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)

The trial randomly assigned 652 patients with non-ulcer dyspepsia (NUD), defined as chronic or recurrent complaints of acid-related (heartburn, acid regurgitation, epigastric pain) and non-acid related (fullness/vomiting, nausea) symptoms and with no evidence of organic disease, to treatment for 4 weeks with 150 mg of ranitidine (Zantic, CAS 66357-59-3) twice a day, or placebo, according to a double-blind design. The presence and duration of all dyspeptic symptoms were recorded by interviews at the beginning and after 2 and 4 weeks of treatment as well as by diaries. The complete disappearance of all dyspeptic symptoms after 4 weeks in the placebo group was 36%; ranitidine treatment resulted in a significant improvement after 4 weeks (p < 0.05). The effect of ranitidine was slightly more pronounced in acid-related than in non-acid-related symptoms. We conclude that suppression of gastric acid secretion is of clinical value in NUD patients, especially in those suffering from epigastric pain, acid regurgitation and heartburn.
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PMID:Ranitidine in the treatment of non-ulcer dyspepsia. A placebo-controlled study in the Federal Republic of Germany. 781 86

Patients with functional dyspepsia were assigned at random to cognitive psychotherapy (10 sessions of 50 min duration, n = 50) or to a control group (no treatment, n = 50). Before treatment all patients were assessed on psychological, somatic and lifestyle factors. If allocated to the therapy group all patients were also asked to define the main problems they wanted to discuss in therapy ('target complaints'). The patients were evaluated at the end of therapy (after 4 months) and at 1 yr follow-up. Outcome measures were dyspeptic symptoms, scores on 'target complaints' and psychological parameters. Both groups showed improvement in dyspeptic and psychological parameters after 1 yr. The improvement in the control group was attributed to a non- specific effect of increased interest and attention. The therapy group showed greater reduction than the control group on dyspeptic symptoms [days of epigastric pain (p = 0.050), nausea (p = 0.024), heartburn (p = 0.021), diarrhoea (p = 0.002) and constipation (p = 0.047)]; and on scores on 'target complaints' (p = 0.001).
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PMID:Psychotherapy in functional dyspepsia. 787 28

GI motility changes little--if at all--with age in healthy patients. However, a variety of diseases, including diabetes and Parkinson's disease, may cause autonomic neuropathy that is manifest as a motility disorder in the GI tract. Autonomic neuropathy can cause dysmotility in the esophagus, stomach, and gut. Symptoms are often nonspecific, including difficulty in swallowing, nausea, vomiting, heartburn, indigestion, diarrhea, and constipation. Nonpharmacologic treatment includes management of underlying diseases, avoidance of anticholinergic medications, and dietary changes. Agents with prokinetic action are the therapy of choice when drug treatment is indicated.
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PMID:GI motility disorders: diagnostic workup and use of prokinetic therapy. 790 Nov 29

In Iceland, the consumption of pharmaceutics for lesions of the gastrointestinal tract is 20 DDD/1,000 inhabitant days, which is 2-3 times more than that of any of the other Nordic countries. A nationwide investigation showed 1.54 per cent of the Icelandic population to be on continuous ulcer medication, consumption being greatest in the 70-79-year-old age group. H2-blockers are used in 79 per cent of cases, omeprazole in 17 per cent, and other drugs in 4 per cent. Of the prescriptions, 65 per cent were issued by GPs, 15 per cent by gastro-enterologists and 14 per cent by other categories of physicians, the remaining 6 per cent being issued at hospitals. The reasons given by patients for the medication were ulcer problems (30 per cent), heartburn (29 per cent), gastritis (21 per cent), dyspepsia (9 per cent), and side-effects of other medication (7 per cent).
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PMID:[The use of ulcer medication in Iceland]. 790 99

Persistent symptoms after cholecystectomy are common, occurring in up to 40 per cent of patients. Severe pain persists in 10 per cent of cases. A total of 450 patients were studied, 200 after open cholecystectomy and 250 after the laparoscopic operation. Patient notes were reviewed and a postal questionnaire was circulated. Responses were obtained from 155 patients (77.5 per cent) undergoing open cholecystectomy and 205 (82.0 per cent) having the laparoscopic operation. Mean (s.d.) follow-up was 32(23) months after open cholecystectomy and 15(7) months after the laparoscopic procedure. Right upper quadrant pain was more common after open cholecystectomy (9.7 versus 3.4 per cent, P < 0.05). Indigestion and heartburn were equally prevalent in the two groups. Some 59.4 per cent of patients were free from symptoms after open cholecystectomy compared with 63.4 per cent following the laparoscopic operation; there was symptomatic improvement in 30.3 and 31.7 per cent respectively. Symptoms were the same or worse in 10.3 per cent of patients after open cholecystectomy compared with 4.9 per cent after the laparoscopic operation (P < 0.05). Patients report significantly less right upper quadrant pain after laparoscopic than after open cholecystectomy.
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PMID:Long-term pain: less common after laparoscopic than open cholecystectomy. 795 18

Functional dyspepsia (or 'non-ulcer') is usually defined as chronic or intermittent upper abdominal symptoms for which no organic cause can be found. Division of functional dyspepsia into subgroups such as reflux-like, ulcer-like, dysmotility-like and non-specific dyspepsia has been proposed, but lacks a scientific basis. Gastric acid hypersecretion, Helicobacter pylori-associated gastritis, gastric and small intestinal motor disorders, psychological and neurohormonal factors all might play a role in the pathogenesis. The heterogeneity of the underlying abnormalities makes it unlikely that one single treatment modality will ever be beneficial to all patients. In general practice, a therapeutic trial, with either a prokinetic or an acid secretion inhibiting drug, is usually carried out before diagnostic procedures are performed to exclude organic abnormalities. In the choice of the initial therapy, some guidance can be derived from the prominent symptoms. In a study in 30 H. pylori-negative patients with functional dyspepsia ranitidine (150 mg bid) significantly reduced the severity of heartburn. The effect was most pronounced in patients of the reflux-like subgroup.
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PMID:Pathophysiology and treatment of functional dyspepsia. 801 77

Although more than a fourth of the adult population reports dyspeptic complaints, little is known about the prevalence of clinically relevant UGI endoscopic findings in these patients in comparison with asymptomatic volunteers. This type of information is required in order to assess the relative risks of organic dyspepsia and the sensitivity and specificity of dyspeptic complaints for peptic lesions. In an attempt to fill this gap, the authors compared two trials carried out in the German-speaking part of Switzerland: (a.) 172 adult asymptomatic volunteers (age 20-78 years, 74 females, 98 males) participated in an epidemiological trial to measure the prevalence of positive CLO-urease tests and of upper GI-tract lesions. (b.) 119 patients (age 18-84 years; 68 females, 51 males) consulting their family doctor because of upper digestive symptoms of at least 1 month's duration (epigastric pain or discomfort, heartburn, acid regurgitation, early satiety, bloating, etc.) were referred for UGI endoscopy as a screening procedure; functional dyspeptics were thereafter randomized to a double blind drug trial (not reported here). In both trials the gastric presence of Helicobacter pylori was measured by means of the CLO-urease test. Prevalences of lesions and of positive urease-tests in the dyspeptic population were compared with the sex and age adjusted prevalences registered in the control population.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Endoscopic findings in volunteers and dyspeptic patients]. 805 29

This study examined secondary-claims data to measure the cost of using non-antacid antiulcer agents to treat patients with heartburn or dyspepsia. Health care utilization data were obtained from the Pennsylvania Medicaid program. The study population comprised all enrollees with dyspepsia or heartburn, excluding those with a history of ulcers. The rate and cost of gastrointestinal-related outpatient services were examined for patients receiving antiulcer drug monotherapy. The mean age of the study population (n = 1830) was 39.1 years. Ranitidine patients (n = 856) received monotherapy for an average of 71.1 days. Cimetidine (n = 395) and famotidine (n = 255) patients received monotherapy for an average of 65.0 and 71.7 days, respectively. (Mean duration of monotherapy for the other four groups ranged from 58.0 to 112.6 days). On average, there were 0.83 prescriptions issued, 0.21 physician visits, and 0.23 outpatient hospital visits per patient-month across all treatment groups. The average cost to the Pennsylvania Medicaid program was approximately $68 monthly per patient. Drugs accounted for the majority of these costs ($51.04), followed by surgical/diagnostic procedures ($5.13), outpatient hospital visits ($4.89), and physician visits ($4.15).
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PMID:Use of non-antacid antiulcer agents in the treatment of heartburn and dyspepsia. 820 96

In 20 patients with diagnosis of functional dyspepsia due to dysmotility and/or reflux, the effectivity and tolerance of two prokinetic drugs--metochlopramide (MCP) (10 mg. three daily doses, vo) and cinitrapide (CTP) (1 mg., 3 daily doses, vo)--were assessed using a protocol of a propective and cross-sectional study after a blank period. Following the treatment with MCP and CTP, statistically significant improvements were observed in the intensity/severity of postprandial epigastric fullness, flatulence, epigastralgia, pyrosis, active regurgitations and anorexia. The MCP was more effective for the improvement of vomiting in these patients; however, the number of defecations per week increased significantly only after the CTP therapy. The therapeutical effectivity of both drugs, according to a subjective and objective global assessment was similar, with good results of 60-65% for MCP and 55-60% for CTP. Tolerance of both drugs was good. None of the patients spontaneously referred to the presence of side effects and only 3 patients (15%) treated with MCP and 2 patients (10%) treated with CTP mentioned some of the suggested side effects, which were absent before the onset of treatment. Both drugs produced an increase in the levels of Prolactine, but their average values were within the normal range. Only in two patients treated with MCP and in one patient treated with CTP, values slightly higher than the upper normal limit were observed. No significant differences were observed when comparing the results obtained with MCP therapy and CTP therapy.
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PMID:[Metoclopramide versus cinitapride in the treatment of functional dyspepsia]. 821 64

Antacids have for long been regarded as the mainstay of pharmacologic therapy in patients with dyspepsia. The advent of the histamine H2-antagonist and of proton pump inhibitors has provided simpler and overall more efficient therapeutic modalities for severe forms of dyspepsia. This relates especially to aggressive forms of peptic ulcer disease and severe reflux oesophagitis, where even high dose histamine H2-antagonist therapy has its clear limitations. Antacids nevertheless continue to be widely used in less severe forms of dyspepsia, especially in patients suffering from heartburn. In such patients self medication of antacids as first therapeutic measure is still very common. This is well exemplified by an American nd British survey. Out of 6760 randomly selected British general practice patients 875 suffered from reflux-like symptomatology without having consulted their physician for the symptomatology for minimum one year. Antacids were taken by 61% of them. The advent of controlled endoscopic trials and the emergence of the H2-receptor blockers as a yardstick of ulcer therapy, however, facilitated reappraisal of the value of antacids in various conditions. This has given a clear-cut answer in well defined entities such as peptic ulcer disease and stress ulcer prophylaxis but has left many open questions in heterogeneous conditions especially in and around gastroesophageal reflux disease.
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PMID:Clinical use of antacids. 826 Jul 36


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