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

The significance of the human immunodeficiency virus (HIV) in the small intestinal lamina propria in patients with the acquired immune deficiency syndrome or conditions related to that syndrome who have chronic diarrhea and malabsorption is unclear. To investigate this issue, upper endoscopy (after a 12- to 16-hour fast) with duodenal biopsy and aspirate was performed in 20 HIV-infected seropositive homosexual men referred for diarrhea of more than 8 weeks duration (Group 2) and in 9 HIV-infected homosexual men referred for dysphagia or dyspepsia with no symptoms of malabsorption (Group 1). All biopsy specimens were examined by light microscopy and immunochemical staining with monoclonal antibody against HIV glycoprotein gp41. Electron microscopy was performed in 18 patients in Group 2 and in all patients in Group 1. Immunogold electron microscopy was used as a confirmatory test for identified HIV particles. In addition, D-xylose absorption was measured in all patients after a 25-g dose of D-xylose with measurement of serum D-xylose concentration 1 hour after the dose and measurement of 5-hour urinary D-xylose excretion. Mean serum D-xylose was 35.4 +/- 4.5 mg/dL in Group 1 and 15.8 +/- 2.3 mg/dL in Group 2 (P less than 0.001), whereas mean urine D-xylose was 5.5 +/- 0.6 g in Group 1 and 2.0 +/- 0.4 g in Group 2 (P less than 0.001). Immunoperoxidase for gp41 was positive in 5 (56%) patients in Group 1 and in 12 (60%) patients in Group 2. Lamina propria HIV viral particles were identified by electron microscopy in both patient groups. Viral particles were seen within and adjacent to the cytoplasm of mononuclear cells and were not present in enterocytes or neuroendocrine cells. There were no significant differences in serum or urine D-xylose tests between patients with and without lamina propria HIV. In addition, lipid accumulation in intercellular spaces near the basolateral membrane of adjacent enterocytes was seen in 33% of patients with chronic diarrhea. These findings suggest that lamina propria HIV is not a direct cause of enteropathy in HIV-infected patients and that lymphatic obstruction may be one pathophysiologic mechanism producing this malabsorptive state.
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PMID:Histopathologic findings of duodenal biopsy specimens in HIV-infected patients with and without diarrhea and malabsorption. 141 28

Diseases presenting with dyspepsia fall into two general categories: organic and functional. Overall, most patients with dyspepsia have no underlying identifiable disease process. The diagnostic yield of organic causes is less in younger patients, and, conversely, serious organic lesions are common in elderly dyspeptic patients. The commonest organic causes of dyspepsia are peptic ulcer disease, gastroesophageal reflux, biliary tract disease, and gastric cancer. Symptoms and physical signs may help to differentiate these organic causes from functional dyspepsia but endoscopic or radiographic/ultrasound studies are usually necessary to ensure the appropriate diagnosis. Less common organic causes of dyspepsia not to be overlooked include drugs, pancreatitis, malabsorption syndromes, metabolic disorders, ischemic heart disease, and collagen vascular disorders.
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PMID:Dyspepsia: organic causes and differential characteristics from functional dyspepsia. 189 24

Gastrointestinal bloating is a common complaint met within the general practitioner's office. The most important cause of this symptom is an increase in the volume of gas in the gastrointestinal tract. Differential diagnoses include aerophagia, ingestion of gas-producing foods, gastric hypersecretion, bacterial overgrowth in the small intestine, disordered gastrointestinal transit, malabsorption or maldigestion of carbohydrates. In addition, nonulcer dyspepsia and the irritable bowel syndrome must be excluded. The diagnosis is based on a history of eructation, heart burn, flatulence and diarrhea, dietary habits, physical examination, laboratory analysis and apparative diagnostic measures. Therapy depends on the underlying cause of the disease.
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PMID:[Meteorism]. 191 70

The total gastrectomy, as known can expose to some sequences which form on a pathophysiologic and clinic plain syndrome of "AGASTRIC". The most paradigmatic of these disturbances are the weight loss, the pain, the dyspepsia, the anorexia, can be erroneously interpreted as a recurrence of the neoplasm illness. On the base of these disturbances, there are some pathophysiological alterations associated to the resection. The postprandial distension syndrome, the dumping, the diarrhea, the anemia, can be relieved by an appropriated hygienic-diet therapy. The reflux of biliopancreatic secretion into the esophagus, the disturbances related to the duodenal exclusion, the accelerated transit can be loosed or reduced by a correct technic, while the cloridopeptic deficiency is obviously unresolvable. From 1981 till 1988, 43 patients were submitted to a total gastrectomy for adenocarcinoma (29 M, 14 F), having a middle age of 62 years: 30 with a radical intent (Ro), and 13 palliative. Besides 10 of the Ro group were submitted to a enlarged intervention. The digestive continuity was renewed through an interposition of isoperistaltic jejunal loop according Mouchet-Camey in 23 cases, by use of a dysfunctional loop according Roux en-Y in 5, and by esophagus-jejunal T-L anastomosis such omega, according Horloff in 2 cases. There were registered one decrease for A.R.D.S. All the patients were been followed according the follow-up protocol, for monitoring neoplasm evolution of the illness and the eventual metabolic-functional disturbances. In the periodic postoperative control all the patients with Mouchet-Camey reconstruction had no evidenced dumping syndrome, neither cases of malabsorption of the essential nutritive principles, with constant recover of the weight.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Digestive continuity, after total gastrectomy for cancer, via the interposition of a jejunal loop]. 208 78

Individuals with chronic renal failure (CRF) may have a variety of gastrointestinal (GI) problems, including dyspepsia, acid peptic disease, and bacterial overgrowth. We investigated gastrointestinal function in 11 uremic patients, seven of whom were on dialysis three times a week and four who were not on dialysis. Ten normal subjects were studied as controls. The nutritional status of the patients did not differ from that of the control subjects. Seven patients demonstrated abnormal GI endoscopic findings, although none was severe; they also had prolonged oral-cecal transit times but had no evidence of bacterial overgrowth, and all had normal numbers of lymphocyte subpopulations within the intestinal mucosa. The patients had significantly reduced activities of mucosal sucrase and maltase but not of lactase. In spite of the reductions in these enzymatic activities, carbohydrate malabsorption was not evident in the CRF group, probably because of the vast reserve of the small intestine. No differences were noted between the groups in the activities of several intestinal peptidases. From these data, we concluded that GI function is essentially normal in patients with CRF and postulate that this normality, which is in contrast to previous findings, is related to recent advances in the clinical management of uremic patients.
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PMID:Gastrointestinal function, morphology, and immune status in uremia. 213 74

Vitamin B12 deficiency develops over a slowly progressive continuum. Early manifestations may be generalized weakness or fatigue, indigestion, diarrhea, or depression. Pernicious anemia is considered the classic cause, but others include malabsorption because of achlorhydria or other gastric dysfunction, fish tapeworm infection, and strict vegetarianism. Iron deficiency often coexists. Because presentation is often atypical, vitamin B12 deficiency is a diagnostic consideration whenever neuropsychiatric signs or symptoms are unexplained.
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PMID:Vitamin B12 deficiency. Important new concepts in recognition. 220 95

Multiple biopsies from the lower duodenum were obtained during endoscopy of 171 patients with dyspepsia, diarrhoea and/or suspected malabsorption. Histological evidence of lambliasis was obtained in six (3.5%). Antibiotic treatment with metronidazole, 250 mg two or three times daily for seven to 11 days (which had to be repeated in two cases), improved symptoms in four. In most of the patients "functional upper-abdominal symptoms" had been diagnosed after extensive examinations. In case of unclear upper-abdominal symptoms, chronic or chronic-recurrent diarrhoea and/or malabsorption lambliasis should be considered and histological examination of the duodenal mucosa undertaken.
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PMID:[Lambliasis: a cause of malabsorption and diarrhea?]. 272 87

The prevalence of pancreatic diseases as the cause for dyspepsia differs in clinical materials between 0 and 25-30%. In parallel, the incidence rate of chronic pancreatitis varies between 0.7 and 10 per 100,000 inhabitants per year. The correct figures are unsettled. The main reason for the great variability in figures for frequency of chronic pancreatitis is probably the different clinical awareness and variable practice for performing morphological and functional studies of the pancreas in patients with dyspepsia. Epidemiologic data indicate, but do not prove, an increasing frequency of chronic pancreatitis at least valid for the alcoholic chronic pancreatitis. Pancreatic function and pancreatic disease are probably connected to different gastro-intestinal diseases (duodenal ulcer, inflammatory bowel diseases, malabsorption syndromes, subtotal and total gastrectomy and to some extent in patients with hepatobiliary diseases). The prevalence of chronic pancreatitis can be calculated to around 70 per 100,000 inhabitants in the Western world. Around one-third of these present with exocrine pancreatic insufficiency. The demand for enzyme substitution based on marked exocrine pancreatic insufficiency in patients with chronic pancreatitis, pancreatic cancer and mucoviscidosis can be calculated to approximately 150 patients per 1 million inhabitants. The question concerning the analgetic effect of pancreatic enzyme substitution is still unsettled.
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PMID:Exocrine pancreatic function in dyspepsia. 349 32

Thirty-one children with sucrose malabsorption are reported. All had a flat blood sugar curve after sucrose ingestion but a normal one after monosaccharides. Seventy-five percent were malnourished and 11 were dehydrated at admission to hospital. Seven had to have intravenous rehydration. After institution of a sucrose-free diet, the symptoms disappeared and the patients gained weight. Eighteen had had symptoms for greater than 1 year, 13 for greater than 2 years, and 7 for greater than 5 years before their cause was discovered. Familial occurrence of sucrose malabsorption was shown in three to five cases. Four children were reinvestigated 7-15 years after diagnosis. All had chronic dyspepsia, and none kept a strictly sucrose-free diet. Three of the four patients were underweight for their age by from 5 to 16 kg, whereas the fourth was as underweight as compared to height. It is concluded that the high incidence of sucrose malabsorption found in Greenland together with the high sucrose consumption might be of nutritional hygienic significance for the population.
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PMID:Sucrose malabsorption in children: a report of thirty-one Greenlanders. 406 74

An investigation of 102 men comprising alcoholics, patients with non-ulcer dyspepsia, and healthy controls is reported. It demonstrates that alcohol is a cause of chronic gastritis and the severity of the mucosal lesion is directly related to the duration of excess drinking. Contrary to popular belief, chronic gastritis does not give rise to symptoms. The effect of alcohol on the gastric mucosa is a direct one and is not mediated by malnutrition, hepatic damage, intestinal malabsorption, anaemia, ascorbic acid deficiency, or any disturbance in immune tolerance. The natural history of chronic gastritis is described, involving an initial hypertrophy and hyperfunction of the gastric mucosa, followed by atrophy and hypofunction. Cigarette smoking is confirmed as another cause of chronic gastritis. The non-ulcer dyspepsia syndrome is unrelated to chronic gastritis.
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PMID:Chronic gastritis, alcohol, and non-ulcer dyspepsia. 508 67


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