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)

Decreased acid clearance and increased exposure to acid of the duodenum have been reported in a subset of functional dyspepsia patients. However, the mechanism by which increased duodenal acid exposure may affect symptoms is unclear. The aim of the present study was to investigate the effects of duodenal acidification on proximal gastric tone and mechanosensitivity in humans. An infusion tube with a pH electrode attached was positioned in the second part of the duodenum, and a barostat bag was located in the gastric fundus. In 12 healthy subjects, fundic tone and sensitivity to distensions were assessed before and during duodenal infusion of 0.1 N hydrochloric acid or saline in a randomized, double-blind design. In 10 healthy subjects, meal-induced accommodation was measured during duodenal infusion of acid or saline. Acid infusion in the duodenum significantly increased fundic compliance and decreased fasting fundic tone. This was accompanied by a significant decrease in the pressures and the corresponding wall tensions at the thresholds for discomfort. During infusion of acid, significantly higher perception and symptom scores were obtained for the same distending pressures. The meal-induced fundic relaxation was significantly smaller during acid infusion compared with saline infusion. In conclusion, duodenal acidification induces proximal gastric relaxation, increases sensitivity to gastric distension, and inhibits gastric accommodation to a meal. Through these mechanisms, increased duodenal acid exposure may be involved in the pathogenesis of dyspeptic symptoms.
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PMID:Influence of duodenal acidification on the sensorimotor function of the proximal stomach in humans. 1276 Sep 3

Fascioliasis has not been confirmed as a human disease entity until now in Korea despite of sporadic discovery of ova of Fasciola sp. in human fecal materials being never traced to the confirmation of infection. Almost all of the cases with ova in their stool have been related with consumption of cattle liver whether eaten in raw or processed. The present authors confirmed a human fascioliasis case who was a Korean housewife of 42-year-old living in Seoul, during the exploratory laparotomy. The patient had been healthy until October 1975 when abrupt onset of urticaria, dyspepsia, epigastric discomfort developed. And the fluctuation of these symptoms was followed by epigastric colicky pain attacks from December 4, 1975. A complete worm of Fasciola sp. was removed during the bile-duct exploration with stone forceps in lower half of common bile duct, on January 20, 1976. The patient only agreed that she had eaten some raw liver of cattle on September 1975 but denied any possible sources of infection such as drinking of untreated water, handling of water flower and grass, and eating of raw watercress. The measurements of the removed worm: 35. 61 mm in body length, 14.00 mm in maximum body width(Length/width ratio, 2.54:1), distribution of testes to body length 33.9%, number of branches of ovary 22, the size of intrauterine ova 157.2 x 108. 4 micrometer in average. These findings are not compatible with the classical descriptions of both Fasciola hepatica and F. gigantica, and it was concluded it is so-called Fasciola sp. which is intermediate between two species as proposed by many Japanese workers.
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PMID:[A Case Of Human Fascioliasis In Korea] 1291 44

This study evaluated the analgesic efficacy of administering preoperatively rofecoxib or naproxen sodium to patients undergoing abdominal hysterectomy. A randomized, double-blinded prospective study was conducted with 60 women undergoing elective abdominal hysterectomy under general anesthesia. Patients were randomly allocated into one of three equally sized groups. Patients in the first group received rofecoxib 50 mg 1 h before operation (group R), patient in the second group received naproxen sodium 550 mg 1 h before surgery (group N) and patients in the third group received a placebo tablet in the same time (group P). Total amount of used morphine mixture was higher in placebo group (93+/-6 ml) than in the group R (50+/-4 ml) and group N (64+/-6 ml). There were significant difference for total amount of used morphine mixture between group P and other two groups. There was significant difference in the volumes of morphine mixture used in the first 12 h in group P and other two groups. The occurrence of side effects such as, dyspepsia, epigastric discomfort, heartburn, were similar in group R and group P. However, this side effects were increased in group N. Rofecoxib receiving preoperatively was provided clinical efficacy for postoperative pain control and well tolerated for gastrointestinal side effects comparable with naproxen sodium.
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PMID:A comparative study of the effect of rofecoxib (a COX 2 inhibitor) and naproxen sodium on analgesic requirements after abdominal hysterectomy. 1450 73

Dyspepsia is a general term that describes pain or discomfort that is centred in the upper abdomen. It reportedly affects up to 40 per cent of adults in any one year. A test and treat strategy is now recommended for all patients with uncomplicated dyspepsia. Any patient presenting with alarm features, such as recurrent vomiting or dysphagia, should be referred to a specialist for further investigation.
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PMID:The management of dyspepsia. 1456 32

The "GI Cocktail" is a mixture of medications often given in the Emergency Department (ED) for dyspepsia symptoms. Several combinations are used, but the most effective has not yet been determined. This study compared three combinations commonly given for dyspepsia. The study was a prospective, randomized, double-blinded trial comparing antacid (group 1); antacid + Donnatal (group 2); antacid + Donnatal + viscous lidocaine (group 3) for acute treatment of dyspepsia in the ED. Patients were randomly assigned to receive one of the three medication combinations. Patients rated their discomfort on a Visual Analog Scale (VAS) immediately before receiving the medication and 30 min later. Change in VAS was the primary study endpoint. A 13-mm difference in VAS was considered clinically significant. VAS change in the three groups was compared using multivariable regression, controlling for pretreatment VAS, study drug, previous antacid use, and gastrointestinal (GI) history. One hundred twenty patients were enrolled between July and December 2000. One hundred thirteen subjects (113) completed the protocol: Group 1 (N = 38); Group 2 (N = 37); Group 3 (N = 38). There was no statistically significant difference between the groups in terms of age, gender, GI history, previous antacid use, or initial degree of pain. Group 1 had a 25 +/- 27 mm mean (+/- SD), decrease in pain; Group 2, 23 +/- 22 mm decrease; and Group 3, 24 +/- 26 mm decrease. There was no statistically significant difference in pain relief between the three groups on univariate analysis or multivariable regression. In conclusion, the addition of Donnatal or Donnatal + lidocaine to an antacid did not relieve dyspepsia better than plain antacid. The "GI Cocktail" concoction may not be necessary.
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PMID:The GI Cocktail is no more effective than plain liquid antacid: a randomized, double blind clinical trial. 1458 49

Functional dyspepsia is defined by the presence of pain/discomfort in the upper abdomen without evident of organic disease which explain it; it must not be relief by defecation and its onset must not be related to changes in freqfrecuentlyuency or consistency feces. Diagnosis also requires pain or discomfort to be present for 12 weeks, not necessarily consecutives, in the last year. It is classified in three subgroups: ulcer-like, dysmotility-like and unspecified). Functional dyspepsia represents not only a diagnostic challenge but also a therapeutic problem, since no specific drug is available. An appropriate management of functional dyspepsia should consider patient's personality, diagnostic work-up, therapeutic alternatives and patient-doctor relationship. Many patients "live" their disease as the center of their life, sometimes creating great problems to physicians. Doctors should dedicate enough time to the patient, show interest in patient's problems, make a rigorous physical examination, and perform an appropriate work-up individualized for each patient. Regarding therapeutic decisions, it is important to reassure patients about the absence of organic disease. However it should be avoid to tell them that no disease exist at all; instead, the functional nature of the disease must be emphasized, explaining what and how upper GI tract is malfunctioning; Patients should know that doctor understand their symptoms are true symptoms; also, they must be informed bout the excellent outcome, without changes in life expectancy and a natural trend to improve with time; doctor should help patients to recognize that emotional situation have a great impact in disease course; and a therapeutic plan should be discussed and agreed with patients.
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PMID:[Functional dyspepsia. The physician and the patient]. 1461 48

Epigastric pain may occur as a specific and localized symptom, as part of a group of symptoms that include heartburn, or in association with bloating or early satiety. The current classification (Rome II) characterizes ulcer-like dyspepsia by predominant pain centered in the upper abdomen and characterizes dysmotility-like dyspepsia by discomfort. The large number of patients presenting with epigastric pain has led to the development of empirical strategies.
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PMID:Epigastric pain in dyspepsia and reflux disease. 1467 10

Helicobacter pylori (HP) has been proposed as a mechanism of functional dyspepsia, but its role is still unclear. Our aim was to investigate the association between HP infection and dyspeptic symptoms and to verify whether the infection affects the pathophysiological mechanism of functional dyspepsia. The presence of HP and its association with dyspeptic symptoms were studied in 326 patients. Also, the effect of HP infection on solid/liquid gastric emptying rates, gastric sensitivity, and accommodation to meal was studied. HP was present in 17% of the patients, who showed symptom prevalence similar to that of HP-negative patients. Presence of HP did not significantly affect gastric emptying rates for solids and liquids, discomfort sensitivity thresholds (8.7 +/- 0.3 vs 9.8 +/- 0.9 mm Hg), or meal-induced gastric relaxation (133 +/- 12 vs 125 +/- 29 ml; all P's NS). In conclusion, in patients with functional dyspepsia the presence of HP infection does not seem to affect significantly the overall prevalence of symptoms or the gastric sensory-motor functions.
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PMID:Symptom patterns and pathophysiological mechanisms in dyspeptic patients with and without Helicobacter pylori. 1471 6

The purpose of this study was to examine whether the symptoms experienced by patients with unstable angina (UA) differed from the symptoms experienced by patients with myocardial infarction (MI). Data were obtained from two studies: one examining the symptoms of MI (n=238) and one examining the symptoms of UA (n=100). Interviews were conducted after hospital admission at three medical centers in the Midwest. There were no differences between patients with MI or UA in age, gender, or race. The patients experiencing MI reported significantly more nausea (46% vs. 32%), vomiting (19% vs. 2%), indigestion (42% vs. 16%), and fainting (9% vs. 2%). The patients experiencing UA reported significantly more chest discomfort (97% vs. 87%), lightheadedness (52% vs. 39%), numbness in the hands (43% vs. 28%), and neck discomfort (31% vs. 13%). Patients with MI rated the peak intensity of the chest discomfort higher than patients with UA (mean 8.4 vs. mean 7.7).
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PMID:Differences in the symptoms associated with unstable angina and myocardial infarction. 1501 50

Functional bowel disorders (FBDs) are defined by symptoms of gastrointestinal (GI) dysfunction, discomfort and pain in the absence of a demonstrable organic cause. Since the prevalence of FBDs, particularly functional dyspepsia and irritable bowel syndrome, can be as high as 20%, FBDs represent a significant burden in terms of direct healthcare and productivity costs. There is emerging evidence that the discomfort and pain experienced by many FBD patients is due to persistent hypersensitivity of primary afferent neurons, which may develop in response to infection, inflammation or other insults. This concept identifies vagal and spinal sensory neurons as important targets for novel therapies of GI hyperalgesia. Sensory neuron-specific targets can be grouped into three categories: receptors and sensors at the peripheral nerve terminals, ion channels relevant to nerve excitability and conduction and transmitter receptors. Particular therapeutic potential is attributed to targets that are selectively expressed by afferent neurons, such as the transient receptor potential channel TRPV1, acid-sensing ion channels and tetrodotoxin-resistant Na + channels.
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PMID:Gastrointestinal pain in functional bowel disorders: sensory neurons as novel drug targets. 1510 53


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