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

It was investigated whether central pain mechanisms including the endogenous antinociceptive system were involved in functional dyspepsia defined as: abdominal pain without abnormal findings. Pain sensitivity was measured by an ischaemic pain test comparing 21 functional dyspepsia patients with two control groups: 1) 24 patients with organic abdominal pain, and 2) 13 healthy pain-free controls. The endogenous opioids beta-endorphin, met-enkephalin immunoreactivity, and dynorphin immunoreactivity were measured in cerebrospinal fluid (CSF) from nine patients with functional dyspepsia and pain-free controls undergoing minor surgery while under spinal analgesia. There was no significant difference between the groups in pain sensitivity, but subdivision of the functional dyspepsia group showed that individuals with pain and no symptoms of irritable bowel syndrome (IBS) were significantly more sensitive to ischaemic pain than functional dyspepsia patients with IBS. The CSF beta-endorphfin concentration was significantly decreased in the functional dyspepsia group as compared with the controls. There were no significant group differences regarding met-enkephalin immunoreactivity and dynorphin immunoreactivity. Because of post-lumbar-puncture headache, this part of the investigation was suspended after nine patients. Functional dyspepsia is probably a pain syndrome with decreased central antinociceptive activity.
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PMID:[Reduced concentration of beta-endorphin in cerebrospinal fluid and reduced pain tolerance in patients with functional dyspepsia]. 783 29

Six symptoms of Manning et al are widely used in clinical practice to diagnose irritable bowel syndrome (IBS). We studied 123 patients to evaluate the diagnostic value of Manning's criteria, using a preformed bowel symptom questionnaire which included these six symptoms. This study included 65 patients with IBS, 35 patients with non-ulcer dyspepsia, 23 patients with organic diseases of colon and 45 healthy controls. Sensitivity of presence of three or more symptoms of Manning's criteria discriminating irritable bowel syndrome from all other groups was 66.1%. Manning's criteria discriminated irritable bowel syndrome from organic diseases of colon with specificity and positive predictive value of 66.9% and 82.6%. When irritable bowel syndrome was compared with non-ulcer dyspepsia and healthy controls, specificities of Manning's criteria were 91.4% and 93.3% and positive predictive values 93.4% and 93.4% respectively.
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PMID:Evaluation of Manning's criteria in the diagnosis of irritable bowel syndrome. 800 73

The relationships between psychiatric disorders and the symptoms of both irritable bowel syndrome (IBS) and non-ulcer dyspepsia (NUD) are herein investigated and discussed. Functional disorders of the small and large intestine induce irritable bowel syndrome. NUD is a syndrome that displays symptoms that might originate in the upper digestive system despite the absence of any organic disorder. In addition, it has also been suggested that the occurrence of NUD is based on a functional disorder of the upper digestive systems. Based on our studies of serious cases with both NUD and IBS, in approximately 50% of the NUD patients as well as about 50% of the IBS cases, a depressive disorder was found to be most closely related to the onset and continuance of the symptoms of either NUD or IBS. According to the evaluations of NUD and IBS as functional disorders and psychiatric disorders, the patients underwent treatment and all demonstrated a good response to the various treatment regimens. It is thus considered that NUD and IBS should be evaluated as both functional digestive disorders and psychiatric disorders.
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PMID:[A depressive disorder in patients with irritable bowel syndrome and non-ulcer dyspepsia]. 800 9

From March to October 1989, 237 French gastroenterologists included 1,301 patients referred for irritable bowel syndrome in a 9-month epidemiological survey based on questionnaires and monthly auto-evaluation. In the patient population, the high preponderance of women (sex ratio: 2.33), the high prevalence of cholecystectomy (9%), appendectomy (53%) and an association with at least one symptom of non-ulcer dyspepsia (70%) were observed. Fifty per cent of the patients completed the 9-month follow-up period; among them, 60% declared an improvement in their symptoms, but only 30% in their quality of life and independently of the clinical course. This study suggests that symptoms and quality of life in patients consulting for irritable bowel syndrome should be taken into account separately, both in daily practice and in therapeutic evaluation.
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PMID:[Profile and evolution of irritable bowel syndrome. Prospective national epidemiological study of 1301 patients followed-up for 9 months in Gastroenterology. Groupe d'Etude Nationale sur le Syndrome de l'Intestin Irritable (SII)]. 801 96

To study the prevalence of peptic ulcer, non-ulcer dyspepsia and irritable bowel syndrome (IBS) in the Dutch and Japanese working population, a structured history using a questionnaire on gastrointestinal symptoms during the preceding 3 months was obtained from persons undergoing a periodic medical examination. Principal components factor analysis of questionnaire responses was conducted to examine interrelationships of symptoms. In Holland, 427 men and 73 women participated (mean age 48.0 years), while in Japan 196 men and 35 women took part (mean age 48.8 years). In both the Japanese and the Dutch population, factor analysis yielded clusters of symptoms consistent with previously defined clinical syndromes: dyspepsia, diarrhoea-predominant IBS and constipation-predominant IBS. The prevalences of verified peptic ulcer history were 19% and 17% (95% confidence intervals (CI): 14-26% and 7-34%) in Japanese men and women in contrast to 5% and 0% (95% CI: 3-8% and 0-5%) in Dutch men and women respectively. The ratio of duodenal to gastric ulcer was 4.5: 1 in Holland and 1.5:1 in Japan. The 3-month period prevalence of non-ulcer dyspepsia was 13% in both the Japanese and the Dutch population and was twice as high in women as in men (p < 0.01). There was considerable overlap between dyspepsia subgroups. IBS was present in 25% of the Japanese and in 9% of the Dutch (p < 0.001) and occurred twice as often in women as in men (p < 0.01). In conclusion, factor analysis supported the existence of dyspepsia and IBS as distinct syndromes in both countries.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Peptic ulcer, non-ulcer dyspepsia and irritable bowel syndrome in The Netherlands and Japan. 801 69

Although physiological stimuli in the healthy gastrointestinal tract are generally not associated with conscious perception, chronic abdominal discomfort and pain are the most common symptoms resulting in patient visits with gastroenterologists. Symptoms may be associated with inflammatory conditions of the gut or occur in the form of so-called functional disorders. The majority of patients with functional disorders appear to primarily have inappropriate perception of physiological events and altered reflex responses in different gut regions. Recent breakthroughs in the neurophysiology of somatic and visceral sensation are providing a series of plausible mechanisms to explain the development of chronic hyperalgesia within the human gastrointestinal tract. A central concept to all these mechanisms is the development of hyperexcitability of neurons in the dorsal horn, which can develop either in response to peripheral tissue irritation or in response to descending influences originating in the brainstem. Taking clinical characteristics and the concept of central hyperexcitability into account, a model is proposed by which abdominal pain from chronic inflammatory conditions of the gut and functional bowel disorders such as noncardiac chest pain, nonulcer dyspepsia, and irritable bowel syndrome could develop by multiple mechanisms either alone or in combination.
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PMID:Basic and clinical aspects of visceral hyperalgesia. 783 12

In 1984 a random sample of a 70-year-old Danish population of 1119 subjects was questioned about abdominal symptoms and 5 years later survivors were contacted for follow-up. The participation rate at the primary study was 72% and 91% of the surviving subjects attended the follow-up. One-year period prevalences of single symptoms were 1-40%, annual incidence values 1-25% and 5-year disappearance rates were more than 50%. Irritable bowel syndrome occurred with a prevalence of 6-18% depending on definition, and incidences were of a similar magnitude. At the 5-year follow-up 50-79% of subjects originally suffering from irritable bowel syndrome no longer did so. The annual prevalence rate of symptoms of upper dyspepsia varied from 9% to 25%, annual incidence was 3-12%, and cumulative 5-year disappearance rate 45-65%. It is concluded that abdominal symptoms and the syndromes they constitute occur frequently and fluctuatingly in the elderly population.
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PMID:Prevalence, incidence and prognosis of gastrointestinal symptoms in a random sample of an elderly population. 802 24

The prevalence of sleep disturbances was studied in patients with severe non-ulcer dyspepsia. It was also considered if the change in sleep pattern was associated with changes in the rhythmic fasting motor activity of the gastrointestinal tract, and if motor events correlate with the patient's symptoms. Motor activity in the duodenum was monitored over a 24 hour period under freely ambulatory conditions in 10 healthy controls and in 10 patients with severe non-ulcer dyspepsia using a transnasally placed catheter with six solid state pressure transducers connected to a digital data logging device. Symptoms and sleep disturbance were assessed by questionnaire and diary. Based on their symptoms, the patients were separated into two groups: those with dyspepsia symptoms only (non-ulcer dyspepsia; n = 5) and those with dyspepsia and additional functional symptoms thought to arise from the lower gastrointestinal tract (non-ulcer dyspepsia+irritable bowel syndrome; n = 5). When compared with either the control or the non-ulcer dyspepsia+irritable bowel syndrome group, non-ulcer dyspepsia patients had a considerably decreased number of migrating motor complexes during the nocturnal period (0.7 v 4.6), a decreased percentage of nocturnal phase I (5.2% v 78.0%), and an increased percentage of the nocturnal period in phase II (94% v 15.4%). Patients with non-ulcer dyspepsia+irritable bowel syndrome were not different from normal controls. Four of the non-ulcer dyspepsia patients and all of the non-ulcer dyspepsia+irritable bowel syndrome patients reported difficulties with sleep. Clusters of high amplitude tonic and phasic activity, not accompanied by subjective reports of discomfort were noted in several patients in both groups during the study. In eight of 10 patients, abdominal pain was reported during normal motor activity, while in one patient, pain correlated with phase III of the migrating motor complex. In contrast with previous reports in patients with irritable bowel syndrome, our findings suggest an abnormality of diurnal rhythmicity--shown in changed sleep and changed rhythmic duodenal motor activity--in patients with chronic abdominal pain thought to arise from the upper gastrointestinal tract.
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PMID:Sleep and duodenal motor activity in patients with severe non-ulcer dyspepsia. 806 19

A psychosomatic syndrome is defined as a syndrome in which psychological processes play a substantial role in the etiology of the illness in some of the patients. The main conclusions on the extent of the biological and psychosocial contributions to several psychosomatic syndromes are presented and the relationship of these syndromes to somatization and somatoform disorders is discussed. The syndromes summarized include fibromyalgia, chronic fatigue, motility disorders of the esophagus, nonulcer dyspepsia, irritable bowel syndrome, urethral syndrome, behaviors causing disturbances of physiology, and some defined pain syndromes. The findings suggest that the extent of the biological and psychosocial contributions vary among these syndromes as well as among individuals with the same syndrome. In some syndromes the extent and nature of the biological contribution has not been established with certainty. There is evidence to suggest that many of the phenomena of the somatoform disorders are caused by clustering of psychosomatic syndromes or their incomplete or atypical manifestations and a low sensation threshold. The results of the controlled studies of various methods of psychotherapy and drug treatments of the psychosomatic syndromes are listed; these studies have practical implications because the adoption of these methods is likely to enhance the efficacy of the treatment of somatoform disorders.
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PMID:Psychosomatic syndromes, somatization and somatoform disorders. 812 71

A prospective study of dyspepsia was carried out in a primary referral hospital between 1974-1987 including 1540 patients of whom 1433 were seen as outpatients. The study protocol was agreed in advance and a structured questionnaire was used to elicit relevant clinical information: up to three diagnoses were permitted for each patient. The commonest principal diagnoses were duodenal ulcer (26%), functional dyspepsia (22%), and irritable bowel syndrome (IBS) (15%); alcohol related dyspepsia (4%) was as common as gastric carcinoma or symptomatic gall stones. Multiple diagnoses were common (31% given two diagnoses, and 6% given three) so that in all 2111 diagnoses were given to 1540 patients; the functional disorders (IBS and functional dyspepsia) considered together accounted for 39% of all diagnoses made. Whereas organic conditions were diagnosed by clinicians with confidence (63-98% considered 'certain'), even when given as the principal or first diagnosis IBS was considered 'certain' in only 61% and functional dyspepsia 48%. The demographic symptom data, together with information on tobacco and alcohol use, and work lost are described in detail.
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PMID:A database on dyspepsia. 830 69


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