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

When 102 patients with dyspepsia who had normal findings on barium-meal examination in 1964 were interviewed in 1970, 85 of them (76%) were symptomatically improved, and only three were later shown to have a peptic ulcer. This suggests that "x-ray-negative dyspepsia" has a good prognosis in a general practice setting.
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PMID:Natural history of patients with x-ray-negative dyspepsia in general practice. 464 90

A survey of recurrent indigestion in four general practices (19,619 patients) showed a wide range of dyspeptic complaints. Of these 82 (4.2 per 1,000) already had a proved ulcer and 144 (7.3 per 1,000) had symptoms suggesting a duodenal ulcer and had either not been investigated or had previously had a normal barium meal. A duodenal ulcer was found radiologically in half the men (46 out of 95) but in only 16% of the women (8 out of 49). In 11 (25%) of the 46 men shown to have an ulcer a barium meal had been previously reported as normal. Evidence is put forward that ulcer symptoms in the large residue of patients with a normal barium meal (38 men, 29 women) were produced by a primary duodenal condition (duodenitis) of which ulcer was one complication.
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PMID:Duodenal ulcer and recurrent dyspepsia. 491 92

Barium meal studies have shown evidence of a recurrent ulcer or of stenosis in 12 out of 24 patients with recurrent dyspepsia after vagotomy and pyloroplasty. These 12 patients have been subsequently proved to have had recurrences and all but one are now cured by further surgery. Barium meals in 12 patients show no evidence of recurrence or stenosis, and follow-up clinical studies suggest that they do not have recurrent ulcer. Radiological studies appear to have great value in the interpretation of recurrent dyspeptic symptoms after vagotomy and pyloroplasty.
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PMID:Recurrent ulcer after vagotomy and pyloroplasty: the x-ray appearances and their value in diagnosis. 542 42

Of 19 patients with chronic non-specific lung disease, chosen without reference to dyspeptic symptoms, 17 (89%) exhibited duodenogastric reflux of barium indicating pyloric incompetence. In the one patient who proved to have a gastric ulcer the amount of reflux diminished when the ulcer healed. The degree of pyloric incompetence was not found to be related to the severity of arterial blood gas or pH disturbance or to the presence of right heart failure. All patients who exhibited reflux had evidence of obstructive airways disease and most were receiving bronchodilators.We believe that reflux of detergent bile into the stomach may explain the high incidence of dyspepsia and acute gastric ulceration in chronic non-specific lung disease.
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PMID:Pyloric incompetence in chronic non-specific lung disease. 554 53

Lactic dehydrogenase (LDH) and beta-glucuronidase concentrations were measured in the resting gastric juice of 113 patients presenting with dyspepsia. All patients were investigated by double-contrast barium meal, endoscopy with biopsy, and, when appropriate, by laparotomy. In all patients tested there was a positive correlation between LDH and beta-glucuronidase concentrations. An index derived from the two enzyme activities correctly predicted the presence of gastric carcinoma in 41 out of 42 cases, and identified the only 2 cases of early gastric cancer in the series. There were 13 (11.5%) false-positive results, all in cases with extensive intestinal metaplasia, a change which may be associated with an increased risk of gastric malignancy. The measurement of gastric-juice enzymes is useful in the diagnosis of gastric cancer and may be of value in the identification of high-risk groups. The test is easily performed, inexpensive, and reproducible.
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PMID:Gastric-juice enzymes--an aid in the diagnosis of gastric cancer? 611 86

The activity of sorbiperan was assessed during radiological examinations of 15 patients with hypomobility of the gallbladder, associated in some cases with atonic dyspepsia, and 25 cases of spastic colon with constipation and/or diarrhea due to diverticulosis, dolichocolon, sigmoiditis, or parasitosis. Patients with gallbladder dysfunction were examined radiologically before and after oral administration of 20 to 40 ml of sorbiperan, the dose varying as a function of bodyweight. In 3 patients, the hypermobility of the gallbladder provoked by this agent was greater than that observed with all usually employed products, in 11 cases the cholagogue produced an excellent effect, while in one case there was no observed effect. Patients with colitis were administered a barium enemea, and an initial series of films were taken. These were repeated after addition of 80 ml of sorbiperan to the same enema. Total, rapid evacuation of the colon was observed in 8 cases, while in 15 cases it was of excellent quality. No effect was noted in 2 cases. Sorbiperan provokes effective contractions of the gallbladder, favours sphincter of Oddi dynamics, increases motility of all digestive tract segments, and very significantly accelerates gastro-entero-colic peristalsis. Tolerance was excellent.
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PMID:[Cineradiological study of the activity of sorbiperan on the gallbladder and colon (author's transl)]. 626 14

Since many dyspeptic patients are still investigated initially by radiology, a policy was initiated whereby all such patients were directly referred for combined simultaneous double-contrast barium meal and cholecystogram. This policy was aimed at reducing patient visits to hospital and increasing diagnostic yield. The results of 1,444 combined procedures are presented. Of these, 310 (25.5%) had a positive finding on barium meal only; 275 (19%) were positive for cholecystogram only; 117 (8.1%) were positive for both examinations; 742 (51.4%) were negative for both examinations. Of all the patients (427) who had a positive finding on barium meal, 27.4% (117) also had a positive finding on cholecystogram. Of all the patients (392) with a positive cholecystogram, 29.8% (117) also had a positive barium meal. Diagnostic yield rose considerably with patient age. It was found that simultaneous barium meal and cholecystogram presented no serious technical difficulties. It was concluded that in patients over 40 years old, this policy improved diagnostic yield as many patients had both gall bladder and upper gastrointestinal pathology. In all other patients this policy markedly reduced the number of hospital visits. Combined simultaneous double-contrast barium meal and cholecystogram is therefore recommended for hospitals which used radiology for the first line investigation of dyspepsia. Also, the general principle of examination of both gall bladder and upper gastrointestinal tract is pertinent where other first line investigations are used.
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PMID:Combined barium meal and cholecystogram--an analysis of 1,444 patients. 647 31

One hundred and ninety-nine male London office workers with dyspeptic symptoms elicited by a self-administered questionnaire were randomly allocated to intervention and control groups to assess the potential benefits of screening. The members of the intervention group were interviewed and examined, and those men who were considered to have a possible or probable peptic ulcer received a barium meal examination (53%). At the clinical interview the intervention group were advised against both smoking and drinking alcohol. Eighteen months later both groups were recalled for interview and examination and their sickness absence in the intervening period was assessed. The intervention group did not alter their cigarette consumption but did reduce their alcohol intake by an average of 10%. The control group increased their alcohol intake by 20%. Both groups tended to improve symptomatically, and there were no differences in symptoms between the groups at the end of the study. Sickness absence was not affected by the intervention. It is concluded that screening for ulcer-type dyspepsia is not justifiable in male London office workers.
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PMID:A randomised controlled trial of the effects of screening for ulcer-type dyspepsia. 675 44

The diagnostic value of barium meal and endoscopy for the diagnosis of gastric ulcer and cancer was studied in 173 unselected patients with upper abdominal dyspepsia. The predictive value of both positive and negative results was higher for endoscopy than for barium meal. This was also found in earlier studies comprising hospitalized patients, with a consequent higher prevalence of disease, but this study shows that the superiority of endoscopy is maintained in a low-prevalence outpatient population. The diagnostic efficiency of both endoscopy and X-ray was independent of the order of examination. Knowledge of the result of the first examination thus did not improve the efficiency of the second one. Parallel use of endoscopy and barium meal results in a maximum of diagnostic yield but requires the highcost of double examination and supplementary examinations in cases of discrepancy between the two results. Routine use of barium meal with selective use of endoscopy in X-ray-positive cases requires a smaller number of examinations but results in the loss of an unacceptable number of diagnoses. When both costs and diagnostic yield are considered, endoscopy seems to be the examination of choice, with X-ray examination reserved for exceptional cases when endoscopy for one reason or another cannot be carried out. Hospital facilities should be planned with the aim of developing endoscopic services capable of taking over the traditional leading role of X-ray examination in the gastroduodenal field.
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PMID:X-ray examination and/or endoscopy in the diagnosis of gastroduodenal ulcer and cancer. 736 20

In an urban general practice serving 7800 patients, all patients presenting over five and a half years with dyspepsia lasting more than two weeks were investigated by fibreoptic endoscopy and cholecystography, and many by barium meal. Of the 393 patients with dyspepsia, 346 completed the investigation: 180 had specific disease of the oesophagus, stomach, duodenum, or gall bladder, including six with carcinoma. Al further 67 had mucosal disease, and only 99 patients had no abnormality. After the first year the number of patients presenting annually and the percentage of patients with specific lesions remained constant. The annual incidence for patients with dyspepsia was about 1% and for patients with specific lesions 0.4%, suggesting that each year those who became symptom free (either spontaneously or because of treatment) were balanced by a similar number who developed symptoms. In contrast to the conclusions of other workers that an "open-access" endoscopy service could not be justified because the number of patients with specific lesins fell during their survey, we suggest that such endoscopy services are indeed worth while for providing an accurate diagnosis of dyspepsia.
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PMID:Endoscopic studies of dyspepsia in a general practice. 742 12


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