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

We define the concept of functional dyspepsia and analyze the putative mechanisms involved in its pathogenesis. We consider the evidence for gastroduodenitis, including the relationship of spiral organisms and viruses in this entity, and for functional dyspepsia as a manifestation of gastric secretory dysfunction and upper gut dysmotility. Functional dyspepsia is probably a heterogeneous condition in which multiple etiopathogenetic mechanisms are involved. Nevertheless, patients with functional dyspepsia constitute a sizable fraction of gastroenterological practice and therefore this disorder deserves intense research.
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PMID:Functional dyspepsia. Symptoms and underlying mechanism. 353 16

Non-ulcer dyspepsia, also termed "nervous dyspepsia," is a heterogeneous syndrome: ulcerlike symptoms can occur with the irritable bowel syndrome, gastroesophageal reflux, and other disorders. In addition, there is a significant subgroup of non-ulcer dyspepsia sufferers who have no disorder associated with, and no known cause for, their dyspepsia, and the dyspepsia in this subgroup is given the provisional name of "essential dyspepsia." The aim of this study was to assess if psychological factors are associated with patients who present with essential dyspepsia. Psychometric testing was carried out on 76 essential dyspepsia patients (including 18 patients with gastroduodenitis), 76 randomly selected dyspepsia-free community controls (matched for age, sex, and social class), and 66 duodenal ulcer controls. Essential dyspepsia patients were retested a mean of 3.6 mo later. Using stepwise regression analysis, the initial scores of essential dyspepsia and duodenal ulcer subjects showed them to be more neurotic, anxious, and depressed than community controls; these abnormalities persisted in essential dyspepsia patients on retesting and were not affected by the symptom status. It is concluded that essential dyspepsia patients who present for investigation with symptoms are more likely to be persistently neurotic, anxious, and depressed than dyspepsia-free controls, and this is unrelated to the presence of symptoms, but the association may not be of major clinical significance, as the numerical differences observed between groups were small and the correlation coefficients were low.
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PMID:Association of anxiety, neuroticism, and depression with dyspepsia of unknown cause. A case-control study. 394 18

To evaluate the frequency and type of gastroduodenal mucosal inflammatory changes in patients with symptomatic acid peptic disease and nonulcer dyspepsia, 100 patients with gastrointestinal symptoms indicative of acid peptic disease or dyspepsia and 10 control subjects were clinically evaluated and underwent radiographic, endoscopic, and biopsy studies of the stomach and duodenum. Clinical evaluation revealed that of the 100 patients, 61% had classic and 39% had atypical manifestations of acid peptic (ulcer) disease. Endoscopic and histologic evaluation revealed that 25 patients had peptic ulcer craters, 86-90% of whom had associated gastroduodenitis. Thirty-nine patients had acute and 20 patients had chronic gastroduodenitis without ulcer crater. Twelve symptomatic patients had no histologic changes in the gastroduodenal mucosa. Two of the ten control subjects had mild gastritis. In the 61% of the patients with classic manifestations of peptic ulcer disease, we could not clinically distinguish the 24 patients with craters, (40% of the classic group) from the 25 patients with acute gastroduodenitis without craters (41% of the classic group). As a result of this study of our group of patients, we believe that gastroduodenitis can be symptomatic and may present with the same manifestations as peptic ulcer crater. Further study will be required to determine whether gastroduodenitis is an independent entity or part of the spectrum of acid peptic (ulcer) disease.
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PMID:Gastroduodenitis. A broader concept of peptic ulcer disease. 741 90

The frequency of Helocobacter pylori (Hp.) infection and active chronic antral gastritis among people with excessive alcohol consumption is not known. A high alcohol intake regularly causes acute gastroduodenitis. In this study, the prevalence of Hp. infection and active chronic antral gastritis in alcoholics compared with nonalcoholic controls was studied. Further, the frequency of gastrointestinal symptoms was registered. Diagnostic methods for Hp. were compared. Twenty-four alcoholics admitted to the hospital for detoxification underwent upper gastrointestinal endoscopy regardless of symptoms. Twelve individuals admitted to upper endoscopy mainly for dyspepsia, with low alcohol consumption and without gross pathology by upper endoscopy, were chosen as controls. Three diagnostic methods for Hp. were used: culture, direct microscopy, and histology. Hp. infection was found in 7 of the 24 alcoholics (29%) according to culture. In controls, 4 of 12 (33%) had a positive Hp. culture. In the alcoholic group, culture was more sensitive than histology. There was a good correlation between the different diagnostic methods in the control group. Histologically active chronic antral gastritis was found in 6 of the alcoholics (25%) and in 5 of the controls (42%). Five of the 7 Hp.-positive alcoholics and all of the Hp.-positive controls had an active chronic antral gastritis. Hp. infection is not more frequent in alcoholics than in controls. In both groups, there was a good correlation between Hp. infection and histologically, active chronic antral gastritis.
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PMID:Helicobacter pylori, active chronic antral gastritis, and gastrointestinal symptoms in alcoholics. 797

In one thousand of 1500 examinees with nonulcerous dyspepsia the syndrome was due to chronic gastritis, duodenitis and gastroduodenitis, in five hundred of them it was attributed to probable dysfunction of the upper gastrointestinal tract. Morphological evidence of chronic gastritis activity is essential but not the only factor affecting the dyspepsia syndrome. Of importance are also motor dysfunctions: high intragastric and/or intraduodenal pressure, unbalance of intracavitary pressure parameters, gastroesophageal and duodenogastric refluxes. A significant contamination of antral mucosa with Helicobacter pylori aggravated dyspeptic manifestations.
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PMID:[Non-ulcer dyspepsia syndrome]. 804 98

The incidence and mean score of Helicobacter pylori-related, active antroduodenitis, lesions of superficial antral epithelium and duodenal gastric-type metaplasia were higher in endoscopic biopsies from a large series of patients with duodenal ulcer, when compared with asymptomatic patients or patients with non-ulcer dyspepsia. In 65 out of 73 patients with duodenal ulcer who could be followed up, H. pylori was eradicated using a combination of amoxycillin, 3 g daily, metronidazole, 1 g daily, and omeprazole, 20 mg daily. Rapid and permanent (6-month follow-up) abolition of both gastroduodenitis activity and lesions of the gastric surface epithelium was observed in these 65 patients. There was also a progressive decrease in total immune-inflammatory cells but without a substantial change in duodenal gastric-type metaplasia. Similar, but transient and quantitatively less prominent, improvements were observed in the antroduodenal mucosa, which had been temporarily cleared of H. pylori by treatment with omeprazole alone. Conversely, increased gastritis activity, epithelial lesions and immune-inflammatory cell scores were found in the short term in the corpus mucosa, which was not cleared of H. pylori after omeprazole treatment. It is concluded that, of the various H. pylori-related mucosal changes, antroduodenitis activity and antral epithelial lesions most closely reflect the severity of mucosal damage and are probably the most important factors in duodenal ulcerogenesis. Their complete and rapid suppression after bacterial eradication may be a key factor in preventing ulcer relapse.
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PMID:Effects of eradication of Helicobacter pylori on gastritis in duodenal ulcer patients. 804 21

Helicobacter pylori is the most common bacterial pathogen world-wide and has been identified in all countries. As long-term infection with H. pylori could potentially lead to duodenal or gastric ulcer disease, asymptomatic chronic gastritis, chronic dyspepsia, or gastric malignancy, including both adenocarcinoma and B-cell lymphoma, a large number of different treatment regimens aimed at eradicating H. pylori has been evaluated and reported. Despite numerous H. pylori treatment studies the optimum regimen for its eradication remains unclear. A treatment regimen, which is effective, safe and inexpensive could be used widespread and reduce the risks of the long-term complications of infection. In this study we compared the efficacy, side effects and cost-effectiveness of 12 different therapy regimens for H. pylori eradication by using meta-analysis methodology. 486 patients (256 male, 230 female; mean age 40.8 years) with H. pylori associated duodenal ulcer (n = 140), gastritis (n = 254), gastroduodenitis (n = 92) were treated with 12 different therapy-regimens. Endoscopy was performed at baseline and 6 weeks after discontinuation of eradication therapy. H. pylori status was assessed by urease test and histology. The therapy with a H2-receptor antagonist is less effective than the triple therapies with omeprazole or lansoprazole. Bismuth-based triple therapies have a mean overall eradication rate of 68%, but are limited by frequent side effects causing poor drug compliance.
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PMID:[Meta-analysis of determining the pathogen eradicating efficacy of various therapeutic regimens in Helicobacter pylori infection]. 1002 50

We report on our experience with laparoscopic cholecystectomy in 15 patients, 12 females and 3 males (mean age: 44 years), with chronic acalculous cholecystitis. These patients presented with recurrent episodes of biliary colic together with a dysmorphic or dysfunctioning gallbladder as confirmed by ultrasound and/or cholescintiscan with 99m-Tc HIDA performed in fasting conditions and after meals. First of all, we considered the possible presence of concomitant digestive disease (peptic ulcer disease, recurrent pancreatitis, irritable bowel syndrome, chronic hepatitis) potentially responsible for the pain. Ultrasound investigations revealed a pathological gallbladder in 10 patients. Cholecystectomy was curative in 8/10. Cholescintiscan revealed a pathological gallbladder in 8 patients and cholecystectomy was curative in only 5 of these. No postoperative deaths or significant complications occurred. The mean duration of the operation (35 vs 48 min) and hospital stay (2.1 vs 2.8 days) were reduced in comparison to 346 cholecystectomies performed for gallstones. After 6-36 months' follow-up, resolution of symptoms was successful in 10/15 cases (66.6%); in 3 cases, only dyspepsia was reduced, whilst in the other 2 cases, who also presented concomitant irritable bowel syndrome and gastroduodenitis, there was no improvement in pain. In all but the latter two cases (86.6%), histological examination revealed chronic gallbladder inflammation. In conclusion, laparoscopic cholecystectomy was curative (66.6%) or led to an improvement in symptoms (20%) in patients with chronic acalculous cholcystitis. Cholescintiscans were not always diagnostic for the disease, whereas ultrasound findings were more useful as an indication for surgery.
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PMID:[Diagnostic problems and results of laparoscopic cholecystectomy in chronic acalculous cholecystitis]. 1119 May 28

Gastroscopy is the preferred method of diagnosis of upper gastrointestinal (UGI) disorders which often present with dyspepsia. Since the discovery of helicobacter pylori (H. pylori) as an important aetiological agent in gastroduodenal disease, investigation for this organism during UGI endoscopy has become a standard clinical practice. We have studied a large number of Nigerian patients with dyspeptic symptoms referred for endoscopy for the spectrum of gastroduodenal diseases and the incidence of H. pylori infection. Detection of H. pylori was done on gastric muscosal biopsies either by the Campylobacter-Like Organism (CLO)-urease test or by histropathology. A total of 834 patients were studied out of which 268 were investigated for H. pylori. A hundred and ninety-five patients (73%) were positive for H. pylori and the peak age was in the fourth decade. Duodenal ulcer (DU) was the most common endoscopic finding (38.7%). The incidence of H. pylori infection was 76% among patients with DU, gastritis, gastroduodenitis and gastric outlet obstruction. However, all the anterior and pyloric channel Duus tested for H. pylori were positive gastric ulcer (GU) was diagnosed in only 4.7% of patients but 82% of them tested for H. pylori were positive. H. pylori was significantly associated with GU occurring with gastritis. Gastric carcinoma was diagnosed in 52 patients (6.2%) and 50% of those tested for H. pylori were positive. This study shows that H. pylori plays an important role in the aetiopathogenesis of peptic ulcer disease among Nigerian patients and that the diagnosis of anterior and pyloric channel Duus or gastroesophageal polyp disease may be an indicator of massive H. pylori infection.
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PMID:Upper gastrointestinal findings and incidence of Helicobacter pylori infection among Nigerian patients with dyspepsia. 1176 14

Primary chronic gastroduodenitis (PCGD) accounts for 60-85% of the diseases of the gastroduodenal zone. In our study 90 patients with PCGD were divided into three groups getting one of the following therapies: electric sleep, hofitol, electric sleep plus hofitol. The effects of the treatments were assessed with updated techniques including computed pH-metry. Hofitol showed a good effect on dyspepsia, enhanced the alkalizing ability of the duodenal bulb. Electric sleep relieved pain and asthenoneurotic syndromes, decreased high acidity of the gastric juice in the body of the stomach. Electric sleep in combination with hofitol normalized macroscopic picture of the upper gastrointestinal tract and corrected imbalanced immunity.
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PMID:[Combined use of electric sleep and hofitol in the treatment of primary chronic gastroduodenitis]. 1475 4


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