site of valium injection. One death was recorded from the procedure over the period.
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PMID:Upper gastrointestinal endoscopy in Zaria, northern Nigeria. 208 5

Two cases of sudden death due to perforation of a benign oesophageal ulcer into a major blood vessel are reported. In one man, anaemia and aspiration pneumonitis dominated the clinical picture. He had an oesophageal stricture and a chronic peptic ulcer associated with an incarcerated hiatus hernia. Death was due to haemorrhage caused by perforation of the ulcer into the thoracic aorta. The second patient presented with confusion and falls, backache and indigestion. She had a hiatus hernia and a large benign chronic oesophageal ulcer. Death was due to perforation of the ulcer into the left pulmonary vein. The cases are presented for their rarity, to illustrate the complex and late presentation of problems in geriatric medicine, and as a reminder that reflux oesophagitis can be dangerous.
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PMID:Sudden death from perforation of a benign oesophageal ulcer into a major blood vessel. 325 Dec 22

In a study of forty-two patients with dyspepsia, hiatus hernia or duodenal ulcer, dicyclomine (Merbentyl) has been demonstrated to be effective in the control of the symptoms of this disorder. Under double-blind conditions an antacid or placebo supplement was provided and no significant difference in benefit was recorded. The antacid was given in a large tablet and this preparation was more conscientiously taken by patients, and this was equally true for large placebo tablets. Clearly patients like to take frequent treatment for dyspepsia, but symptom control is quite adequate if Merbentyl is given alone.
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PMID:Comparison of dicyclomine with antacid and without antacid in dyspepsia. 673 20

Over a four year period, from August 1987 to July 1991, thirteen cases of chronic and recurrent gastric volvulus were encountered comprising six paediatric and seven adult patients. In none of the patients was the condition clinically suspected; diagnosis being made only at meticulous upper gastro-intestinal (UGI) barium series. The paediatric patients typically presented with obstructive symptoms of projectile vomiting especially after meals and failure to thrive. The adults had variable symptoms of dyspepsia, recurrent intermittent upper abdominal discomfort or pain, occasionally accompanied by vomiting or retching mimicking many different upper abdominal conditions, such as peptic ulcer, biliary tract or pancreatic disease but with negative findings at endoscopy and abdominal ultrasound scanning. All cases were organo-axial type of gastric volvulus. Associated conditions were small sliding hiatus hernia in two adult cases; partial small bowel malrotation in two cases, high jejunal obstruction also in two cases and congenital hip dislocation in one patient. An infant had umbilical hernia, previous meconium cyst and meconium peritonitis. The condition seems not as uncommon as previously thought; the key to diagnosis being constant awareness, a high index of clinical suspicion and a carefully performed UGI barium series especially during the attack of pain.
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PMID:Gastric volvulus: more common than previously thought? 765 6


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