Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Helicobacter pylori attracted widespread interest from gastroenterologists because of its potential aetiologic role in disorders of the upper gastrointestinal tract. Based on extensive microbiological studies, Campylobacter pylori was renamed Helicobacter pylori, and the organism represents a new genus of bacteria. It is generally accepted that H. pylori causes chronic, non-specific gastritis (type B gastritis). The inflammatory response occurs even though the bacterium does not penetrate the gastric epithelium; it is found on the surface of and adjacent to the epithelium. The clinical significance of histological gastritis is unknown. The bacterium is often found in asymptomatic subjects. In Caucasian adults, the prevalence of infection increases with increasing age. Higher rates of infection are found in blacks and Hispanics than would be expected for their age. Whether these different rates are the result of racial or socioeconomic factors is not known. It is theorized, but not proven, that high rates of infection with H. pylori at an early age may explain the high incidence of gastric carcinoma found in Hispanic populations. H. pylori is found in almost every patient with duodenal ulcer disease, although no direct evidence for a causal relationship exists. Indirect evidence is based on the findings that if H. pylori infection is eradicated, ulcer recurrence is less likely (up to one year of follow-up). A small percentage of patients have a relapse despite eradication of the organism, suggesting a role for other factors in duodenal ulcer disease. The role of H. pylori in gastric ulcer disease is unknown. Seventy to eighty per cent of patients with gastric ulcer have evidence of H. pylori infection, and preliminary data seem to support the existence of two distinct aetiologic groups: those with gastric ulcers related to H. pylori infection and those with gastric ulcers related to use of non-steroidal anti-inflammatory drugs. The role of H. pylori in non-ulcer dyspepsia is unknown. Some clinicians believe that H. pylori causes non-ulcer dyspepsia and treat these patients for H. pylori infection. However, the data supporting this practice are poor. Treatment is only recommended for patients with resistant duodenal ulcers and patients who have frequent relapses of duodenal ulcers and who are willing to take triple-drug therapy (bismuth compounds, metronidazole, tetracycline) for the infection. As 95% of patients with duodenal ulcer have evidence of H. pylori infection, there is probably little need to confirm the diagnosis of H. pylori infection.
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PMID:Helicobacter pylori: review of research findings. 188 32

Colloidal bismuth subcitrate (CBS; DeNol) has been studied in clinical trials investigating the treatment of duodenal and gastric ulcer, non-ulcer dyspepsia, duodenitis, non-steroidal anti-inflammatory drug (NSAID)-induced disease, and Helicobacter pylori-induced gastroduodenitis. Healing rates for duodenal ulcer with CBS are significantly better than with placebo and are similar to results obtained with cimetidine or ranitidine. CBS is significantly better in the treatment of duodenal ulcer resistant to standard doses of H2 antagonists than increased doses of H2 antagonists. Duodenal ulcer relapse at 12 months after initial healing with CBS is significantly less than with H2-antagonist therapy. Ulcer healing with CBS is not influenced by smoking. H. pylori eradication with CBS appears to have little effect in ulcer healing but is of major importance in preventing ulcer relapse. CBS is effective in combination with antibiotics in eradicating H. pylori-associated gastritis. In gastric ulcer disease CBS therapy resulted in significant healing advantages over placebo and was comparable to treatment with cimetidine and sucralfate. CBS has been shown to be effective in the treatment of erosive duodenitis. The role of CBS in treatment of non-ulcer dyspepsia and NSAID-induced damage awaits further clinical studies.
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PMID:Clinical indications and efficacy of colloidal bismuth subcitrate. 195 21

Over the last 25 years there has been a considerable decrease in the prevalence of peptic ulcer worldwide. Since the introduction of potent anti-ulcer drugs the number of elective operations for peptic ulcer (PU) has decreased considerably, whereas the number of emergency operations has remained largely unchanged. The current incidence of PU perforation is 4-10 per 100,000 population. Perforation accounts for 40-50% of emergency operations for PU. Currently one third to over one half of patients presenting with PU perforation are aged over 65, with an increasing percentage of female patients and gastric ulcer perforations. There appears to be a correlation between PU perforation and ingestion of non-steroidal antiinflammatory drugs (NSAIDS), especially in women over the age of 65. About 50% of patients presenting with perforation of PU do not report a previous history of ulcer dyspepsia or treatment with anti-ulcer drugs. Many authors think the lack of a PU history reported by many patients is unreliable and may lead to erroneous conclusions in about half of patients. Mortality of PU perforation is currently 10-20% in most series, with a higher mortality of 10-40% for perforated gastric ulcer (GU) compared to duodenal ulcer (DU), for which mortality rates of 0-10% are currently reported. A number of centers report an increase in PU perforation mortality: this is due to an increased number of elderly patients in whom ulcer perforation mortality is enhanced by preexistent or concomitant diseases of other organs and systems. In the treatment of PU perforation the discussion centers around the choice between simple closure of the perforation and definitive ulcer surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Current status of therapy for gastroduodenal ulcer]. 197 Sep 9

In order to better define management policies we attempted to construct risk models for rebleeding on initial conservative management and mortality after emergency surgery for failure of medical therapy in 387 patients with bleeding gastric ulcer. Several different models were constructed using logistic regression analysis with validation by the 'leaving-one-out' method. However, despite large patient numbers, modelling in this way is difficult because of inherent wide variation between patients. Suitable models for rebleeding were regarded as rather unsatisfactory, for although overall accuracy was 86%, sensitivity was only 54%. More promising was a model for mortality after emergency surgery which had an accuracy of 93% and a sensitivity of 80%. Such mortality models incorporating age, history of previous malignant disease or dyspepsia, the presence or absence of ascites and total transfusion requirements may well prove to be of value in surgical practice. This paper seeks to examine the process of modelling rebleeding and mortality and of interpreting the models produced.
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PMID:Risk models for rebleeding and postoperative mortality in bleeding gastric ulcer. 204 98

Helicobacter (Campylobacter) pylori has been cultured from the antral biopsies of 85-90% of patients of gastritis, gastric ulcer and duodenal ulcer at different centres. Studies conducted all over the world have firmly implicated this organism in the aetiology of active superficial gastritis and recurrences of duodenal ulcer. Two hundred patients with upper abdominal pain, distension, vomiting and/or haemetemesis were subjected to OGD scopy. In 163 of these patients there was endoscopic evidence of gastritis; in 24 there was DU; in 3, GU and in 10 it was normal. Diagnosis of H pylori infection was made by the rapid biopsy urease test which is nearly 100% specific and 98% sensitive. 170 out of 200 patients were positive for H pylori. Among these were 138 patients of gastritis (84.6%); 22 cases of DU (91.6%); 2 cases of GU (66.6%) and 8 in whom endoscopy was normal. Histological examination of the antral biopsy specimens showed mild to severe infiltration of mucosa with lymphocytes and plasma cells. None of the 170 H pylori positive cases showed polymorphonuclear infiltration which has been stressed repeatedly by most Western authors to be characteristic of "active" superficial gastritis associated with H pylori infection. Even in those with a history of dyspepsia of barely 4 weeks duration or less there was no PMN infiltration in the mucosa. Thus the local response to infection by H pylori of the gastric mucosa is different in Indian patients.
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PMID:Unusual features of Helicobacter (Campylobacter) pylori--associated gastritis in India. A study of 200 cases. 209 22

The clinical efficacy of famotidine has been clearly shown in the short- and long-term treatment of a number of acid-related diseases such as duodenal and gastric ulcer as well as in the acute management of reflux esophagitis. In addition, famotidine effectively treats anastomotic ulcer and nonulcer dyspepsia. Based on a number of considerations--chemical structure, pharmacokinetics, pharmacodynamics, clinical efficacy, tolerability, and dosage regimen--famotidine represents an end-point in the development of the H2-antagonist group of anti-ulcer agents.
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PMID:Clinical efficacy of famotidine in the treatment of acid-related diseases: an overview. 221 Jun 12

In Singapore, peptic ulcer is more common amongst Chinese than amongst Malays or Indians. Earlier work has suggested that, amongst female Chinese, Cantonese women are more susceptible to ulcer disease when compared to females of other dialect groups. The aim of the present study was to confirm or refute this possibility. The dialect group distribution of 897 Chinese patients with peptic ulcer (duodenal ulcer 601, gastric ulcer 296) was compared with that of non-ulcer dyspepsia patients and 1602 general medical patients attending the same medical units. The proportion of various dialect groups (including Cantonese) was similar in all patient groups. The proportion of ulcer patients presenting with haemorrhage was also similar in the different dialect groups. We conclude that no major dialect differences exist in peptic ulcer frequency amongst the Chinese in Singapore.
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PMID:The influence of dialect group on peptic ulcer frequency amongst the Chinese in Singapore. 222 52

Recent advances of Campylobacter pylori (C. pylori) in human gastric disease and peptic ulcer were reviewed. C. pylori is a microaerophilic, motile, gram negative spiral rod bacterium. And all strains of C. pylori has a strong urease activity. In our experience. 91% of duodenal ulcer, 88% of gastric ulcer and 43% of control have C. pylori associated gastric mucosa. Patients of peptic ulcer with C. pylori infection were high relapse than patients of peptic ulcer without C. pylori, C. pylori is now known to be the most common and important case of pathologic gastritis, and C. pylori infection have been associated with gastric ulcer, duodenal ulcer, and non-ulcer dyspepsia. Although it has been only possible to culture C. pylori for about 6 yr in Japan, there are already sufficient data available to allow us to develop the basic framework that relates C. pylori gastritis to the causation of peptic ulcer disease.
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PMID:[Campylobacter pylori in patients with gastroduodenal disease]. 232 83

Endoscopic gastric antral biopsy specimens (133) from 92 dyspeptic patients with endoscopically evident gastritis (34; including one patient with dual pathology) gastric ulcer (13), duodenitis (17; including one patient with dual pathology) duodenal ulcer (29) and 41 subjects of non ulcer dyspepsia (NUD) with endoscopically normal upper gastrointestinal tract were examined for H. pylori by stained smear, various urease tests, culture and histopathology. Crushed tissue smear stained by Gram's method using carbol fuchsin counterstain proved to be the simplest and a reliable technique. Up to 4 h urease broth + ve test correlated well with smear and culture. Positive association of H. pylori with disease was considered when at least two of the above methods were suggestive. Significantly higher positivities were observed in gastritis (61.7%), gastric ulcer (84.6%), duodenitis (58.8%) and duodenal ulcer (82.8%) patients, as compared to NUD subjects (46.3%). Severe histopathological lesions were frequently associated with multiple bacteriological test positives.
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PMID:Evaluation of different methods for detection of Helicobacter pylori in patients with gastric disease. 234 21

Upper gastrointestinal lesions associated with non-steroidal anti-inflammatory drug (NSAID) treatment are commonly implicated as the cause for iron deficiency anaemia in patients with rheumatic diseases. Such patients, however, may also have other causes for iron deficiency, including blood loss from the intestine. One hundred and four patients (mean age 58 years; male 21, female 83; smokers 14) with rheumatic disease (rheumatoid 91, others 13) and absent bone marrow iron stores (mean haemoglobin 83 g/l) were examined. At endoscopy 47 of 104 (45%) had upper gastrointestinal lesions (oesophageal ulcer 4, gastric ulcer 25, gastric erosion 13, duodenal ulcer 4, gastric ulcer and duodenal ulcer 1). Endoscopic healing was assessed in 23 patients with upper gastrointestinal lesions. Eighteen of 23 (78%) lesions healed with treatment. An improvement of anaemia occurred in 10 of 18 (56%) patients with healed lesions. Twenty three of 104 (22%) patients had dyspeptic symptoms. Ten of 23 (43%) patients with dyspepsia had an upper gastrointestinal lesion as compared with 30 of 81 (37%) patients without dyspepsia. A faecal occult blood test result was available in 53 patients. Of these, 13 were positive while 40 were negative. An upper gastrointestinal lesion was present in seven of 13 (54%) patients positive for the faecal occult blood test as compared with 14 of 40 (35%) negative for the test. Thus upper gastrointestinal lesions have previously been overestimated as the cause of iron deficiency anaemia in patients receiving NSAIDs. A positive faecal occult blood test or the presence of dyspepsia is not associated with upper gastrointestinal lesions in such patients.
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PMID:Iron deficiency anaemia in patients with rheumatic disease receiving non-steroidal anti-inflammatory drugs: the role of upper gastrointestinal lesions. 238 58


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