Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0024623 (gastric cancer)
 36,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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.
 ...
PMID:The treatment of dyspepsia. 92 13

In order to evaluate quality of life and functional results following surgery for gastric cancer we studied 89 patients with no evidence of disease at a minimum of 12 months postoperatively. Patients were treated with total gastrectomy and jejunal pouch reconstruction according to Hunt-Lawrence-Rodino (n = 59), distal gastric resection (n = 21) or proximal gastric resection (n = 9). No significant differences were found between total gastrectomy or distal gastric resection with respect to dumping or heartburn, while patients with proximal gastric resection suffered from both. The latter group of patients reported both reduced feelings of hunger and appetite, resulting in a reduced nutritional status. Similar differences were observed when patients were assessed for quality of life; feeling well, feeling ill and capacity to work were all reduced in patients with proximal gastric resection, and their scores were lower when scoring systems according to Visick, Karnofsky, Spitzer and Troidl were applied. Psychological-rating scales measuring complaints and distress confirmed the superiority of total gastrectomy with pouch reconstruction or distal gastrectomy compared to proximal gastric resection. We conclude that in terms of postoperative quality of life, distal gastric resection has no advantage over total gastrectomy with pouch reconstruction. Proximal gastric resection incurs bothersome sequelae and should, therefore, be avoided.
 ...
PMID:Quality of life and functional results following different types of resection for gastric carcinoma. 237 97

From 1973 to 1983, 802 patients with gastric cancer were operated on. Out of them, 292 (36.4%) received total gastrectomy. Reconstruction was performed mainly by the Billroth II procedure associated with the closure of the afferent loop according to Plenk's method. 90 patients living more than 3 months complained of the following: heartburn, 18 (20%); reflux, 12 (13.3%); retrosternal pain, 3 (3.3%); stenotic sensation, 23 (25.6%); diarrhea, 10 (11.1%); abdominal pain, 14 (15.6%); and dumping syndrome, 6 (6.7%). It seems to indicate that the quality of life after total gastrectomy is satisfactory.
 ...
PMID:[Clinical studies on the complaints of survivors living more than 3 months after total gastrectomy]. 358 41

A prospective randomized study was carried out to evaluate the nutritional and clinical results of two reconstructive procedures after total gastrectomy for gastric cancer: Longmire-Mouchet (LM) operation with loop interposition and maintained duodenal transit and Roux-en-Y (RY) reconstruction with duodenal exclusion. 22 patients, 11 with LM reconstruction and 11 with RY reconstruction were studied pre-and postoperatively. The average follow-up was of 30 +/- 8 months. The clinical results were shown to be substantially similar to the two groups. No patients complained of heartburn or dysphagia. At esophagoscopy no signs of esophagitis were detected in both groups. The two time course curves of body weight variation did not show statistically significant differences even though in RY patients the body weight has reverted more rapidly to basal values.
 ...
PMID:Nutritional effects of total gastrectomy. A prospective randomized study of Roux-en-Y vs Longmire-Mouchet reconstruction. 383 Sep 53

To evaluate quality of life and functional results following surgery for gastric cancer we studied 104 patients with no evidence of disease at a minimum of 12 months postoperatively. Patients were treated with total gastrectomy and jejunal pouch reconstruction according to Hunt-Lawrence-Rodino (n = 59) or simple esophagojejunostomy (n = 24) and distal subtotal gastrectomy (n = 21). No significant differences were found between total gastrectomy with pouch reconstruction and distal gastric resection with respect to dumping or heartburn, whereas patients with total gastrectomy and restoration with esophagojejunostomy suffered from both. The latter group of patients also had reduced nutritional status. Although there is a lack of a proper definition of quality of life, all instruments applied to its measurement indicated improved results for patients with pouch reconstruction and those after distal gastrectomy, but we could not state any significant differences. We conclude that in terms of postoperative functional results as well as quality of distal gastric resection has no advantage over total gastrectomy with pouch reconstruction; hence a reduction of surgical radicality in an attempt to improve postoperative results is not justified. Pouch reconstruction should be considered the treatment of choice for reconstruction after total gastrectomy.
 ...
PMID:Reconstruction after gastrectomy and quality of life. 767

H2-receptor antagonists have been widely prescribed in the last 20 years and are considered to rank among the safest drugs known. In several countries they have been switched to over-the-counter (OTC) status, and a similar move is under consideration in Canada. Some concerns have been raised as to the effectiveness of these drugs in the treatment of dyspepsia and heartburn, their safety when taken for self-diagnosed symptoms, and the potential for their use to delay diagnosis or mask serious disease. The author presents evidence to support the use of OTC H2-receptor antagonists in the treatment of dyspepsia. He argues that the safety record of these drugs is reassuring and that they are unlikely to mask gastric cancer. Finally, he describes the appropriate place of OTC H2-receptor antagonists in the overall management of acid-related disorders.
 ...
PMID:Habit, prejudice, power and politics: issues in the conversion of H2-receptor antagonists to over-the-counter use. 854 66

Dyspepsia, defined as "pain or discomfort centered in the upper abdomen" is reported by one in four adults in Western societies. The most important causes are non-ulcer (functional) dyspepsia, peptic ulcer, gastroesophageal reflux, and, rarely, gastric cancer. Persons with heartburn alone are not considered to have dyspepsia. The division of dyspepsia into symptom-based subgroups (ulcer-like, dysmotility-like, reflux-like, and unspecified dyspepsia) has proven to be of doubtful value for the clinician, as it has a low predictive value for identifying the causes of dyspepsia. Upper endoscopy remains the "gold standard" test; ultrasound and blood tests have a low yield. The role of Helicobacter pylori in peptic ulcer disease is well known, but the clinical role of the infection in non-ulcer dyspepsia remains very controversial. In uninvestigated dyspeptic patients who are H. pylori infected based on a non-invasive test, empiric anti-H. pylori therapy is a reasonable and probably cost-effective option. In documented non-ulcer dyspepsia, prokinetics are superior to placebo while antisecretory therapy is of less certain efficacy.
 ...
PMID:Dyspepsia: current understanding and management. 950 76

We report a rare case of idiopathic sclerosing encapsulating peritonitis (SEP). During a laparotomy before undergoing a distal gastrectomy with Billroth II reconstruction for early gastric cancer, the patient was found to have a membranous encapsulation wrapping each small bowel loop, unlike peritoneal encapsulation or typical SEP. He had complained of persistent heartburn, distension and diarrhea for 2 months in the post-operative course. The second laparotomy, which was performed to improve prolonged transit, revealed typical SEP with a thick and fibrotic membrane that encased the small bowel entirely. Stripping of the sclerosing encasing membrane, separation of the adherent loops of the proximal small bowel, and Braun's anastomosis were performed. The patient complained of epigastric fullness and diarrhea after he was relieved from the complete bowel obstruction for 45 days post-operatively. Trimebutine maleate was administrated 5 months after the second operation and this markedly improved his symptoms. This case might reflect the developmental process of idiopathic SEP. In addition, the use of a motility regulator may improve symptoms related to the abnormal intestinal motility by this disease.
 ...
PMID:Possible development of idiopathic sclerosing encapsulating peritonitis. 1022 20

A 66-year-old man was referred to our institute for investigation of heartburn and epigastralgia. Endoscopic examination demonstrated a type 4' gastric cancer which occupied the whole stomach. At laparotomy, multiple small nodules were found in the spleen which were diagnosed as metastases of the gastric cancer. Thus, total gastrectomy with distal pancreatectomy, splenectomy, cholecystectomy, and left adrenalectomy, combined with D4 lymph node dissection, was performed. Microscopic examination of the tumor revealed tubular and mucinous adenocarcinoma which invaded the muscularis propria. Sarcoid reactions were observed in the submucosa adjacent to the carcinoma tissue. Only one lymph node from station no. 8a demonstrated tumor metastasis, while those from station nos. 1, 2, 7, 8, 9, 10, 11, 13, and 16 revealed sarcoid reactions without tumor metastases. Subsequently, the multiple small nodules that had been presumed to be splenic metastases at laparotomy were found to be sarcoid reactions similar to those seen in the submucosa and regional lymph nodes. Since no skin or ocular lesions indicative of systemic sarcoidosis were seen in this patient, a diagnosis of advanced gastric cancer associated with sarcoid reactions was established. To our knowledge, there have been no previous reports regarding an association between sarcoid reactions in the spleen and gastric cancer.
 ...
PMID:Gastric cancer with sarcoid reactions in the regional lymph nodes, the stomach wall, and the splenic parenchyma: report of a case. 1038 71

Dyspepsia, according to the internationally accepted Rome criteria, refers to pain or discomfort centred in the upper abdomen; patients with predominant heartburn are excluded from this group, although minor or infrequent heartburn is commonly associated with dyspepsia. It is an important condition not only because it is common and costly, but because it may indicate the presence of serious disease such as peptic ulcer or gastric cancer. However, the most frequent causes of dyspepsia are functional dyspepsia and gastro-oesophageal reflux disease. The discovery of Helicobacter pylori has resulted in important advances in the management of dyspepsia. The clinician faced with a patient who has persistent or recurrent dyspepsia needs to differentiate clearly those patients who have not been previously investigated from patients documented to have functional dyspepsia after investigation (fig 1). Here, the management of H pylori positive dyspeptic patients who have and have not been fully investigated will be reviewed.
 ...
PMID:How should Helicobacter pylori positive dyspeptic patients be managed? 1045 33


1 2 3 4 Next >>