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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Reflux gastritis is a symptom-complex consisting of antacid-resistent epigastric pain, nausea and frequent vomiting, weight loss and anaemia, sometimes with evident gastrointestinal haemorrhage. Gastric secretory studies usually show achlorhydria. The onset of symptoms is usually abrupt in previously healthy subjects. From 1973 to 1977, eleven patients with the established diagnosis of reflux gastritis have been treated with a Roux-en-Y reconstruction, as a remedial operation. There was no mortality in the series. At follow-up after a mean time of two years, the result was graded as excellent in ten patients and as fair in one. It is concluded that the Roux-en-Y procedure can be recommended in patients with reflux gastritis.
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PMID:Roux-en-Y loop reconstruction as remedial operation for reflux gastritis after gastric resection. 27 33

Alkaline gastritis and alkaline esophagitis are now precisely defined syndromes. They occur most often after gastric surgery in which function of the pyloric and lower esophageal sphincter is compromised. Reflux of bile in these patients can then lead to severe inflammation of the gastric and lower esophageal mucosa. Epigastric pain, nausea and bilious vomiting are characteristic symptoms. Gastroscopy with biopsy is, therefore, the definitive diagnostic test; during endoscopy bile is seen in the lower esophagus or stomach, and the mucosa is red, friable and contains acute erosions. Conservative therapy including the administration of cholestyramine has not been helpful. Surgery consisting of diversion of the duodenal contents away from the stomach and lower esophagus is the treatment of choice. The Roux-en-Y procedure has been used most often and has resulted in the amelioration of the symptoms and signs in most patients.
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PMID:Alkaline gastritis and alkaline esophagitis: a review. 32 67

Bile acids have been proposed to be important in the pathophysiology of the syndrome of "bile reflux gastritis" after surgery. To examine the role of cholestyramine, an ion exchange resin that binds bile acids, on symptoms of this syndrome, we did a randomized, double-blind crossover study on 16 patients. No differences in frequency of abdominal pain, nausea, vomiting, or bitter taste were observed among cholestyramine (4 g, three times daily for 3 weeks), placebo, and routine (dietary restriction and ad libitum antacid) treatment periods. We conclude that this regimen of cholestyramine was ineffective in symptomatic treatment of bile reflux gastritis.
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PMID:Effect of cholestyramine on the symptoms of reflux gastritis. A randomized, double blind, crossover study. 33 Mar 2

Seventeen patients have completed a double-blind cross-over study of hydrotalcite against placebo in the treatment of bile vomiting after surgery for peptic ulcer. Overall there was no significant difference between the two treatments, with 9 patients improving on hydrotalcite and 5 on placebo. The original operation had been peformed less than 3 years before the study in 9 patients; in this subgroup there was an improvement on hydrotalcite treatment in 8 patients but in only 1 on placebo. These differences are statistically significant (P less than 0.005). Nausea, vomiting, heartburn and epigastric tenderness were improved although gastritis and endoscopic changes were not affected. It appears that hydrotalcite can help palliate symptoms of bile vomiting occuring soon after surgery for peptic ulcer.
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PMID:Hydrotalcite in the treatment of bile vomiting. 33 90

This study reports on ten patients with typical bile gastritis who had no prior gastric surgery. Clinical symptoms included burning epigastric pain unrelieved by food or antacid, episodic nausea, and vomiting of bile. In all patients the symptoms appeared after cholecystectomy, with (four patients) or without (six patients) transduodenal sphincterotomy; the symptoms were often initially attributed to chronic pancreatitis. Six patients had hypochromic, microcytic anemia. Eight patients had basal achlorhydria; stimulated acid secretion was low or absent in seven patients. Gastroscopic examination revealed gastritis, most prominent in the prepyloric antrum, and abundant bile lakes. Mucosal biopsy disclosed chronic gastritis. Although medical therapy failed, seven of eight patients treated by vagotomy, hemigastrectomy, and long Roux-en-Y gastrojejunostomy had immediate and sustained relief. Cholecystectomy appears to be a critical factor in the pathogenesis of bile gastritis in patients who have not had prior gastric surgery. Without the reservoir function of the gallbladder, the unregulated flow of bile into the duodenum probably promotes the access of bile to the unprotected gastric mucosa.
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PMID:Bile gastritis without prior gastric surgery: contributing role of cholecystectomy. 42 2

We observed 16 patients suffering from postoperative gastritis: 8 after a truncal vagotomy with pyloroplasty, 6 after a Billroth II type gastrectomy, 1 after a truncal vagotomy with a Billroth I type antrectomy, 1 after correction of a hiatal hernia with pyloroplasty. Symptoms appeared from 1 month to 16 years after surgery. They consisted in epigastric pain, nausea, vomiting, weight loss. The diagnosis is established essentially on the clinical picture and the endoscopy, which shows the presence of bile in the stomach and hyperemia of the mucosa. Microscopic lesions are constant, but there is no histologic specificity. 12 of 16 patients were operated on (Roux-enY loop). The reflux was suppressed in each case. Results of the operation were excellent or good in 10 patients, fair in one and unsatisfactory in one.
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PMID:[Postoperative gastritis caused by reflux. Apropos of 16 cases]. 65 39

One hundred and forty-two pediatric patients between age 1 month and 20 years had 163 endoscopic procedures. Of 66 with chronic abdominal pain, 21 had a source identified endoscopically that was seen in only 15 by esophagogram and upper gastrointestinal series. Of 31 with nausea, vomiting, dysphagia, and/or odynophagia and retrosternal pain, endoscopy demonstrated the source in 19 patients and radiographic studies in 14. Of 34 with hematemesis and/or melena, 26 had a bleeding site identified endoscopically but only 4 of 28 had an identified source by radiographic studies. Duodenal and gastric ulcers and hemorrhagic gastritis were the commonest cases of upper gastrointestinal bleeding and organically of chronic adbominal pain. Functional abdominal pain was the commonest cause of chronic abdominal pain in those endoscoped. Foreign bodies were removed from the esophagus and stomach of 6 patients and dislodged in 2 others. Caustic ingestion was recognized in the esophagus and stomach of 2 patients who did not have mouth burns. The GIF-P2-prototype with four-way tip control and ability to retroflex 180 degree up, 60 degree down, and 100 degree right and left was superior to GIF-P1 and CF-P-prototype for visualization of the entire esophagus, stomach, duodenal bulb, and postbulbar area in patients less than 10 years old. Visualization of the duodenal bulb was possible in 28 of 29 pediatric patients, and of the postbulbar area in 25 of 26 in whom it was attempted. Infants who weighed as little as 3 to 5 kg were successfully examined. Retroflexion was possible in 29 of 30 to see the fundus and cardioesophageal junction. Patients older than 10 years were better examined with the GIF-D because of its increased ability to transmit light. Sedation for the school-age child with 0.5 to 1.0 mg per kg of diazepam and 1 to 2 mg per kg of meperidine given intravenously provides excellent sedation in most instances. General anesthesia is preferable for the preschooler and infant. Minor complications occurred in 2 patients who received less than adequate sedation and in 1 patient with general anesthesia.
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PMID:Upper gastrointestinal fiberoptic endoscopy in pediatric patients. 87 Mar 72

Chronic erosive gastritis (C.E.G.) is a gastric mucosal lesionwith characteristic radiological and endoscopic appearances. Pyloric gland hyperplasia is seen on histological examination of biopsy specimens. C.E.G. is uncommonly reported in the English literature. In reviewing 3,800 upper gastro-intestinal endoscopies from 1971--1976, 108 patients were diagnosed as having typical features of chronic erosive gastritis, an incidence of 2.8%. There was a significant association with duodenal ulceration and an overall male predominance. The lesion can also co-exist with gastric ulceration and has been observed as an incidental finding in patients examined urgently for upper gastro-intestinal bleeding. In this context C.E.G. should be distinguished from acute mucosal erosions. Symptoms may relate to the accompanying peptic ulceration, although dyspepsia epigastric pain, fullness and nausea may possibly occur with C.E.G. alone.
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PMID:Chronic erosive (verrucous) gastritis. A study of 108 patients. 89 82

In 27 patients after selective or truncal vagotomy and pyloroplasty the occurrence of duodenogastric reflux was checked by two methods, by the measurement of Bromsulphalein (BSP)-concentration in the gastric aspirate after BSP was given intravenously and by instillation of a barium meal in the second part of the duodenum followed by upper GI-series. In 20 of 23 patients reflux was recorded radiologically, in 18 of 27 patients reflux was shown by the BSP-Method. Proven bile reflux was associated with major postoperative discomfort, such as epigastric fullness, nausea and epigastric pain, it was also associated with gastritis as shown by microscopic examination of biopsies taken from the antrum. It is recommended to consider duodenogastric reflux as a possible reason for patients complaints after vagotomy and pyloroplasty. To avoid those complaints the preference of proximal gastric vagotomy without pyloroplasty is supported, if preoperative gastric emptying is not impaired.
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PMID:[Duodenogastric reflux after vagotomy and pyloroplasty (author's transl)]. 125 49

Data from four double-blind studies of the treatment of patients with rheumatoid arthritis or osteoarthritis were combined. For 4 to 12 weeks, 747 patients received Arthrotec, a combination of 50 mg of diclofenac and 200 micrograms of misoprostol, and 754 patients received 50 mg of diclofenac; the drugs were given twice or three times daily. The five most commonly reported adverse events were abdominal pain by 23.2% of the diclofenac/misoprostol patients and 19.8% of the diclofenac patients; diarrhea by 19.9% and 11.3%; nausea by 11.8% and 6.5%; dyspepsia by 11.2% and 7.8%; and flatulence by 8.0% and 3.1%. Other adverse events, reported by similar proportions of both treatment groups, included headache, gastritis, dizziness, vomiting, and constipation. In the diclofenac/misoprostol-treated patients, the abdominal pain and diarrhea were rated mild in 30.6% and 24.3%, moderate in 49.1% and 51.4%, and severe in 20.2% and 24.3%. Serious adverse events occurred in eight of the diclofenac/misoprostol-treated patients and in 13 of the diclofenac-treated patients; 12.6% and 10.1%, respectively, were withdrawn from the study because of adverse events. Results of laboratory tests of hepatic and renal function were similar in the two treatment groups.
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PMID:Overall safety of Arthrotec. 143 22


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