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

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

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

In a double blind crossover comparison with placebo, the effects of cisapride (10 mg tid for two weeks), a non-antidopaminergic gastrointestinal prokinetic drug, on gastric emptying times and on symptoms were evaluated in 12 patients with chronic idiopathic dyspepsia and gastroparesis. Gastric emptying was studied by a radioisotopic gamma camera technique. The test meal was labelled in the solid component (99mTc-sulphur colloid infiltrated chicken liver). Nine symptoms (nausea, belching, regurgitations, vomiting, postprandial drowsiness, early satiety, epigastric pain or burning, heartburn) were graded weekly on a questionnaire. Cisapride was significantly more effective than placebo in shortening the t1/2 of gastric emptying (p2 = 0.04), but no significant difference was observed between the two treatments with regard to the improvement of total symptom score (p2 = 0.09). No side effects were reported during the study.
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PMID:Effect of chronic administration of cisapride on gastric emptying of a solid meal and on dyspeptic symptoms in patients with idiopathic gastroparesis. 355 6

Dyspepsia may be caused by reflux esophagitis. We evaluated the symptoms of 45 patients aged 52 +/- 14 years who had a follow-up of 1 to 5 years. Endoscopy and histology demonstrated microscopic inflammation in 14, isolated mucosal defects in 12 and severe inflammation in 19 of the 45 patients. Belching was the leading symptom in patients with microscopic and severe esophagitis, heartburn in mild esophagitis. Upper abdominal pain, nausea and vomiting were present in 31%, 24% and 22% of the patients, respectively. Thus, reflux esophagitis is frequently accompanied by symptoms of dyspepsia which resemble those of other causes of dyspepsia. In contrast, disorders of gastric and intestinal motility may be associated with esophageal motor disturbances, particularly in gastric dysrhythmia, diabetic gastroenteropathy, irritable bowel syndrome, and idiopathic intestinal pseudo-obstruction. How much the esophagus contributes to the clinical symptomatology of dyspepsia awaits further elucidation.
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PMID:Esophageal disorders in the etiology and pathophysiology of dyspepsia. 386 Sep 17

Fifty-eight patients with uncomplicated diverticular disease of the colon took bran crispbread, ispaghula drink, and placebo for four months each in a randomised, cross-over, double-blind controlled trial. Assessments were made subjectively, using a monthly self-administered questionnaire, and objectively, by examining a seven-day stool collection at the end of each treatment period. In terms of a pain score, lower bowel symptom score (the pain score and sensation of incomplete emptying, straining, stool consistency, flatus, and aperients taken), and total symptom score (belching, nausea, vomiting, dyspepsia, and abdominal distension) fibre supplementation conferred no benefit. Symptoms of constipation, however, when assessed alone, were significantly relieved. Both fibre regimens produced the expected changes in stool weight, consistency, and frequency. It is concluded that dietary fibre supplements in the commonly used doses do no more than relieve constipation. Perhaps the impression that fibre helps diverticular disease is simply a manifestation of Western civilisation's obsession with the need for regular frequent defecation.
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PMID:Are fibre supplements really necessary in diverticular disease of the colon? A controlled clinical trial. 626 96

An interpretation of many of the classical signs of ruminal dysfunction is possible by extrapolation from the results of research in rumen physiology. Correlation of motility and ruminal fluid characteristics will often provide a means of establishing the degree, the duration and the differential diagnosis of the dysfunction detected. In the case of disorders of ruminal motility, general anaesthesia and diseases at any sites which produce pain or fever can inhibit the hindbrain reflex centres responsible for evoking primary and secondary cycle contractions of the reticulorumen. Simple indigestion/rumen impaction, vagus indigestion and hypocalcaemic milk fever cause ruminal stasis, probably because they relax the reticuloruminal smooth muscle and hence decrease the reflexly excitable sensory inputs from tension receptors. Grain engorgement/ruminal acidosis and extreme bloat are likely to excite other sensory receptors (epithelial receptors), which reflexly inhibit cyclical motility. Bloat occurs when eructation is inadequate either because the oesophagus is obstructed or because cardiac opening is reflexly inhibited by the presence of ruminal fluid rather than gas at the cardia in conditions of subnormal motility or of leguminous frothing.
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PMID:Clinical diseases of the rumen: a physiologist's view. 687 96

Several studies, using pH monitoring with event markers, have identified patients with normal oesophageal exposure to acid despite an apparent relation between symptoms and reflux episodes. In this series of 771 consecutive patients referred for 24 hour oesophageal pH monitoring, a probability calculation was used to evaluate the relation between symptoms and reflux episodes. Oesophageal exposure to acid was normal in 462 of 771 recordings (59.9%); despite this, 70.8% (327 of 462) of these patients used at least once the event marker. In 96 patients (12.5% of total patients) with normal oesophageal exposure to acid, there was a statistically significant association between symptoms and reflux episodes. The symptom cluster of such patients was similar to that usually seen in patients with gastro-oesophageal reflux disease, but symptoms like belching, bloating, and nausea were common thus overlapping with the symptom pattern of functional dyspepsia. In these patients both the duration and the minimum pH of reflux episodes (either symptom related or asymptomatic) were significantly shorter and higher, respectively, when compared with those of patients with gastro-oesophageal reflux disease. These results are consistent with the idea that oesophageal hypersensitivity to acid is the underlying pathophysiological feature of this syndrome.
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PMID:Reflux related symptoms in patients with normal oesophageal exposure to acid. 888 28

The efficacy and safety of the peripheral kappa-receptor agonist fedotozine was investigated in a double-blind, placebo-controlled, dose-ranging study involving 146 patients with nonulcer dyspepsia (NUD). After a two-week washout, patients were assigned to one of four groups to receive either placebo or fedotozine three times a day at doses of 10, 30, or 70 mg for six weeks. Analysis of mean symptom intensity scores showed that the 30-and 70-mg doses of fedotozine were superior to placebo in relieving postprandial fullness, bloating, abdominal pain, and nausea. Eructation and early satiety were marginally affected. The 30-mg dose was significantly more effective than placebo in reducing the total symptom score. Eight-two mostly minor adverse effects were recorded, but no significant differences in distribution emerged between placebo and treatment groups. The number of withdrawals declined significantly as a function of increasing dose. These results indicate that 30 mg three times a day is the minimal effective dose of fedotozine in the treatment of NUD symptoms and that this treatment is safe.
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PMID:Double-blind dose-response multicenter comparison of fedotozine and placebo in treatment of nonulcer dyspepsia. 817 19

The main symptom of gallstone disease is biliary pain. Biliary pain is not necessarily colicky or postprandial, and it most frequently occurs at night during the same clock-time. The relief of biliary pain by cholecystectomy would support the idea that the gallbladder or the stones caused pain. Long-term follow-up studies after cholecystectomy are infrequent, however. Our studies show that biliary pain is relieved in 99% of patients after 4 years of follow-up. The nonspecific symptoms associated with gallstones (i.e., dyspepsia, bloating, belching, etc.) remained in 12% of these patients. We have also shown that the gallbladder itself, without stones, can cause pain and that this biliary pain is relieved in 77% of patients by cholecystectomy. The impact of gallstones on the patient depends on the quality of cholecystectomy as classically measured by morbidity and mortality. However, quality must also be monitored by comparing the long-term relief of biliary pain and the cost. Quality cannot be monitored through inaccurate national databases or multicenter trials. Rather, the continuous quality improvement (CQI) technique of larger centralized health care systems may be the most accurate monitoring system. This technique coordinates the entire health care system by assuming that any process can improve its quality, no matter how good it may already be. Our CQI laparoscopic cholecystectomy database has yielded preliminary perspectives on accurate data collection and improving costs. After a thorough examination, 5% of the database contained cases not done laparoscopically (coding errors), whereas it missed 21% of true laparoscopic cholecystectomy cases (staff errors). Only with the accuratized database were we able to provide insight into cost-savings procedures.
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PMID:Clinical manifestations and impact of gallstone disease. 848 Aug 72

This paper identifies the symptom profile associated with the four main diagnoses of functional digestive disorders (dyspepsia, gastro-oesophageal reflux disease (GORD), gastritis, and constipation) made by general practitioners in Belgium. Results are also presented from a multicentre study in which the effects of cisapride, administered as an oral tablet or suspension, were evaluated in patients with these functional digestive disorders. Analysis of symptom patterns revealed that early satiety and postprandial abdominal bloating were the most prominent symptoms, followed by eructation (belching), heartburn, regurgitation, postprandial epigastric burning or discomfort, and nausea. These symptoms occurred in all diagnostic groups. However, different symptom patterns were associated with each of the disorders; for example, heartburn and regurgitation were the core symptoms in patients diagnosed as having GORD, early satiety and abdominal bloating were characteristic of patients diagnosed with dyspepsia, and fasting or postprandial pain were characteristic of patients given the diagnosis of gastritis. Therefore, it appears that these diagnoses used by general practitioners in Belgium closely correspond to reflux-like, dysmotility-like and ulcer-like dyspepsia, as defined by an international working party. Cisapride improved the core symptoms in about 80% of patients with GORD or dyspepsia, relieved all epigastric symptoms in about 80% of patients with gastritis, and significantly decreased the use of laxatives and increased stool frequency in constipated patients. Cisapride was well tolerated and thus appears to be a useful option in the treatment of functional digestive disorders in a general practice setting.
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PMID:Functional dyspepsia versus other functional gastrointestinal disorders: a practical approach in Belgian general practices. 851 55


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