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)

Many physicians consider gallstones to be a cause of vague upper abdominal discomfort. However, both dyspepsia and gallstones are common conditions in the general population, and the relationship between the two has continued to generate controversy. In this editorial, I review the evidence for and against a relationship between gallstones and dyspepsia. The data suggest that upper abdominal discomfort, heartburn, bloating, and other vague symptoms are not related to gallstones and the routine ordering of an ultrasound in the patient with dyspepsia is not warranted.
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PMID:Gallstones and upper abdominal discomfort. Innocent bystander or a cause of dyspepsia? 779 21

In an open, multicenter trial, 329 patients (who attended gastroenterology practices or outpatient gastroenterology departments of hospitals) with a mean age of 47.3 years, received 5 mg of cisapride three times a day (TID) for at least 2 weeks for the treatment of persistent, recurring symptoms of functional dyspepsia. The patients' symptoms required investigation or were unresponsive to previous drug treatment. When necessary, the dose of cisapride was increased to 10 mg TID, in most patients after 1 week of treatment, and the duration of therapy was extended to 4 weeks. At the end of cisapride treatment, the most frequently reported symptoms of functional dyspepsia were significantly improved. At the onset of the trial, 72.3% of patients complained of a moderate-to-severe feeling of fullness; this decreased to 19.7% after 2 weeks of treatment and to 15.3% after 4 weeks. The symptoms of bloating, a feeling of heaviness in the stomach, and postprandial epigastric discomfort showed similar improvement. Overall, 43.6% of patients were symptom-free or almost symptom-free after 1 week of cisapride treatment, 69.6% after 2 weeks, and 71.5% after 4 weeks. Only 11% of patients needed the increased dose of cisapride. Six weeks after completion of the trial, 74 patients (22.5%) had recurrent symptoms of functional dyspepsia. Adverse experiences were noted in 74 patients (22.5%), most commonly loose stools (7.6% of all patients), fatigue (4.9%), and headaches (4.0%). In most cases, these adverse experiences were mild and transient in nature and led to premature discontinuation of treatment in 11 patients (3.3%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic functional dyspepsia: short- and medium-term outcome of a therapeutic trial with cisapride. 792 10

The pathogenesis of nonulcer dyspepsia (NUD) is unknown. Gas and postprandial bloating are frequent symptoms. The role of Helicobacter pylori (HP) in the pathogenesis of NUD is controversial. We studied the intestinal gas profile of NUD patients (N = 34) at baseline and after lactulose administration. The prevalence of hydrogen and methane producers was similar among HP+ and HP- patients. Breath H2 concentrations in response to lactulose showed significantly greater rise among HP+ subjects (P < 0.0001). HP positivity was associated with higher total breath excretion for H2 and methane combined (2984 +/- 1038 vs 1776 +/- 521 ppm/hr) compared to HP- subjects (P < 0.05). There was no correlation between peak H2 and methane levels. The role of alterations in intestinal gas in producing symptoms in HP+ patients with NUD needs further investigation.
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PMID:Helicobacter pylori is associated with alterations in intestinal gas profile among patients with nonulcer dyspepsia. 805 Mar 8

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

In 30 patients with dyspepsia caused by dysbacteriosis of the gastrointestinal tract the authors administered the preparation Lactobacillus acidophilus (Rossel Co. Canada)--1. capsule with 2 billion live bacteria, in the morning after breakfast. The patients were divided into four groups: maldigestion, malabsorption, radiation enterocolitis and administration of antibiotics. The patients recorded themselves their subjective symptoms: pain, pressure, bloating, flatulence and appetite, and as to objective symptoms, the number and consistency of bowel movements, changes of body weight. The most rapid effect was achieved in dysbioses after antibiotics--within 3-4 days normalization occurred which persisted even after discontinuation of the drug. In maldigestion after one week bloating, flatulence, abdominal pain and pressure in the epigastrium was milder, and within two weeks the condition improved further. An excellent effect was achieved in radiation enterocolitis. In patients with lactose intolerance the tolerance of dairy products improved. No side-effects were observed, the preparation was very well tolerated; the mean body weight increment was 0.75 kg in three weeks. The preparation proved a new useful probiotic which is highly effective in dyspepsias caused by dysbiosis of the intestinal microflora.
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PMID:[Lactobacilli in the treatment of dyspepsia due to dysmicrobia of various causes]. 814 Jul 65

Although delayed gastric emptying is found in some patients with functional dyspepsia, there seems to be little relation between rate of emptying and symptoms. This study examined the hypothesis that food maldistribution rather than gastric stasis may equate to symptoms in such patients and used scintigraphic techniques to quantify the partition of gastric contents between proximal and distal stomach during gastric emptying. Eleven patients with functional dyspepsia characterised by chronic severe postprandial bloating without organic abnormality, and 12 healthy volunteers, ingested a standard meal labelled with technetium-99M (99mTc). Serial images of the gastric area in anterior and posterior projections were taken for 90 minutes, regions of interest for proximal, distal, and total stomach were defined, and activity time curves were derived from the geometric means of anterior and posterior counts. Total emptying in patients (median: 46 minutes; range: 30-76) was not significantly different from controls (45 minutes; 28-58) and only three showed delayed gastric emptying. In controls, food remained predominantly in the proximal half of the stomach after ingestion and then redistributed to the distal half. In the patients, however, initial activity in the proximal half after ingestion (48%; 40-65) was significantly lower (p < 0.05) than in controls (60%; 39-73) and distributed more fully to the distal half of the stomach with a peak distal activity (56%; 34-58), which was consistently higher than in controls (36%; 33-42) (p < 0.05). It is concluded that this subgroup of functional dyspepsia patients show abnormal intragastric distribution of food, independent of gastric emptying rate.
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PMID:Abnormal intragastric distribution of food during gastric emptying in functional dyspepsia patients. 815 Mar 41

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

Our objective was to obtain national data of the estimated prevalence, sociodemographic relationships, and health impact of persons with functional gastrointestinal disorders. We surveyed a stratified probability random sample of U.S. householders selected from a data base of a national market firm (National Family Opinion, Inc.). Questions were asked about bowel symptoms, sociodemographic associations, work absenteeism, and physician visits. The sampling frame was constructed to be demographically similar to the U.S. householder population based on geographic region, age of householder, population density, household income, and household size. Of 8250 mailings, 5430 were returned suitable for analysis (66% response). The survey assessed the prevalence of 20 functional gastrointestinal syndromes based on fulfillment of multinational diagnostic (Rome) criteria. Additional variables studied included: demographic status, work absenteeism, health care use, employment status, family income, geographic area of residence, population density, and number of persons in household. For this sample, 69% reported having at least one of 20 functional gastrointestinal syndromes in the previous three months. The symptoms were attributed to four major anatomic regions: esophageal (42%), gastroduodenal (26%), bowel (44%), and anorectal (26%), with considerable overlap. Females reported greater frequencies of globus, functional dysphagia, irritable bowel syndrome, functional constipation, functional abdominal pain, functional biliary pain and dyschezia; males reported greater frequencies of aerophagia and functional bloating. Symptom reporting, except for incontinence, declines with age, and low income is associated with greater symptom reporting. The rate of work/school absenteeism and physician visits is increased for those having a functional gastrointestinal disorder. Furthermore, the greatest rates are associated with those having gross fecal incontinence and certain more painful functional gastrointestinal disorders such as chronic abdominal pain, biliary pain, functional dyspepsia and IBS. Preliminary information on the prevalence, socio-demographic features and health impact is provided for persons who fulfill diagnostic criteria for functional gastrointestinal disorders.
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PMID:U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. 835 66

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

To ascertain the effect of gastric emptying on the symptoms of non-ulcer dyspepsia (NUD) patients, we randomly selected 60 NUD patients and, as control, 26 dyspepsia-free volunteers. We measured the gastric emptying time of mixed food (270 kcal), using real-time ultrasonography in two ways. NUD patients were divided randomly into two groups and given domperidone or placebo in a double-blind trial. Of the NUD patients 48% had delayed gastric emptying times and associated epigastric pain, bloating, early satiety, and regurgitation. A prokinetic agent not only improved emptying time but also relieved some of the symptoms of the NUD patients. Real-time ultrasonography proved a useful method for evaluating gastric emptying.
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PMID:A study of gastric emptying in non-ulcer dyspepsia using a new ultrasonographic method. 848 69


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