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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

Pepsin 1, the ulcer-associated pepsin, occurred significantly more frequently in the gastric juice of those patients with duodenal ulcer who did not secrete A, B, or H antigens into gastric juice than in those secreting these antigens. This observation may explain the increased proportion of such non-secretors among patients with duodenal ulceration. In patients with gastric ulcer and non-ulcer dyspepsia, and in a miscellaneous group of patients, there was no association of pepsin 1 secretion with secretor status, suggesting that the association noted in duodenal ulceration is an indirect rather than a direct one. No increase of pepsin 1 occurred in group O patients with peptic ulcer, so that the increased proportion of such patients in peptic ulcer does not arise from differences in pepsin 1 secretion.
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PMID:Hereditary aspects of duodenal ulceration: pepsin 1 secretion in relation to ABO blood groups and ABH secretor status. 11 57

Tests of gastric secretion are seldom diagnostic in the investigation of gastric and duodenal ulceration, but they can provide evidence that is helpful in arriving at a diagnosis. Common tests include basal acid output, pentagastrin-stimulated maximal and peak acid output, and the Hollander test. There is some evidence that they may be useful in selecting the type of operation for peptic ulceration. Indications for performing these tests relate to the Zollinger-Ellison syndrome, duodenal ulcer, recurrent dyspepsia after operation for duodenal ulcer, and decisions concerning the choice of operation for peptic ulcer. In order to perform these functions they must be properly conducted and interpreted; they are simply an adjunct to clinical judgement, and complementary to other laboratory tests.
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PMID:Clinical usefulness of gastric acidity studies. 16 33

Fifty-four patients on haemodialysis for chronic renal failure underwent renal transplantation. Basal and maximum acid output and the incidence of peptic ulcer before transplantation were not significantly different from those of controls. But after renal transplantation the incidence of symptoms of peptic ulcer was high (22%) and four out of six patients who developed gastrointestinal bleeding died from this complication. In men peak acid output was significantly increased after renal transplantation and was associated with a 30% incidence of symptoms of peptic ulcer compared with 10% in women, who showed no significant change in mean basal or peak acid output. Peptic ulceration after transplantation was not associated with steroid dosage, hyperparathyroidism, or the height of blood urea concentrations. Given criteria of a history of dyspepsia, abnormal barium meal findings, or gastric hypersecretion, it was not possible to identify patients at risk from peptic ulceration or life-threatening complications after renal transplantation. Thus the routine screening of these patients for peptic ulcer has no practical value, and the incidence of fatal complications is not high enough to justify routine prophylactic anti-ulcer surgery aimed at reducing acid secretion before renal transplantation.
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PMID:Peptic ulceration, gastric secretion, and renal transplantation. 32 38

Many questions regarding duodenitis remain unanswered. However, the evidence suggests that duodenitis is a clinical entity which can give rise to dyspepsia and, on rare occasions, gastrointestinal haemorrhage. Conventional and double contrast radiology has only a small part to play in the diagnosis of duodenitis but is important in helping to exclude other lesions such as duodenal ulcer. Provided care is taken during the fibre-optic visualization of the duodenal bulb, the endoscopic appearances of moderately severe duodenitis correlate well with the histological changes seen. A diagnosis of apparent duodenitis should be confirmed by the histological criteria described. Treatment at present is similar to that of peptic ulcer, with the withdrawal of any predisposing and precipitating factors such as aspirin, alcohol and smoking. Antacids may relieve the symptoms. It is not yet known what effect these measures may have on the duodenitis as opposed to the symptoms of dyspepsia. The H2-receptor antagonist, cimetidine, should be effective in treating duodenitis but double blind clinical and endoscopic studies are required to confirm this. The place of surgery is as yet undefined. With the data at present available, it appears that duodenitis is part of the pathophysiological spectrum of the duodenal ulcer diathesis rather than a separate disease. It may represent both the production and healing phases of duodenal ulceration. In some patients the duodenal mucosa may proceed from normal to duodenitis and then to normal again without the development of frank duodenal ulceration (Figure 4). Prospective studies are required which should include a long-term clinical follow-up of a large number of patients with duodenitis accurately and specifically diagnosed by endoscopy and histopathology.
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PMID:Duodenitis. 36 6

73 patients with definite active rheumatoid arthritis were treated with naproxen, 250 mg b.i.d. One month after the start of therapy the patients were examined as to following parameters: spontaneous pain and pain on movement, duration of morning stiffness, fatigue, grip strength, functional joint index, ESR and consumption of analgesics. On statistical analysis a significant improvement of all the parameters, with the exception of ESR was shown, 52 of the 73 patients were very satisfied resp. satisfied with the treatment, whereas the physician evaluated the therapeutic results as very good to good in 49 of the cases. In 50 of the patients the therapy with naproxen, 250 mg b.i.d., was continued for two more months. In most of these cases it was possible to achieve an additional improvement in the parameters evaluated. Unwanted side effects occurred in 7 patients, of which in 4 the treatment had to be discontinued (in two cases because of dyspepsia and once each because of an angioneurotic edema and a recurrence of a peptic ulcer, respectively). The three patients in whose cases therapy was continued suffered from mild gastrointestinal disturbances.
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PMID:[Treatment of progressive chronic polyarthritis with a non-steroidal antirheumatic agent with a long half-life]. 44 68

The main point for a surgeon treating a perforated peptic ulcer is to choose between a simple treatment of the complication and a treatment both of complication and ulcer disease. So, the A. have analysed their series of 58 patients with perforated peptic ulcer: one patient underwent nasogastric suction as suggested by Taylor, 16 patients underwent suture plication of the perforation, 41 underwent immediate gastrectomy. A fully follow-up was performed: in the suture-plication group only 28.5% was symptonfree, the remaining 71.5% had recurrent dyspepsia or underwent definitive gastrectomy. Follow-up results of the immediate gastrectomy patients and elective gastrectomy patients are the same. The A. discuss the different procedures of treatment and their specific indications. Surgical treatment is the selected one and simple suture and immediate gastrectomy are not opposite.
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PMID:[The choice of operation in perforated gastroduodenal ulcer]. 50 43

Eighteen patients with dyspepsia and vomiting which followed surgery for peptic ulcer have completed a study to examine the role of diverting bile from the stomach by a Roux-en-Y procedure. Bile regurgitation and mild epigastric pain relieved by vomiting were abolished. Measurements of bile acids in the fasting gastric aspirate were useful in predicting the outcome of surgery; good results were obtained when initially there was reflex into the stomach of more than 120 mumol/hour of bile acids. A wider group of patients than those selected in previous series may benefit from this operation, as good results can be obtained in patients with dyspepsia relieved by alkali and without achlorhydria or gastritis. Endoscopy was repeated one year after Roux-en-Y operation. Erythema of the mucosa was improved, but gastritis did not improve.
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PMID:Selection of patients for bile diversion surgery: use of bile acid measurement in fasting gastric aspirates. 63 35

One hundred and eighteen patients with dyspepsia after peptic ulcer surgery were assessed by a double contrast barium meal and fibre-optic endoscopy, for the possibility of recurrent ulceration. There was overall endoscopic-radiological agreement in 89%. It is concluded that the two techniques are complementary and that a double contrast barium meal performed and interpreted by an experienced radiologist can demonstrate the presence or absence of a recurrent peptic ulcer with an acceptable degree of accuracy.
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PMID:Endoscopic and radiological assessment of recurrent ulceration after peptic ulcer surgery. 64 80

To assess the diagnostic accuracy of a computer-aided-diagnosis system when implemented in different parts of the world, an automated system, which had established its reliability in Leeds, England, was transferred to Sherbrooke, Quebec. In this preliminary study two retrospective series, comprising 104 patients with acute abdominal pain and 101 patients with dyspepsia, were drawn from the files of the Centre Hospitalier Universitaire in Sherbrooke. The history and physical-examination sheet was analyzed, coded and tested against the Leeds data base on a WANG 2200 computer, and the results were compared with the final Sherbrooke pathologic diagnosis. Overall the computer made a correct diagnosis in 78.8% of cases of acute abdominal pain and 70% of cases of dyspepsia. Computer diagnoses of appendicitis were correct in 97% of cases and the system recognized 91% of the actual appendicitis cases. Similar figures for cholecystitis were 91% and for peptic ulcer, 87%. However, the "pick-up" rate by the computer of pancreatitis was only 25%. It is concluded that geographical differences in disease presentation will probably not impair the validity of the computer method used in this study. A comparison of various diagnostic methods and levels of competence will await a prospective trial of this method.
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PMID:Computer-aided diagnosis of gastroenterologic diseases in Sherbrooke: preliminary report. 76 27


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