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

This paper describes the clinical presentation of 360 patients suffering from "dyspepsia" at the time of their initial visit to two hospitals in Yorkshire. Disease categories studied were cholecystitis, duodenal ulcer, gastric ulcer, gastric cancer, and "functional" dyspepsia, with at least 50 patients in each category. The findings of this series are contrasted with "textbook" descriptions of these conditions. Some contrasts are quite surprising-for example, most of the 360 patients claimed that their pain was not aggravated by food. It is suggested that one reason for diagnostic error in this area of medicine is that clinicians have a faulty mental "database" of information with regard to the presentation of the various diseases concerned.
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PMID:Clinical presentation of patients with "dyspepsia". Detailed symptomatic study of 360 patients. 62 1

An open study was carried out in general practice to assess the analgesic effectiveness, tolerance and side-effects of salsalate when given at a dosage of 3 g per day for 6 weeks. Sixty-six patients who were known long-term analgesic users were treated: they included 16 with active inflammatory disease of rheumatoid type, 20 with degenerative joint disease, and 27 with other musculo-skeletal conditions. Three patients were withdrawn during the study because of gastro-intestinal upset. Assessments, using rating scale scores, were made pre-trial and at 2-weekly intervals of joint pain, other musculo-skeletal pain, and duration of morning stiffness. The results showed that there was marked improvement in joint pain and morning stiffness, particularly in those patients with inflammatory joint disease. Improvement in musculo-skeletal discomfort was less evident. Side-effects were reported on 24 occasions, the most frequent being dyspepsia. Faecal occult blood tests showed that there were 7 patients with probable blood loss during treatment, 4 of them, however, had no other clinical signs or symptoms of gastrointestinal intolerance.
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PMID:The use of salsalate for control of long-term musculo-skeletal pain: an open, non-comparative assessment. 65 29

The occurrence of gastritis in antral and body mucosa is compared in an Icelandic and a Danish group of patients with gastric ulcer, duodenal ulcer, and X-ray negative dyspepsia. In all 93 Icelandic and 88 Danish patients were examined. All signs of antral gastritis were more frequent in Icelandic than in Danish patients, but only the incidence of superficial inflammation and decreased mucus content in surface and crypt epithelium differed significantly. In body mucosa pseudopyloric metaplasia was more frequent in Iceland and occurred equally freqeuntly in all three diseases. A statistically significant correlation was found between macroscopic gastritis and occurrence of antral superficial inflammation and between smoking and superficial inflammation and decreased mucus content in the pyloric biopsy specimen. The presence of histological gastritis was not correlated to the intake of alcohol and salicylic acid, nor to the presence of pain at the time of investigation.
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PMID:A prospective comparative study of clinical and pathological characteristics in Icelandic and Danish patients with gastric ulcer, duodenal ulcer, and X-ray negative dyspepsia. II. Histological results. 67 62

Laterolateral choledochoduodenostomy is commonly used in the treatment of lithiasis and both benign and malignant stenosis of the main bile duct, and is regarded on all sides as safe and free from late complications. The latter, however, were noted in 6 personal cases and consisted of pain (5/6 cases), fever (4/6 cases), and dyspepsia (3/6 cases, icterus (1/6 cases). Surgery revealed recurrent or residual lithiasis (4 cases) and stenosis (4 cases). It is felt that the reflux of duodenal material into the main bile duct after creation of the anastomosis led to ascending cholangitis, stagnation and hence stenosis of the opening. Closure of the opening and extensive papilloplasty is not followed by immediate postoperative sequelae.
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PMID:[Late complications of latero-lateral choledocho-duodenostomy. Physiopathology, diagnosis and therapy. Apropos of 6 cases]. 69 14

A double-blind crossover study in 41 patients with knee joint osteoarthrosis was carried out to compare the efficacy of 1200 mg. azapropazone per day with 1600 mg. ibuprofen per day. After an initial week on placebo, patients received one or other of the active medications for 2 weeks, then a 1-week placebo wash-out period before being crossed over to the alternative drug for a further 2 weeks. Objective assessments were made of knee joint movement, and of knee joint and thigh circumference. Patients made daily assessments of pain and a final overall assessment of preference for one or other treatment period. The results showed that azapropazone produced a significant improvement (p less than 0.05) in knee joint mobility over placebo, both active drugs were more effective than placebo (p less than 0.05) in providing pain relief, but that there was no significant difference between the two in these parameters. There was a highly significant patient preference, however, for azapropazone (p less than 0.01) compared to ibuprofen treatment periods. The most commonly reported side-effect with both drugs was dyspepsia, but in no case was it sufficiently severe to necessitate stopping treatment.
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PMID:A comparative study of azapropazone and ibuprofen in the treatment of osteoarthrosis of the knee. 77 81

Dyspepsia may result from over-indulgence in alcohol and food, or from anxiety and emotional problems. It may also indicate a peptic ulcer, oesophagitis or less commonly, gallstones or gastric cancer. Investigation by endoscopy or barium studies is always indicated when an organic lesion is suspected. Reassurance, tranquillizers and antispasmodics help patients with functional dyspepsia. Antacids given hourly between meals are important in the treatment of all symptomatic peptic ulcers. Cimetidine causes rapid symptomatic relief of duodenal ulcer symptoms, and most ulcers will heal with six weeks' therapy. Gastric ulcer can be treated with carbenoxolone, but this drug is avoided in the elderly and in patients with cardiac failure or hypertension. Anticholinergic drugs are of value in duodenal ulcer, especially for night pain, but they should not be used in patients over the age of 50. Special diets are of no value. For the heartburn of oesophagitis, weight reduction and a regime of regular antacid therapy remain the important measures.
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PMID:The treatment of dyspepsia. 92 13

A sliding hiatus hernia is a common radiological finding and is not always relevant to the patient's symptoms. The possibility of an alternative explantation for the complaint of retrosternal pain or dyspepsia should always be considered, and when anaemia is present the site of occult blood loss is often lower in the gastrointestinal tract. The majority of patient's with symptomatic gastro-oesophageal reflux can be controlled with medical measures. Surgical intervention in cases of uncomplicated hiatus hernia should be recommended only after careful preoperative assessment and even then a satisfactory result cannot be absolutely guaranteed.
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PMID:Common gastroenterological problems. II.--Sliding hiatus hernia. 107 40

A number of drugs are available that act fairly specifically as "mild" analgesics, although this description by no means implies that their clinical effectiveness is limited to the relief of slight pain and trivial disability. They are effective by mouth and their action is mediated peripherally. Among the possible mechanisms of action, the inhibition of prostaglandin synthesis is currently regarded as most likely to be relevant. Some centrally acting drugs of the narcotic analgesic type, such as codeine and dextropropoxyphene are effective orally; they are usable in the same way as other mild analgesics and may be preferable for some types of pain. Many problems arise in the assessment and comparison of mild analgesics, both experimentally and clinically. Subjective assessments may be made on a pain scale by the patient himself, or by a trained observer. Individual variations are all-important, and the limitations of controlled trials need to be remembered. Alternative drugs and mixtures have little advantage over aspirin, but specific drug tolerance, in the long term, varies from patient to patient. Gastric irritation is most likely to occur with aspirin in the presence of chronic dyspepsia or acute precipitating causes such as alchoholic gastritis. Allergy also occurs in some susceptible individuals. The risk of renal damage with phenacetin is increasingly appreciated, and the possibility of hepatic damage from paracetamol is now recognised. Other side-effects and interactions are summarized in the review, and some notes are given on therapeutic and non-therapeutic use.
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PMID:Simple analgesics. 110

197 consecutive, non-acute, medical patients who presented with upper abdominal pain were subjected to a standard programme of investigation. The investigation represents an attempt to supplement general clinical experience with exact data. In about half the patients no cause of the pain was found and a diagnosis of X-ray negative dyspepsia was made by elimination. It is concluded that a special research effort is needed to explain the complaint in this large group of patients. Duodenal ulcer was twice as common as gastric ulcer, and two patients suffered from gastric cancer. The diagnostic value of the symptomatology was analysed, but only the relation of pain to meals was found to be of diagnostic interest. In particular, the probability of duodenal ulcer was low and that of X-ray negative dyspepsia high, if the pain was provoked by eating. The age, sex, and acid production also had diagnostic value.
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PMID:A diagnostic study of patients with upper abdominal pain. 120 11

A hospital series of 1042 duodenal ulcer patients was examined to determine the relationship of the age of onset of ulcer dyspepsia with the blood group and with the family history of ulcer dyspepsia. It was found that those patients whose symptoms begin in the first two decades of life (early onset patients) contain a significantly larger proportion of group A, B, and AB subjects and a significantly stronger family history of dyspepsia than those whose symptoms begin from the fourth decade of life onwards (late onset patients), in whom blood group O prevails. The group O status is shown to be associated with a significant proneness to duodenal ulceration and a significant proneness to bleed, and in the late onset patients a significant proneness to bleed recurrently and severely. Bleeding is the predominent complication in the early onset patients. There is a significantly increased tendency for the late onset ulcers to perforate, to become stenosed, to have severe pain, and to be virulent--that is, to be multiple, post-bulbar, or giant. While these features do not appear to be related to the effect of ageing, the occurrence of associated gastric ulceration and the mortality rate was shown to be related.
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PMID:Duodenal ulcers: early and late onset. 126 84


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