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

We conducted a survey on functional gut disorders and health care seeking behavior in a large non-patient population of an Italian region (Umbria). 533 subjects were interviewed by means of a specific questionnaire. 44 (8.5%) reported symptoms compatible with the irritable bowel syndrome, 30 (5.8%) had non-colonic pain, 48 (9.2%) chronic constipation, and 20 (3.8%) dyspepsia. It is concluded that in our region there is a relatively high percentage of subjects that do not commonly seek health care, although affected by functional gut disorders.
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PMID:Functional gut disorders and health care seeking behavior in an Italian non-patient population. 276 61

A group of outpatients with chronic non-organic upper abdominal pain was followed up 5-7 years after the index investigation, to evaluate the predictive value of several variables on the basis of a questionnaire and a laboratory pain study. Fifty-four per cent had symptoms of irritable bowel syndrome. A low pain tolerance measured with an ischemic pain technique significantly predicted a poor course of the disease (P = 0.03). So did a high score indicating psychic vulnerability (P = 0.02) and two social factors: poor school and vocational education (P less than 0.01). Without significant predictive value were level of abdominal pain rated on a visual analogue scale, length of dyspepsia history, bowel habits, relation of pain to meals and to life events, heartburn, headache, back pain, dysmenorrhea, paresthesias in fingers or feet, present occupation, sex, marital status, days absent from work because of the disease, and consumption of tranquilizers, cigarettes, and alcohol. The findings indicate that psychologic factors and a low pain tolerance may be elements in this poorly understood syndrome. This is supported by earlier findings of a decreased pain tolerance and an elevated psychologic score in this group compared with controls.
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PMID:Predictors for the course of chronic non-organic upper abdominal pain. 278 Dec 39

Dyspepsia stands for a constellation of symptoms referrable to the upper gastrointestinal tract. However, the term dyspepsia is too vague to be useful in scientific work unless critically defined. In many cases dyspepsia coincides with the irritable bowel syndrome. An increased use of endoscopy and the possibility of prompt symptom relief in peptic ulcer by treatment with H2-receptor antagonists have focused the interest on patients with ulcer-like dyspepsia but in whom there is no evidence of ulcer disease. This large group of patients deserves further nosologic classification and there is a strong need of pathophysiologic and interventional studies.
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PMID:Dyspepsia. Definition and discussion of nomenclature. 286 94

Dyspepsia, defined as chronic or recurrent upper abdominal pain or nausea, is a common occurrence. Dyspepsia without an ulcer (non-ulcer dyspepsia) is diagnosed in patients at least twice as often as peptic ulceration. Diseases that may present with similar symptoms include gastroesophageal reflux, biliary tract disease, chronic pancreatitis, and irritable bowel syndrome. A careful history and physical examination, supplemented by selected tests, usually lead to a correct diagnosis. The pathogenesis of non-ulcer dyspepsia remains unknown. Gastric acid secretion, duodenogastric reflux, psychological factors, environmental exposures, and heredity probably do not play a major role. Some patients may have motility disturbances, but whether these disturbances cause dyspepsia is unknown. Campylobacter pylori infection and associated gastritis are common in non-ulcer dyspepsia, but their etiologic role is controversial, as is the importance of chronic duodenitis. By recognizing the heterogeneity of patients who present with non-ulcer dyspepsia, more rational management may be possible. Although an empiric trial of antacids or H2 blockers has been recommended to treat dyspepsia, most controlled trials show that although these substances reduce severity of symptoms, they are no more effective than placebos in non-ulcer dyspepsia.
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PMID:Non-ulcer dyspepsia: potential causes and pathophysiology. 328 48

The effect of cimetidine and placebo was examined in 123 patients with non-ulcer dyspepsia (NUD) by means of a 12-day multi-crossover model with 5 regular interchanges between cimetidine and placebo. The evaluation of effect in individual patients was based on the number of times cimetidine was associated with less symptoms than the preceding or following placebo period. If cimetidine had no effect, the probability of being defined as a cimetidine responder was 25%. In general, cimetidine was associated with less symptoms than placebo (p less than 0.0001). Forty patients were identified as cimetidine responders (R) and the remaining patients were termed non-responders (NR). Symptoms compatible with gastroesophageal reflux were significantly more frequent in R than in NR, whereas the opposite was true for symptoms of the irritable colon syndrome. The ability of symptoms selected by stepwise logistic regression to predict response to cimetidine showed at best a sensitivity of 75% and a specificity of about 65%. No differences were found between R and NR with regard to acid secretion, endoscopic and histologic findings, or the result of an acid perfusion test. The present study supports the existence of a subgroup of cimetidine responders among patients with NUD characterized by symptoms suggestive of gastroesophageal reflux disease in the absence of confirmatory objective evidence.
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PMID:Cimetidine responders in non-ulcer dyspepsia. 329 Oct 85

One hundred fifty-one patients with non-ulcer dyspepsia, defined as chronic epigastric pain without concomitant symptoms of the irritable bowel syndrome and with no evidence of any organic disease other than macroscopic or microscopic gastritis/duodenitis seen at endoscopy on entry into the trial, were randomly assigned to treatment for four weeks with sucralfate or a placebo, 1 g three times a day one-half hour before meals, according to a double-blind model. Seventy-nine patients received sucralfate and 72 patients received a placebo. According to patients' subjective assessment of their symptoms at four weeks, 61 patients (77 percent) in the sucralfate group and 40 patients (56 percent) in the placebo group had become symptom-free or showed improvement, whereas the condition of 18 (23 percent) in the former group compared with 32 (44 percent) in the latter group remained unchanged or deteriorated. The difference between the groups was significant (p less than 0.01). The best response to sucralfate treatment (84 percent or more symptom-free or improved) was achieved in patients with mild or moderate symptoms and without macroscopic or microscopic inflammation of their gastric mucosa--a typical patient with non-ulcer dyspepsia. Our results indicate that sucralfate is significantly more effective than placebo in the treatment of non-ulcer dyspepsia.
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PMID:Sucralfate versus placebo in treatment of non-ulcer dyspepsia. 331 Jun 29

Crean et al1 defined dyspepsia as 'any form of episodic or persistent discomfort or other symptom referrable to the upper alimentary tract, excluding jaundice or bleeding', and listed irritable bowel syndrome (IBS) and formal psychiatric illnesses with gastrointestinal manifestations among the common causes of non-ulcer dyspepsias. This paper will discuss the psychiatric aspects of non-ulcer dyspepsia and will be divided into four parts: --The effects of stress and emotion on the gastrointestinal tract --Personality traits of IBS sufferers --Psychiatric disorders and non ulcer dyspepsias --Treatment strategies.
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PMID:Psychiatric aspects of non-ulcer dyspepsia. 331 50

The incidence of severe duodenal anomalies (MD) has been investigated in 458 patients submitted to barium meal examination and in 176 subjects comprising various clinical subgroups. The incidence of MD in patients submitted to barium meal examination was 11.6%. The incidence of MD in 25 normals was 4%, which was not significantly different from the incidence (10%) of MD in patients with gastroesophageal reflux symptoms. Compared with in normals, MD occurred with a significantly higher incidence in 45 patients with X-ray-negative dyspepsia (24%), in 36 patients with the irritable bowel syndrome (44%), and in 37 patients with asthma (38%). It is concluded that demonstration of MD in a patient is only indicative of a possible disorder.
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PMID:The incidence of severe duodenal anomalies in patients submitted to barium meal examination, in normals, and in different clinical subgroups. 343 6

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

The term 'non-ulcer dyspepsia' lacks a generally accepted definition. A broad spectrum of symptoms could be included under this heading. Therefore, a subclassification with strict and reproducible lines of demarcation is needed. The aim of a recently concluded study was to delineate the category of patients who suffer from chronic or recurrent epigastric pain without symptoms of Irritable Bowel Syndrome and without any anatomical correlates. In order to emphasize the distinction between the studied condition and the less well-defined diagnosis of non-ulcer-dyspepsia we have proposed an alternative designation, "Epigastric Distress Syndrome". The admixture of initially overlooked organic diseases seems to be almost negligible when strict criteria are used for the diagnosis. Gastric acid is probably not involved in the etiology but psychological factors seem to be crucial for the development of this condition. When specifically asked, about every third person report abdominal symptoms. Their complaints are commonly referred to as dyspepsia, but the term lacks a generally accepted definition. In practice, every possible symptom arising from the gastrointestinal tract except jaundice and bleeding could be gathered under this heading. A large number of organic diseases are conceivable causes of dyspepsia, but conditions with presumed functional etiology dominate, at least in outpatient care. In fact, the clinical diagnosis of 'gastritis', which is used to describe upper abdominal complaints without any apparent organic causes, accounts for 2% of all outpatient consultations in Sweden, and it is by far the most commonly used gastroenterological diagnosis in this country.
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PMID:Epigastric distress syndrome. 347 93


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