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

This study reports the findings on endoscopy and the final diagnoses of 172 consecutive patients with dyspepsia from a primary health care center. The purpose of our study was to carry out a thorough gastroenterologic investigation of all patients consulting their general practitioner and reporting dyspepsia during 1 full year, from a population within a defined geographic area. The examinations included patient history, physical examination, laboratory tests, esophagogastroduodenoscopy (EGD), and sigmoidoscopy. All the examinations, including the EGDs, were done at the primary care center. A final diagnosis was settled after a minimum of 6 months. Six per cent had esophagitis, 13% had peptic ulcer disease, 1% had gastric cancer, and 1% had irritable bowel disease. Completely normal endoscopies were seen in 19%. No patient had villous atrophy. Sixty-four per cent had non-ulcer dyspepsia, and 26% had inflammatory bowel syndrome, with great overlapping. It is concluded that open-access endoscopy is a valuable service to primary care, the result of which greatly enhances the diagnostic accuracy in dyspeptic patients entering primary care.
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PMID:Endoscopic findings and diagnoses in unselected dyspeptic patients at a primary health care center. 292 29

There is an explosion of interest in the role of Campylobacter pylori as a cause of active chronic gastritis. This curved spiraled microorganism can readily be detected within the mucus gel covering the stomach mucosa, especially in patients suffering from peptic ulcer disease or non-ulcer dyspepsia. To what extent this intriguing microorganism is causally related to peptic ulcer disease remains to be elucidated, but all the evidence which is available so far supports a pathogenetically important role. There appears to be a striking discordance between in-vitro sensitivity and in-vivo efficacy of antibiotic therapy. At present, the combination of colloidal bismuth subcitrate and amoxycillin or tinidazole appears most effective in temporary elimination of these microorganisms.
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PMID:Significance of Campylobacter pylori. 297 1

Two-hundred and fifty-two patients waiting for a total hip replacement for degenerative hip disease were randomized to two groups of nonsteroidal anti-inflammatory medication using piroxicam, 20 mg per day, and naproxen, 750 mg per day, after exclusion for severe dyspepsia or peptic ulcer, asthma, idiosyncracy, dissent, age below 50 years, Harris hip score above 50, or significant contralateral disease. A significant improvement in the pain and daily activity parameters was obtained in both groups. The effect was better in the piroxicam group one month after the commencement of the treatment, and equal in the groups later during the observation period of 2-5 months. We conclude that continuous medication is beneficial in patients with severe osteoarthritis scheduled for operation. However, the side effects of the medication have to be carefully considered and followed up.
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PMID:Piroxicam and naproxen in patients with osteoarthritis of the hip waiting for total hip replacement. 304 26

The healing properties of colloidal bismuth subcitrate (CBS) on peptic ulcer are well established and several studies have shown that healing with CBS is associated with a lower relapse rate than that produced by H2-receptor antagonists. The recent observation that CBS is effective against Campylobacter pylori has shed light on this because recent studies have shown that eradication of C. pylori by CBS leads to resolution of the associated gastritis and this may explain the low relapse rates. CBS is also effective in C. pylori positive patients with non ulcer dyspepsia (NUD) in whom clearance of these organisms from the stomach is associated with significant improvement of the associated gastritis and symptoms.
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PMID:Bismuth: effects on gastritis and peptic ulcer. 304 53

The M1-selective antimuscarinic drugs pirenzepine and telenzepine moderately reduce gastric acid secretion without inhibiting smooth-muscle activity as much as nonselective antimuscarinics, e.g. atropine and 1-hyoscyamine. They hasten peptic ulcer healing and improve the symptoms of reflux oesophagitis. In combination with H2 receptor antagonists they abolish gastric acid secretion almost completely and can therefore be used in high-risk peptic conditions. Long-term trials have to show whether they can form a medical alternative to parietal cell vagotomy. The effect of M1-selective antimuscarinics on 'nonulcer dyspepsia' is equivocal, but they may possibly be useful in the treatment of spastic constipation.
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PMID:Clinical significance of M1 receptor antagonists. 307 May 80

Worldwide Campylobacter pylori is a major cause of active chronic gastritis in man. This curved spiraled microorganism can readily be detected within the mucusgel especially in the antrum, in particular in patients suffering from peptic ulcer disease or non-ulcer dyspepsia, rarely in individuals with normal gastroduodenal mucosa. Increasingly arguments are being presented in support of a pathogenetic role of C. pylori in non-ulcer dyspepsia and in peptic ulcer disease. There is a striking discordance between in vitro antibiotic sensitivity, and in vivo efficacy with respect to suppression or eradication of the organism. At present the combination of colloidal bismuth subcitrate and amoxicilline or tinidazole appears to be encouraging with respect to longterm eradication of this peculiar microorganism. Eradication by antibacterial treatment ultimately may result in histologic normalization of the gastric mucosa. To what extent peptic ulcer disease. There is a striking discordance between in vitro antibiotic sensitivity, and in.
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PMID:Campylobacter pylori. 307 66

An active 80-year-old woman without a history of peptic ulcer disease, recent nonsteroidal anti-inflammatory drug use, or smoking developed severe, symptomatic epigastric pain initially diagnosed as nonulcer dyspepsia secondary to esophagitis. Initial treatment consisted of 12 weeks of full-dose H2-receptor antagonist therapy. During this therapy the patient developed multiple gastric ulcers confirmed by endoscopy, and continued to have significant dyspeptic symptoms. An additional 16 weeks of combination therapy with ranitidine and sucralfate failed to ameliorate upper gastrointestinal symptoms, and there was significant increase in gastric ulcer size. Repeated ulcer biopsies showed no malignancy. Prior to scheduling elective gastric ulcer surgery, a trial of oral prostaglandin E1 analogue therapy was initiated with an investigational agent. Within the first three weeks of therapy, there was significant symptomatic improvement. Endoscopy of the upper gastrointestinal tract at 12 weeks revealed complete ulcer healing. This case report suggests that prostaglandin E1 analogue therapy should be considered as an alternative to elective gastric ulcer surgery for patients with refractory gastric ulcer.
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PMID:Prostaglandin E1 analogue therapy in the treatment of refractory gastric ulcer in an elderly patient. 314 Jul 54

Gastritis is an inflammation in the gastric mucosa. The definition, classification and diagnosis of gastritis is based on morphological changes. The term 'gastritis' is widely used as a catchbag for upper abdominal complaints. Although acute or specific forms of gastritis may present upper abdominal symptoms, chronic gastritis is asymptomatic, and is not the cause of long standing upper abdominal complaints. Chronic gastritis is a very common condition in the general population. Hence the probability of finding chronic gastritis in endoscopic biopsies of patients with upper abdominal complaints is high for statistical reasons, and this does not prove any causal relation between chronic gastritis and subjective complaints. Campylobacter pylori is associated with chronic gastritis. It may activate the inflammatory process in the gastric mucosa, or it may just be an innocent bystander, which subsists within a diseased mucosa. The role of campylobacter pylory in the etiology of non-ulcer dyspepsia or peptic ulcer is questionable.
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PMID:Gastritis--a misused term in clinical gastroenterology. 324 1

Two cases of sudden death due to perforation of a benign oesophageal ulcer into a major blood vessel are reported. In one man, anaemia and aspiration pneumonitis dominated the clinical picture. He had an oesophageal stricture and a chronic peptic ulcer associated with an incarcerated hiatus hernia. Death was due to haemorrhage caused by perforation of the ulcer into the thoracic aorta. The second patient presented with confusion and falls, backache and indigestion. She had a hiatus hernia and a large benign chronic oesophageal ulcer. Death was due to perforation of the ulcer into the left pulmonary vein. The cases are presented for their rarity, to illustrate the complex and late presentation of problems in geriatric medicine, and as a reminder that reflux oesophagitis can be dangerous.
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PMID:Sudden death from perforation of a benign oesophageal ulcer into a major blood vessel. 325 Dec 22

In a cross-sectional survey for coronary risk factors, 14,390 middle-aged men and women answered a questionnaire concerning life-style, diet and disease, including peptic ulcer (PU) and dyspeptic symptoms. The overall lifetime prevalence of reported PU was 5.3% in men and 2.1% in women. The prevalence of reported dyspeptic symptoms, consistent with non-ulcer dyspepsia (NUD), was 22.6% in men and 18.1% in women. Reporting of both PU and NUD was significantly associated with sex and age, NUD less marked than PU. PU and NUD differed substantially with respect to associations with psychologic, social, life-style, and dietary variables. PU was strongly associated with age, a family history of peptic ulcer, body mass index, and smoking. NUD, on the other hand, showed closest association to psychological factors and social conditions. This difference between PU and NUD might be of aetiological and therefore clinical significance, and calls for therapeutic trials in NUD patients with interventions different from the traditional peptic ulcer treatments.
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PMID:Peptic ulcer and non-ulcer dyspepsia--a disease and a disorder. 326 22


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