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

Nonulcer dyspepsia remains to this date a clinical disease entity that is diagnosed and treated empirically by considering such patients potential ulcer carriers and treating them accordingly with H2 antagonists. The purpose of this study was to assess the therapeutic effectiveness of sulglycotide in patients with nonulcer dyspepsia in a random double-blind trial vs sucralfate. One hundred and eighty-seven consecutive patients with nonulcer dyspepsia were treated with sulglycotide (oral, 200 mg t.i.d. for 6 weeks, n = 93) or with sucralfate (oral, 1 g t.i.d. for the same length of time, n = 94). Drug effectiveness was evaluated in terms of apparent clinical symptom modifications, fiberoptic endoscopy findings and histological aspects of biopsy specimens. Both treatments resulted in prompt abatement of the clinical complaints of nonulcer dyspepsia and the improvement of macroscopic gastritis at endoscopy. These results confirm the usefulness of cytoprotective drugs in nonulcer dyspepsia characterized by gastroduodenal inflammation.
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PMID:A multicenter double-blind study of sulglycotide versus sucralfate in nonulcer dyspepsia. 222 22

Non-ulcer dyspepsia (NUD) is a common complaint in which no systematic illness or organic proximal alimentary tract disease can be identified. The pathophysiology of NUD is probably heterogeneous. Eighty-two subjects with NUD were studied in a prospective randomized placebo-controlled study to assess the efficacy of colloidal bismuth subcitrate (CBS) chewable tablets at a dose of four tablets daily for 1 month. The role of Campylobacter pylori and associated histological gastritis was evaluated. Sixty-one percent of NUD patients had C. pylori in the gastric antrum compared with 25% of age-matched controls. C. pylori was associated with acute and chronic inflammation (P less than 0.001) in the antrum. C. pylori was cleared in 59% of CBS-treated subjects compared with only 4% placebo (P less than 0.05). Both acute and chronic inflammation improved in subjects cleared of bacteria. Clearance of C. pylori and histological improvement was associated with a significant decrease in symptoms. In C. pylori negative subjects improvement in symptoms occurred in both the placebo and active treatment groups. This study would suggest that C. pylori and associated histological gastritis may play a role in non-ulcer dyspepsia.
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PMID:Campylobacter pylori--a role in non-ulcer dyspepsia? 268 24

Non-ulcer dyspepsia is gaining increasing interest among gastroenterologists even though the pathogenetic mechanisms in individual patients are still unknown. On the basis of a number of studies, it can be concluded that in about 60% of patients impairment of gastric evacuation may contribute to the symptomatology (epigastric pain, postprandial fullness, early satiety, bloating, nausea and vomiting). This review summarizes the results of 10 placebo-controlled trials which evaluated the effects of cisapride (3 x 5 or 3 x 10 mg/day) in strict non-ulcer dyspepsia or functional postprandial dyspepsia. In seven of the trials, cisapride proved significantly superior to placebo in relieving epigastric pain and concomitant symptoms in patients with non-ulcer dyspepsia. In the three studies examining chronic functional dyspepsia, belching, postprandial bloating, early satiety and heartburn were significantly improved. In all 10 trials, cisapride was significantly superior to placebo.
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PMID:Efficacy of cisapride in the treatment of epigastric pain and concomitant symptoms in non-ulcer dyspepsia. 269 Mar 25

Nonulcer dyspepsia with or without duodenitis and duodenal ulcer disease are often considered to be a spectrum of the same acid-peptic process. Some reports evaluating basal gastric acid secretion in nonulcer dyspepsia and duodenal ulcer disease have supported that impression; however, results from different studies have been mixed. In order to compare basal gastric secretory profiles in nonulcer dyspepsia and duodenal ulcer disease, we determined basal acid outputs in 66 consecutive patients with the diagnosis of nonulcer dyspepsia. All patients with nonulcer dyspepsia had at least a three-month history of epigastric abdominal pain, and all had negative upper gastrointestinal endoscopies except for 14 with duodenitis. The 66 patients with nonulcer dyspepsia were compared to 40 asymptomatic normal subjects and 114 patients with endoscopically documented duodenal ulcer disease. There was no significant difference in mean basal acid output among all 66 patients with nonulcer dyspepsia (2.9 +/- 2.7 meq/hr), the group of normal subjects (3.2 +/- 2.7 meq/hr), the 14 patients with nonulcer dyspepsia with duodenitis (3.0 +/- 2.1 meq/hr), and the 52 patients with nonulcer dyspepsia without duodenitis (2.9 +/- 2.9 meq/hr). However, mean basal acid output of the patients with duodenal ulcer disease (9.1 +/- 7.6 meq/hr) was significantly higher than all the other groups (P less than 0.001). The gastric acid secretory profiles determined in this study do not appear to support the view that nonulcer dyspepsia with or without duodenitis and duodenal ulcer disease are a spectrum of the same acid-peptide process.
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PMID:Basal gastric acid secretion in nonulcer dyspepsia with or without duodenitis. 291 46

Non-ulcer dyspepsia (NUD) is a poorly defined heterogenous condition less well suited for the conventional randomized and placebo controlled parallel type trials. We have designed a multi cross-over model (MCO-model) with the facility of providing information about drug responses in individual patients. A pilot study suggested that the model may identify individual cimetidine responders among patients with dyspepsia. Preliminary findings from an ongoing study in patients with NUD supports the existence of a subgroup of cimetidine responders characterized by gastroesophageal reflux symptoms and possibly an increased basal acid secretion.
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PMID:Dyspepsia: Therapeutic response as a diagnostic tool. 347 94

Nonulcer dyspepsia remains a difficult disorder to treat because it is a heterogeneous syndrome. Once patients with the irritable bowel syndrome, esophagitis, and other organic diseases are excluded, there remain patients with dyspepsia of unknown cause (termed "essential dyspepsia") and patients with dyspepsia plus symptoms of gastroesophageal reflux without esophagitis. The aim of this study was to determine whether cimetidine or pirenzepine is efficacious in relieving the symptoms of these latter subgroups. Sixty-two consecutive patients were studied who had chronic upper abdominal pain or nausea where endoscopy had shown no evidence of peptic ulceration, esophagitis, or malignancy; 47 had essential dyspepsia, and 15 had dyspepsia plus gastroesophageal reflux. They were initially randomized to either cimetidine or placebo, or pirenzepine or placebo. Patients continued each medication for 1 mo, and, after a washout period, crossed over when again symptomatic; 51 patients completed cimetidine and placebo, and 50 completed pirenzepine and placebo. The results showed that cimetidine was superior to placebo in decreasing the number of upper abdominal pain episodes weekly and the severity of pain, but the absolute improvement was small. Pirenzepine was not superior to placebo in decreasing symptoms.
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PMID:Randomized, double-blind, placebo-controlled crossover trial of cimetidine and pirenzepine in nonulcer dyspepsia. 351 48

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

Dyspepsia or indigestion is one of the most common disorders that is managed by general practitioners and gastroenterologists. Non-ulcer dyspepsia can be defined as upper abdominal pain or nausea in patients in whom endoscopy reveals no evidence of peptic ulceration or gastric cancer. Non-ulcer dyspepsia is a heterogeneous disorder and can be the result of such diverse entities as the irritable bowel syndrome, duodenitis or gastro-oesophageal reflux, or may be idiopathic ("essential" dyspepsia). This review traces the development of modern thought on dyspepsia and non-ulcer dyspepsia, from the 16th century to the present.
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PMID:Dyspepsia and non-ulcer dyspepsia: an historical perspective. 354 May 42

In Central Europe and in South Africa duodenal ulcer disease has been reported to occur twice as often in migrant workers as in the indigenous population. To investigate the reasons for this phenomenon the joint effect of occupation and nationality on the prevalence of gastric and duodenal ulcer was studied in a survey of 73,000 active members of the German workforce. Non-ulcer dyspepsia and gastric, but not duodenal, ulcer were found more frequently in migrant than in indigenous workers. Manual workers were more prone to develop gastric and duodenal ulcer and non-ulcer dyspepsia than sedentary workers. The seemingly increased prevalence of duodenal ulcer in migrant workers observed by other authors may be due to migrant workers being employed predominantly in manual labour which bears a twofold risk of developing duodenal ulcer.
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PMID:Joint effect of occupation and nationality on the prevalence of peptic ulcer in German workers. 371 97

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


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