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

The importance of personality traits in nonulcer dyspepsia and irritable bowel syndrome is a controversial issue. We wished to assess the distribution of abnormal personality traits in nonulcer dyspepsia and the irritable bowel syndrome, define any relation among personality and symptoms, and determine whether personality factors discriminate among patients with functional, psychiatric, or organic gastrointestinal diseases. Patients with nonulcer dyspepsia (n = 31), irritable bowel syndrome (n = 67), organic gastrointestinal disease (n = 64), somatoform disorder (n = 36) and healthy controls (n = 128) were studied. Before diagnostic evaluation by an independent physician, all patients completed the Minnesota Multiphasic Personality Inventory and a symptom questionnaire. Symptom scores for abdominal pain and the Manning criteria, which is considered to be diagnostic for the irritable bowel syndrome, were evaluated. Personality scales in patients with nonulcer dyspepsia, irritable bowel syndrome, and organic disease were very similar. However, patients in the other groups differed from somatoform disorder on nearly all scales. In nonulcer dyspepsia, irritable bowel syndrome, and organic disease, hypochondriasis weakly correlated with pain. Subgroups of irritable bowel syndrome patients with predominant constipation and those with predominant diarrhea had similar personality traits, although hypomania was minimally increased in constipation. Patients who fulfilled the Manning criteria for irritable bowel syndrome had more psychological distress than those who did not. The Minnesota Multiphasic Personality Inventory correctly classified somatoform disorder and health 81% and 75% of the time, respectively, but it classified nonulcer dyspepsia and irritable bowel syndrome correctly in only 32% and 34% of cases. Our results suggest that psychopathology may not be the major explanation for functional gastrointestinal disorders.
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PMID:Relation among personality and symptoms in nonulcer dyspepsia and the irritable bowel syndrome. 200 21

Recognized manifestations of acute graft-versus-host disease (GVHD) of the gastrointestinal (GI) tract include secretory diarrhea, abdominal pain, and, at times, hemorrhage. In a review of 469 patients undergoing allogeneic bone marrow transplantation (BMT) from matched sibling donors at our institution, we have recognized a syndrome of upper GI GVHD. This syndrome, presenting clinically as anorexia, dyspepsia, food intolerance, nausea, and vomiting, was recognized and confirmed histologically in 62 patients (13% by Kaplan-Meier projection) at the initiation of systemic GVHD therapy, a subset of the 197 patients developing grade II through IV GVHD. These 62 patients with upper GI GVHD were significantly older than the overall BMT population and older than the cohort with grade II through IV GVHD, as well. Of the 62 patients, 25 had upper GI GVHD accompanied only by limited (stage 1 and 2) skin GVHD; 13 others with upper GI GVHD plus limited skin involvement at initial presentation later progressed to more extensive multiorgan involvement; 24 others presented with upper GI along with other organ GVHD. This upper GI GVHD syndrome, first recognized at our center in 1983, has been diagnosed with increasing frequency (22% +/- 5%) in the most recent 5-year interval. The upper GI GVHD syndrome is more responsive to immunosuppressive therapy than grade II GVHD defined by Seattle criteria, with complete and continuing responses to treatment observed in 71% +/- 17% (95% confidence interval) of those with the upper GI GVHD syndrome compared with only 37% +/- 10% complete responses in other patients with grade II GVHD (P = .002). Patients failing immunosuppressive therapy for upper GI GVHD often progress to symptomatic lower GI involvement, suggesting that this syndrome may be an earlier and perhaps more treatable manifestation of this unique intestinal immunopathology, which is followed by chronic GVHD in 74% of patients. While upper GI GVHD symptoms are nonspecific and require invasive histologic and microbiologic studies to confirm the diagnosis, we believe this syndrome has been underreported after allogeneic BMT and propose its recognition within the clinical GVHD scoring system.
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PMID:Acute upper gastrointestinal graft-versus-host disease: clinical significance and response to immunosuppressive therapy. 237 89

A newly developed liquid ready-to-use cow's milk based formula (BD) was used as the sole nutrient in 314 healthy term infants below the age of 28 weeks--except for supplementary feeding introduced at an average age of 142 days. The incidence of dyspeptic problems (constipation, diarrhea, vomiting), the parents' and visiting nurses' comments on the product, and the causes of "BD failure" (termination of BD feeding because of suspected cow's milk allergy, dyspepsia, etc.) were recorded as were rates of weight gain and linear growth. It is concluded that BD is a valuable alternative to existing powdered milk formulas and that the growth of the infants compared satisfactorily with published reference values.
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PMID:[Testing of a liquid, ready-to-use, breast milk substitute in the county of Funen]. 240 9

Selected results are presented of studies of diarrhea and its treatment carried out in Guatemala in 1985-1987 and of qualitative studies of child feeding especially during and after diarrhea conducted in 1988-89 by the Nutrition Institute of Central America and Panama (INCAP). This work focuses on ethnoclassification and the role of breast feeding in diarrheal disease, the possibilities and limitations of the common Latin American system of classification into hot or cold properties as an explanatory model for diarrhea, and implications of the findings for public health programs. In the diarrhea studies, 15-20 randomly selected mothers of children under 5 were interviewed in 4 communities of about 1000 inhabitants in both indigenous and Ladino communities. Interviews were also conducted with curanderos, midwives, and other traditional health care providers. The dietary information on children with diarrhea came from focus groups with mothers in 3 marginal urban communities, 3 rural indigenous communities, and 4 rural Ladino communities. Biomedical practice and popular beliefs both consider alterations in the frequency or consistency of stools and stomach pain to be part of the definition of diarrhea. But the mothers viewed diarrhea as either an illness in itself, or 1 symptom of another illness defined by traditional practice such as "empacho" (indigestion) or evil eye, or as a normal accompaniment of changes in child growth and development such as loss of teeth or the 1st steps or words. Diarrhea caused by the mother's mild is believed to be a distinct type that occurs when the milk becomes very cold or hot in the folk classification, or when it is disturbed. Illnesses are viewed as violations of the equilibrium between hot and cold in the diet, activities, emotions, or general state of the nursing mother. Women are considered in a state of cold for about 40 days after birth and should follow specific recommendations for diet, activity, and personal care. Lactation is considered a hot state, and women should continue to consume hot foods to overcome the cold of the postpartum. Lactating women should avoid foods considered very hot, such as coffee, chile, and spicy foods. Strong maternal emotions such as anger or fright are also believed to affect the milk. Treatment may follow various forms depending on the suspected cause, and may include dietary change, consumption of a home or commercial remedy, or complete weaning. Public health programs should take local health systems into account, encouraging favorable prescribed practices such as postpartum rest and attention to the maternal diet. Specific advice to the mother may vary, but health education should maintain the integrated focus on the women that is part of the traditional system.
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PMID:[Breast feeding in the etiology of diarrhea]. 249 Aug 82

27 patients with radiolucent biliary stones in normofunctioning gall bladder were treated with a combination of CDCA and UDCA (CDCA doses = 7.7 mg/kg/day; UDCA--6.5 mg/kg/day); only 23 continued in the study for at least one year. The reasons for leaving were in one case the necessity of a cholecystectomy and treatment interruption in 3 cases. The rate of complete dissolution was of 39%, being of 17% the partial dissolution rate. The only biochemical alteration was the increase of HDL cholesterol at 9 and 12 months of treatment (p less than 0.05 and p less than 0.01 respectively). Transient diarrhea was seen in 17% of the patients and it did not require treatment. The incidence of liver colic during the year before treatment was 26% and it decreased during the 1st year of treatment to 4%. The non-specific dyspepsia observed during the year before treatment was of 48%, and decreased to 17% during the first year of treatment. Only one patient developed calcification of the gallstone, 12 months after treatment.
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PMID:[Combined therapy with chenodeoxycholic acid and ursodeoxycholic acid of radiolucent biliary lithiasis]. 249 Nov 84

Functional bowel disorders are frequent in the general population. In order to determine the prevalence, determinant factors and attitudes of the adult and healthy individuals with respect of the digestive symptoms, a prospective and transversal survey was carried out among the population of Lima city between january and april of 1989. Inclusion criteria were: apparently healthy, age between 18 and 60 yr, no analphabet; and the exclusion criteria were: having been diagnosed of systemic and for digestive organic disease, and regular ingestion of drugs. 911 individuals were interviewed. After exclusion of 51,860 persons were considered for the study, 427 males and 433 females; 428 from the medium socioeconomic level and 432 from the lower. A prevalence of 85.9% of normal individual with digestive symptoms was found, with a higher frequency in females and the low socioeconomic level (p less than 0.001). Vomit, early gastric fullness, non epigastric abdominal pain, constipation and proctalgia were significantly related to female sex and bad taste, regurgitation, early gastric fullness, dyspepsia to some foods, constipation and diarrhea were related to low socioeconomic level. Dysuria, as associated symptom, was frequent in females (p less than 0.001) and dysuria and lumbalgia in the low socioeconomic level (p less than 0.001 and p less than 0.001 respectively). 18.1% of the individuals asked for medical consultation, 14.9% used medical prescriptions, 19.4% had automedication and 41.95 used folk remedies.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Digestive disorders in the adult population of Lima]. 251 41

Abdominal discomfort after eating cowpeas is known to be a major constraint on their greater consumption. Problems associated with cowpea consumption were identified by questionnaire in 448 randomly selected families. Some (28%) of the respondents had never experienced flatulence. Those who did said it occurred when cowpeas were eaten at all (16.7%), as dinner (42%) or without other foods (15%). A subsample of 40 people who complained of serious abdominal discomfort were fed cowpeas cooked by eight different methods at three consecutive dinners for each method. The problems reported were indigestion, vomiting, diarrhoea, increased belching, bad breath, offensive stool, flatulence, constipation, mild abdominal discomfort and sleepiness. Many respondents complained of mild abdominal discomfort with undehulled cowpeas (72.5%) and dehulled cowpeas (42.5%) that had been cooked at atmospheric pressure. Only 12.5% of the respondents complained of discomfort with dehulled cowpeas cooked under extra pressure. Thus, dehulling resulted in substantial reduction in the frequency and incidence of reported discomforts but pressure cooking also had beneficial effects, probably because of the higher cooking temperature attained.
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PMID:Flatulence and other discomforts associated with consumption of cowpea (Vigna unguiculata). 259 40

A prospective, randomized, controlled trial was conducted to compare truncal vagotomy and drainage (TV), selective vagotomy and drainage (SV) and parietal cell vagotomy (PCV) as elective treatment for duodenal ulcer. Between 11 and 15 years after operation, 248 patients were available for study of the recurrent ulceration rate by a life table method, and 197 patients could be studied with regard to postvagotomy symptoms. The recurrent ulcer rates were 28.5% for TV, 37.4% for SV, and 39.3% for PCV. These differences were not statistically significant. The incidence of severe postvagotomy symptoms was as follows: dyspepsia, 18.4% for TV, 20.5% for SV, 8.6% for PCV; dumping, 5.9% for TV, 19.6% for SV, 2.2% for PCV; diarrhea, 9.8% for TV, 11.8% for SV, 4.4% for PCV. The incidence of severe dumping was significantly less frequent among the PCV patients than the SV group. The differences did not reach statistical significance in any of the other groups. There was no significant difference in the Visick gradings among the three groups either before or after treatment of the failures. About two thirds of the patients in each group were finally satisfied with their operation, often after second operations or prolonged medical treatment. It is concluded that none of the three forms of vagotomy can be recommended as the standard operative treatment of duodenal ulceration.
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PMID:Prospective controlled vagotomy trial for duodenal ulcer. Results after 11-15 years. 264 89

This study was conducted to evaluate the efficacy and safety of intravenous sulbactam/ampicillin followed by oral sultamicillin. Parenteral sulbactam/ampicillin was administered for 7 to 14 days to 152 in-patients with moderate to severe infections. All patients were treated with sulbactam/ampicillin, but only 140 patients received oral sultamicillin therapy. Eighty-nine men and 63 women participated in this study. Infections included intraabdominal (42 cases), respiratory tract (52 cases), skin and soft tissue (29 cases), urinary tract (16 cases), and miscellaneous infections (14 cases) that included typhoid fever, gastroenteritis, septicemia, and surgical wound infection. Six (4%) patients reported six study drug-related adverse experiences. Gastrointestinal side effects were most common and included epigastric burning and indigestion. Diarrhea was not reported and no patient discontinued drug therapy because of an adverse event. Laboratory abnormalities were infrequent and clinically insignificant. Overall, 98% of the 114 evaluable patients achieved clinical cure or improvement following treatment with sulbactam/ampicillin and sultamicillin. Cured or improved patients in each diagnostic group were 97% for intraabdominal infections, 100% for respiratory tract infections, 100% for skin and soft tissue infections, 100% for urinary tract infection, and 91% for other types of infections. Only 2 (2%) patients were judged to be treatment failures. Microbiologic efficacy, or eradication, was 86% overall, ranging from 75 to 100%. Persistence of pathogens occurred in 5%, and eradication with development of a superinfection occurred in 4%. Fifty-seven percent (30/50) of the isolates tested were resistant to ampicillin alone whereas only 21% (9/42) were resistant to sulbactam/ampicillin (p = 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sulbactam/ampicillin followed by oral treatment with sultamicillin for medical and surgical infections. 268 17

Multiple biopsies from the lower duodenum were obtained during endoscopy of 171 patients with dyspepsia, diarrhoea and/or suspected malabsorption. Histological evidence of lambliasis was obtained in six (3.5%). Antibiotic treatment with metronidazole, 250 mg two or three times daily for seven to 11 days (which had to be repeated in two cases), improved symptoms in four. In most of the patients "functional upper-abdominal symptoms" had been diagnosed after extensive examinations. In case of unclear upper-abdominal symptoms, chronic or chronic-recurrent diarrhoea and/or malabsorption lambliasis should be considered and histological examination of the duodenal mucosa undertaken.
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PMID:[Lambliasis: a cause of malabsorption and diarrhea?]. 272 87


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