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

In a prospective study the diagnostic value of biopsy and that of brush cytology in the diagnosis of gastric cancer were compared. The patients included in the study were endoscopied because of upper abdominal dyspepsia. When the endoscopic appearance of the mucosa suggested malignancy, and in all cases in which ulcerations were seen, brush cytological smear and at least five biopsies were obtained. The cytology and the biopsy specimens were assessed by two different pathologists in a mutual blind fashion. If the result of the examination suggested or showed the presence of cancer, it was considered positive. The results were evaluated by means of sequential analysis. When 195 examinations had been included in the study, disagreement had occurred in 8 cases, in all of which the biopsy was verified as correct. This difference is significant. In 187 cases the result of the 2 tests were in agreement, but in 3 cases the result of both tests were falsely negative. It was concluded that no diagnostic advantage was gained by the addition of brush cytology to endoscopic biopsy.
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PMID:Biopsy and brush cytology in the diagnosis of gastric cancer. 43 41

In order to assess the risk of gastric cancer (GC) developing in patients with pernicious anaemia (PA), the prevalence of PA was analysed in all patients with GC notified to the Danish Cancer Registry in 1972. Among 877 patients with GC, PA had previously been diagnosed in 19 (2.2%). In seven of these, PA had been diagnosed only shortly before GC. Accordingly, the diagnosis of PA could be regarded as unquestionable only in the remaining 12 cases (1.3%). In either case, the frequency of PA was significantly higher than in a reference group of patients with cancer of the colon who had been selected in the same way. Calculation of the incidence of GC in PA patients showed that this was about three times higher than in the general population. The annual risk of GC was calculated to be 0.3%. In PA patients, the tumour was primarily localized to the body and fundus of the stomach, whereas it mainly involved the antral and pyloric region in patients without PA. In view of the low cancer rate it is concluded that routine gastroscopy and barium meal examination are not indicated in PA patients in general. Whenever a patient with PA complains of dyspepsia, examinations with gastroscopy and barium meal should, however, be carried out on liberal indications.
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PMID:Pernicious anaemia as a risk factor in gastric cancer. 50 4

This paper describes the clinical presentation of 360 patients suffering from "dyspepsia" at the time of their initial visit to two hospitals in Yorkshire. Disease categories studied were cholecystitis, duodenal ulcer, gastric ulcer, gastric cancer, and "functional" dyspepsia, with at least 50 patients in each category. The findings of this series are contrasted with "textbook" descriptions of these conditions. Some contrasts are quite surprising-for example, most of the 360 patients claimed that their pain was not aggravated by food. It is suggested that one reason for diagnostic error in this area of medicine is that clinicians have a faulty mental "database" of information with regard to the presentation of the various diseases concerned.
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PMID:Clinical presentation of patients with "dyspepsia". Detailed symptomatic study of 360 patients. 62 1

This paper reports a comparison in Airedale District General Hospital between computer-aided diagnosis of dyspepsia and endoscopy in a prospective unselected series of 165 patients. Patients were interviewed immediately before endoscopy and the findings analysed by a small desk-top computer-aided system. Each 'new' patient was compared by the computer with a group of 360 similar patients from Leeds (25 miles away). Overall, 83% of the positive lesions found at endoscopy were correctly predicted by the computer, including all but three of the 22 cases of gastric cancer. It is suggested (1) that there is little loss of accuracy in transferring the computer-aided system from one locality to another; and (2) that a computer-aided analysis of the patient interview may be of value in selecting 'high-risk' patients for intensive investigation.
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PMID:Transfer of computer-aided diagnosis of dyspepsia from one geographical area to another. 78 85

Dyspepsia may result from over-indulgence in alcohol and food, or from anxiety and emotional problems. It may also indicate a peptic ulcer, oesophagitis or less commonly, gallstones or gastric cancer. Investigation by endoscopy or barium studies is always indicated when an organic lesion is suspected. Reassurance, tranquillizers and antispasmodics help patients with functional dyspepsia. Antacids given hourly between meals are important in the treatment of all symptomatic peptic ulcers. Cimetidine causes rapid symptomatic relief of duodenal ulcer symptoms, and most ulcers will heal with six weeks' therapy. Gastric ulcer can be treated with carbenoxolone, but this drug is avoided in the elderly and in patients with cardiac failure or hypertension. Anticholinergic drugs are of value in duodenal ulcer, especially for night pain, but they should not be used in patients over the age of 50. Special diets are of no value. For the heartburn of oesophagitis, weight reduction and a regime of regular antacid therapy remain the important measures.
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PMID:The treatment of dyspepsia. 92 13

Iceland (IS) and Denmark (DK) are ethnically, culturally, and economically closely related Nordic countries, but gastric cancer is much more frequent in Iceland, and other differences in the occurrence rates of gastric diseases are also suspected. Therefore a cooperative study was initiated comparing Icelandic and Danish patients with gastric ulcer (GU), duodenal ulcer (DU), and X-ray negative dyspepsia (XND) as regards clinical features, external factors of possible importance for gastritis and cancer, gastroscopic appearance, and histological gastric mucosal changes. The project lasted one year and comprised 93 Icelandic and 88 Danish patients. A large number of comparisons showed a high degree of similarity between Icelandic and Danish patients. Significant differences were found in tobacco consumption (DK greater than IS), duration of symptoms in XND (IS greater than DK), whereas the positon ratio of GU (IS less than DK) and acetylsalicylic acid consumption (DK greater than IS) showed non-significant trends. Significant difference was found between the occurrence of diffuse macroscopic changes of the gastric mucosa (IS greater than DK), which corresponds to the histological differences to be described in a subsequent article.
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PMID:A prospective comparative study of clinical and histological characteristics in Icelandic and Danish patients with gastric ulcer, duodenal ulcer, and X-ray negative dyspepsia. I. Design and clinical features. 92 8

197 consecutive, non-acute, medical patients who presented with upper abdominal pain were subjected to a standard programme of investigation. The investigation represents an attempt to supplement general clinical experience with exact data. In about half the patients no cause of the pain was found and a diagnosis of X-ray negative dyspepsia was made by elimination. It is concluded that a special research effort is needed to explain the complaint in this large group of patients. Duodenal ulcer was twice as common as gastric ulcer, and two patients suffered from gastric cancer. The diagnostic value of the symptomatology was analysed, but only the relation of pain to meals was found to be of diagnostic interest. In particular, the probability of duodenal ulcer was low and that of X-ray negative dyspepsia high, if the pain was provoked by eating. The age, sex, and acid production also had diagnostic value.
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PMID:A diagnostic study of patients with upper abdominal pain. 120 11

This review presents a critical evaluation of the role of Helicobacter pylori eradication in the management of peptic ulcer disease and non-ulcer dyspepsia. On current evidence, H. pylori eradication therapy seems likely to emerge as the most rational and cost-effective treatment for duodenal ulcer. The role of H. pylori eradication in the treatment of gastric ulcer and non-ulcer dyspepsia is unclear and requires further study. The emerging problem of antibiotic resistance in H. pylori is of major clinical importance and a prime cause of treatment failure. There is increasing evidence of a link between H. pylori and gastric cancer but it is premature to recommend large-scale eradication of H. pylori as a valid strategy for the primary prevention of gastric cancer. The search continues for the ideal H. pylori eradication regimen.
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PMID:Eradication of Helicobacter pylori: therapies and clinical implications. 143 52

20 H. pylori-positive patients with gastric or duodenal ulcer disease (n = 16, one with proof of gastric cancer obtained by histology) or severe non-ulcer dyspepsia (n = 4) were entered in a pilot study to examine the effect of a combination of omeprazole (40 mg) before breakfast and ciprofloxacin (2 x 500 mg) 1 hour after meals for 1 week to treat Helicobacter pylori (Hp). The eradication rate was 15% (3 out of 20 patients) 4 weeks after therapy. Ulcer healing occurred in 2 of 3 patients having eradication and 9 of 11 control patients with positive H. pylori urease test and/or culture 4 weeks after treatment. Despite some good theoretical background, this drug combination is inefficient to eradicate H. pylori and cannot be recommended for routine clinical practice. No major side effects of the therapy-regimen were observed.
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PMID:[Ciprofloxacin-omeprazole combination therapy for eradication of Helicobacter pylori]. 186 70

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


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