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

The variation in the healing and the relapse rates of peptic ulcer disease has led to the search for other factors in the pathogensis of peptic ulcer disease. Helicobacter pylori is believed to be responsible for these different patterns of healing. The results of a study to detect Helicobacter pylori in Sri Lankan patients having duodenal ulcer, gastric ulcer, gastritis and non-ulcer dyspepsia are presented in this paper. The method employed was the urease test which detects the urease enzyme of H. pylori in gastric mucosal biopsies taken during upper gastrointestinal endoscopy. There is a high incidence in those with gastritis and duodenitis.
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PMID:Helicobacter pylori and peptic ulcer disease in Sri Lanka. 158 90

We have performed a retrospective study of 103 patients with either peptic ulcer or non-ulcer dyspepsia, infected with metronidazole-sensitive strains of Helicobacter pylori (H. pylori), who were treated with a combination of tripotassium dicitrato bismuthate and metronidazole for a period of at least two weeks. Dual therapy with tripotassium dicitrato bismuthate plus metronidazole showed similarly high eradication rates (greater than or equal to 80%) of H. pylori from patients irrespective of age, gender or clinical diagnosis. Most importantly, dual therapy achieved a similar eradication rate of H. pylori infection in 41 patients who had previously been treated with tripotassium dicitrato bismuthate alone or in combination with an antibiotic other than metronidazole. It therefore appears that H. pylori does not become resistant to treatment with tripotassium dicitrato bismuthate.
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PMID:Does a previous course of tripotassium dicitrato bismuthate affect the subsequent chances of successful Helicobacter pylori eradication? 160 49

Pain site and radiation and the effect of various foods were studied prospectively in a consecutive series of patients with chronic upper abdominal pain. Patients followed for less than one year were excluded unless peptic ulcer or abdominal malignancy had been diagnosed or laparotomy had been carried out. A total of 632 patients were eligible for the first study and 431 for the second. Gastric ulcer pain was more likely to be left hypochondrial (17%) compared with pain from duodenal ulcer (4%) or from all other conditions (5%). It was less likely to be epigastric (54%) compared with duodenal ulcer pain (75%). Oesophageal pain was more likely to be both retrosternal and epigastric (25%) compared with non-oesophageal pain (2%). Radiation to the back was more common in peptic ulcer (31%) and biliary pain (35%) compared with functional pain (20%). Pain precipitation by fatty foods was commoner in biliary disease (40%) than in duodenal ulcer (11%), peptic ulcer (9%), or non-ulcer dyspepsia (19%). Orange, alcohol, and coffee precipitated pain more frequently in duodenal ulcer (41%, 50%, and 43% respectively) than in biliary disease (17%, 0%, and 14% respectively). Chilli precipitated pain in one quarter to one half of subjects regardless of diagnosis. Approximately one tenth of all subjects avoided chilli, curry, coffee, and tea because of medical or other advice.
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PMID:Chronic upper abdominal pain: site and radiation in various structural and functional disorders and the effect of various foods. 162 52

Owing to limited endoscopy resources, various screening strategies for endoscopy have been proposed. Helicobacter pylori can be detected with high sensitivity and specificity by serology, and therefore we assessed the effects on diagnostic accuracy and endoscopic workload of a policy of screening clinic patients with dyspepsia before endoscopy by a strategy based on age, Helicobacter pylori serology, and use of non-steroidal anti-inflammatory drugs. 1153 patients were studied, of whom 842 were of known histological H pylori status (histology group) and 293 had serum assessed prospectively by in-house and commercial ELISAs for detection of IgG antibodies to H pylori. Overall, the screening strategy would have reduced endoscopy workload by 23.3% (95% confidence interval 20.9-25.8%) and would have had a sensitivity for detection of peptic ulcer of 97.4% (94.5-99.1%). No peptic ulcer or malignant disease was missed in the patients studied prospectively, but 6 of 192 peptic ulcers in the histology group would have been missed. A policy of screening young dyspeptic patients for H pylori by serology is more sensitive than symptom-based screening strategies, and may have an important role in reducing endoscopy workload.
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PMID:Screening dyspepsia by serology to Helicobacter pylori. 168 95

We present the results of ultrastructural studies of gastric mucosa obtained through upper digestive endoscopy of eight patients with suspicious symptoms of non ulcer dyspepsia or peptic ulcer. Two were male and six female with a median age of 54 years. The urease test to determine the presence of HP and Hematoxylin-Eosin and Warthin-Starry staining techniques were practiced with the purpose of a better detection of bacteria and gastritis. We did not find any correlation between the endoscopic results and the presence of gastritis or HP. Of the 8 patients only one had negative results for HP and for Electron microscopy studies. Chronic active gastritis was seen with light microscopy in all of the cases. Three in this group presented mild focal dysplasia and one case intestinal metaplasia type IIa. The main ultrastructural findings were: a) diminished or absent microvilli underneath the bacteria; b) HP inside phagolysosomes in the cytoplasm of the epithelial cells; c) in some cases, the bacteria was attached to the cell membrane; d) the cellular wall of HP contains mucopolysaccharides and up to four polar flagella; e) there are polymorphonuclear leucocytes in the epithelium. We conclude that Electron Microscopy is not a routine method for studying HP, but it constitutes a good method to study pathogenicity of the bacteria.
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PMID:[Ultrastructural study of the antral mucosa to determine the presence of Helicobacter pylori and its association with chronic active gastritis]. 172 15

This study was carried out to determine the prevalence of antibodies to Helicobacter pylori in northern Nigeria, a region with a low incidence of peptic ulceration. In a random, serological survey of 268 subjects, 228 (85%) of the population studied had IgG antibodies to H. pylori. Fifty-eight of these subjects had experienced dyspepsia in the preceding 6 months. The majority of the population (82%) is infected between the ages of 5 and 10. Despite the high prevalence of antibodies to H. pylori, peptic ulcer is uncommon, suggesting that H. pylori is not important in the etiology of peptic ulcer in this population. Indeed, most patients infected by H. pylori are asymptomatic. The possible reasons for this are discussed.
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PMID:H. pylori, the most common bacterial infection in Africa: a random serological study. 172 21

The aim of this study was to evaluate the long-term prognosis for patients suffering from gastritis associated with Helicobacter pylori infection, and in particular the proportion of cases progressing to peptic ulcer. The study was carried out in one urban general practice. One hundred and three patients who had presented with dyspepsia over the 1973-80 period and who were found to have a macroscopically normal endoscopy were reassessed between seven and 14 years later. Gastric antral biopsies had been taken routinely at endoscopy and were subsequently re-examined for the presence of H pylori. The patients' medical records were examined to establish their consulting rates over the follow-up period and whether they suffered from any other medical conditions. Patients were interviewed to assess the course of their dyspeptic symptoms. Comparison of patients who were unequivocally H pylori positive with those who were negative revealed no significant differences in the consultation rate for gastroenterological symptoms, in the proportion of patients referred to a hospital consultant or for further gastroenterological investigations or in the proportion reporting that their symptoms had improved. However, a statistically highly significant relationship was found between H pylori infection and hypertension. The results of this study have shown that there is a good prognosis for non-ulcer dyspepsia whether or not H pylori infection is present. The association between H pylori gastritis and hypertension clearly merits further investigation.
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PMID:Long-term follow up of patients with gastritis associated with Helicobacter pylori infection. 174 67

The characteristics of peptic ulcer and non-ulcer dyspepsia in young men were studied in 202 consecutive conscripts who attended Central Military Hospital in Helsinki because of long-standing upper abdominal complaints. Active peptic ulceration (APU) was found in 48 patients, inactive peptic ulcer disease (IPU) was diagnosed in 77 patients, non-ulcer dyspepsia (NUD) was diagnosed in 52 patients. In 25 cases the reason for symptoms was another disease, and these patients were excluded from the study. A control series (CON) consisted of 30 symptomless healthy young male volunteers. The likelihood of discriminating between peptic ulcer disease and non-ulcer dyspepsia in a young male patient with dyspepsia are indicated by odds ratios (OR) and its 95% confidence limits (CL 95). Active peptic ulcer disease differs from NUD, e.g., by 1) presence of antrum gastritis, OR 41.5 (CL 95: 10.1-171), 2) Helicobacter pylori in the gastric mucosa, OR 31.0 (7.4-130), 3) Lewisa+ phenotype, OR 8.9 (1.7-45.4), 4) serum pepsinogen I (S-PGI) greater than 100 micrograms/l, OR 4.6 (1.7-12.4), 5) non-secretor status, OR 4.3 (1.6-11.6), and 6) O-blood group, OR 3.0 (1.2-7.7). In conclusion, the status of gastroduodenal mucosa, gastric secretion pattern and distribution of some genetic markers in patient series indicate that young onset peptic ulcer and non-ulcer dyspepsia are two separate entities. Helicobacter-positive antrum gastritis is the best determinant of ulcer risk, but also high S-PGI, Lewisa+ phenotype, non-secretor status and O-blood group are signs of increased risk of peptic ulcer.
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PMID:Young onset peptic ulcer disease and non-ulcer dyspepsia are separate entities. 175 26

The association of chronic obstructive pulmonary disease (COPD) with esophageal-gastric and duodenal disease is very common. In our experience 21.8% of patients with COPD were affected by peptic ulcer and 50.9% by inflammatory disease of upper digestive tract. This association appears independent from smoking and alcohol abuse. Dyspepsia and corticosteroid therapy were associated with endoscopic lesions (dyspepsia was present in 75.6% of patients with abnormal endoscopy vs 42.8% without endoscopic lesions, p less than 0.01 and corticosteroid therapy in 43.9% vs 0, p less than 0.001). On the contrary therapy with theophylline and beta 2-adrenoceptor-agonists is not associated with digestive disease. Spirometric parameters and blood gas analysis were not different among patients with and without endoscopic lesions. We suggest endoscopy of upper digestive tract in patients affected by COPD with dyspepsia and/or corticosteroid therapy.
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PMID:[Association of chronic obstructive bronchitis and upper digestive pathology. A clinical study]. 176 30

The purpose of the communication is to review the different aspects of the Helicobacter (Campylobacter) pylori infection. The first part of the communication is devoted to the description of the different gastric pathologies induced by the Helicobacter pylori infection and to the different methods used for the detection of this infection. Today a consensus assesses a causal role to Helicobacter pylori in the development of chronic active gastritis (or type B gastritis), in the pathogenesis of duodenal ulcer, and a major contributing factor in the development of peptic ulcer disease. The possible role played by this bacterium in the development of non-ulcer dyspepsia is still unclear. H. pylori infections can be detected using different methods including invasive methods--requiring an endoscopy (e.g.: culture of the micro-organism, urease test, microscopy) and non-invasive methods (e.g.: breath test, serology). Each of these methods has advantages but also some disadvantages, and none shows an absolute sensitivity and specificity. The second part of the presentation analyses the results obtained with a serologic method using a specific fractioned and purified antigenic complex extracted from Helicobacter pylori. This report demonstrates a good correlation with the other detection methods. Serology appears also as a useful tool for the therapeutical monitoring of infected patients. Serological results must however be interpreted in the light of the complete clinical examination of the patient.
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PMID:[The role of serology in the diagnosis of Helicobacter (Campylobacter) pylori infection]. 180 38


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