Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have investigated the effect of oral cisapride (10 mg t.i.d.) in a double-blind, placebo-controlled trial in 26 patients with upper gut dysmotility: 11 with gastroparesis (8 diabetic, 3 idiopathic) and 15 with chronic idiopathic intestinal pseudoobstruction. Patients were evaluated at entry and at the end of the 6-wk study by upper gastrointestinal manometry, scintigraphic evaluation of gastric emptying of solids and liquids, measurement of body weight, and scoring of the following symptoms: abdominal pain, nausea, vomiting, early satiety, bloating, and distention. Cisapride and placebo groups were strictly comparable for all parameters assessed. Cisapride resulted in a significant increase in the gastric emptying of solids (p less than 0.05) compared with placebo; cisapride also tended to increase the postcibal antral motility and normalize the abnormal manometric features in the patients with intestinal dysmotility, particularly the characteristics of fasting interdigestive motor complexes and the fed motor pattern. Both cisapride and placebo groups showed an improvement in total symptom scores and there was no significant difference in overall symptom response between the two groups. However, the change in abdominal pain was greater with cisapride (p = 0.07). Cisapride facilitates gastric emptying in patients with upper gut dysmotility. The overall symptomatic benefit during a 6-wk trial of cisapride, 10 mg t.i.d., was not greater than that of placebo, and dose-response as well as longer term trials are necessary to determine the clinical efficacy of this medication.
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PMID:Effect of six weeks of treatment with cisapride in gastroparesis and intestinal pseudoobstruction. 264 50

Symptoms of severe nausea, vomiting, abdominal pain, and frequent bezoars, as well as objective gastric retention, can occur following Roux-Y biliary diversion for alkaline reflux gastritis. Medical therapy and prokinetic drugs have proven ineffective. This review evaluates 37 patients who underwent further gastric resection from 1979 to 1987 to improve gastric emptying and resolve symptoms. Fifteen patients underwent perioperative radionuclide solid-food gastric emptying studies. Seventy-three per cent (27 of 37 patients) of the patients who underwent further gastric resection (70% to 95%) had a satisfactory postoperative response. Twenty patients were graded Visick 1 or 2 and 7 Visick-3 patients, although much improved, still had some symptoms of gastroparesis. Twenty-seven per cent (10 of 37 patients) failed to improve and underwent completion total gastrectomy. Overall, 70% of this group had almost complete resolution of their symptoms. Three of 10 patients were considered "failures" due to postprandial pain in 1 and early vasomotor dumping in 2. Of the 10 patients who failed initial revisional surgery, 7 underwent a 70% to 80% subtotal gastric resection (STG) and 3 patients underwent 85% to 95% extensive resection (EXT.G.). Of the 15 patients who underwent perioperative radionuclide evaluation, a mean two-hour gastric retention of 61.4% +/- 4% (SEM) decreased to 25% +/- 4% following further gastric resection. Eight patients were in the STG group and seven patients were in the EXT.G group. Following STG, mean two-hour gastric retention of 58.2% +/- 3.5% decreased to 38% +/- 3% (p less than 0.05). In seven patients who underwent EXT.G, mean two-hour retention of 65% +/- 4% decreased to 10% +/- 2.5% (p less than 0.005). EXT.G resulted in normal gastric emptying and few late failures. In post-Roux-Y patients with symptoms of gastroparesis and documented gastric retention, EXT.G normalizes gastric emptying and restores a better quality of life. Total gastrectomy should be reserved for those patients who are failed by more extensive resection.
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PMID:The surgical treatment of chronic gastric atony following Roux-Y diversion for alkaline reflux gastritis. 273 Jan 85

Eight patients with postprandial hypotension and orthostatic hypotension were treated with the somatostatin analogue SMS-201-995. Low doses of this drug (0.2-0.4 microgram/kg) raised the blood pressure after breakfast in all six patients with postprandial hypotension. 60 min after breakfast the mean sitting blood pressure was 35 +/- 10 (SEM) mm Hg higher after administration of SMS-201-995 0.4 microgram/kg than after placebo (p less than 0.001). Larger doses (up to 1.6 micrograms/kg) raised upright blood pressure during the postprandial period in five of seven patients. Before therapy three patients were unable to stand after eating; after an injection of SMS-201-995 0.8 microgram/kg at the beginning of breakfast they were able to walk for 35-100 min. The duration of therapeutic effect of each injection was 3-6 h. Treatment was followed by abdominal cramps and nausea in two patients with gastroparesis diabeticorum. SMS-201-995 holds promise as a treatment for postprandial hypotension and orthostatic hypotension.
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PMID:Treatment of autonomic neuropathy with a somatostatin analogue SMS-201-995. 287 21

A method to record the gastric basic electrical rhythm (BER) using skin electrodes is described. Correlation is made with mucosal suction electrodes in 20 volunteers. Successful simultaneous recording from surface electrodes and mucosal electrodes is made in 16/20 subjects (80%). An increase in amplitude of the recorded gastric BER with gastric contractions is demonstrated and discussed. Five patients with gastric motility disturbances and chronic nausea are also investigated. Four of these patients had diabetic gastroparesis. Each had preservation of the gastric BER. The rate was usually normal at three per minute, but during acute nausea episodes which occurred in three of the four, an abnormally increased rate of the BER (tachygastria) was seen. This finding was also seen in a subject with atrophic gastritis and delay of gastric emptying. The surface electrogastrogram may prove to be a useful tool for the investigation of patients with suspected gastric arrhythmias.
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PMID:Human electrogastrograms. Comparison of surface and mucosal recordings. 293 38

Fifteen patients with histologically confirmed pancreatic carcinoma, without evidence of gastroduodenal invasion or obstruction, were prospectively studied to determine the frequency of gastric emptying disorders as determined by a solid-phase gastric emptying study. Nine of these (60%) had gastric emptying curves more than two standard deviations below normal mean values. The majority of patients did not have symptoms of gastric stasis. Nausea and/or vomiting was present in 33% of patients with abnormal gastric emptying and in none of those with normal emptying. Abdominal and/or back pain was present in 8/9 with delayed gastric emptying and in 3/6 with normal emptying. Disordered gastric emptying did not correlate with tumor stage, histology, location, or hyperbilirubinemia. Delayed solid-food gastric emptying may be responsible for the nonspecific abdominal complaints that occur during the course of pancreatic carcinoma, although more frequently, gastroparesis exists on a subclinical level.
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PMID:Pancreatic carcinoma is associated with delayed gastric emptying. 300 47

The effects of domperidone, a peripherally acting dopamine antagonist, were compared with those of placebo in a double-blind randomized study in 16 patients with idiopathic gastric stasis, chronic symptoms of "nonulcer dyspepsia" (including nausea, vomiting, and abdominal pain), and altered gastroduodenal motility. Patients received either domperidone or placebo orally (20 mg before meals and at bedtime) for six weeks. Symptoms were assessed by daily diaries kept by the patients for two weeks while receiving no medication for their gastrointestinal complaints (baseline), and throughout the six-week treatment phase. Studies of gastric emptying of a radiolabeled solid-phase meal were performed at baseline and six weeks after treatment. All patients had delayed gastric emptying at baseline, defined as a half-emptying time of more than mean + 1 SD (from studies of normal controls). An 18- to 24-hr recording of gastroduodenal motor function during fasting was also performed at baseline and after six weeks of either domperidone or placebo treatment. After six weeks of treatment, the symptom scores significantly improved in the domperidone group (P less than 0.05), but not in the placebo group. Gastroduodenal motor activity was unchanged from baseline recordings after six weeks. Solid-phase gastric emptying also showed no improvement in either the domperidone or placebo group of patients. Although domperidone therapy had no significant effect on motility, it appears to be an effective drug for the treatment of the symptoms of nonulcer dyspepsia.
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PMID:Effects of domperidone in patients with chronic unexplained upper gastrointestinal symptoms: a double-blind, placebo-controlled study. 305 42

Postsurgical gastroparesis syndrome (PGS) is a complex disorder characterized by postprandial nausea, vomiting, and gastric atony without evidence of mechanical gastric outlet obstruction. These symptoms can be disabling and are frequently unresponsive to drug therapy. Fifteen patients with documented PGS, including 13 women and two men, were recently treated by completion gastrectomy (CG) over a 5-year period. Gastric emptying study (GES) was markedly prolonged in 12 of the patients studied, and improved partially in only one patient (8%) with the administration of metoclopramide alone or combined with other gastrokinetic drugs. Patients were evaluated both before and after surgery, using a modified Visick rating system and a severity of symptoms (SS) score based on seven gastrointestinal (G.I.) and five systemic variables. All 15 patients underwent CG and reconstruction with a 50 cm Roux-en-Y limb. There were no operative deaths or complications related to the esophagojejunal anastomosis. Mean postoperative follow-up was 13.9 months, with a range of 2-65 months. After CG, the Visick rating and overall SS score improved significantly. The improvement in SS score was primarily due to a significant decrease in G.I. symptoms with little or no change in systemic symptoms. Overall, 86% of patients reported a satisfactory clinical result. CG, while seemingly radical, can be performed with low risk, and for properly selected patients with PGS, may be the treatment of choice.
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PMID:Completion gastrectomy for postsurgical gastroparesis syndrome. Preliminary results with 15 patients. 342 59

In a double blind crossover comparison with placebo, the effects of cisapride (10 mg tid for two weeks), a non-antidopaminergic gastrointestinal prokinetic drug, on gastric emptying times and on symptoms were evaluated in 12 patients with chronic idiopathic dyspepsia and gastroparesis. Gastric emptying was studied by a radioisotopic gamma camera technique. The test meal was labelled in the solid component (99mTc-sulphur colloid infiltrated chicken liver). Nine symptoms (nausea, belching, regurgitations, vomiting, postprandial drowsiness, early satiety, epigastric pain or burning, heartburn) were graded weekly on a questionnaire. Cisapride was significantly more effective than placebo in shortening the t1/2 of gastric emptying (p2 = 0.04), but no significant difference was observed between the two treatments with regard to the improvement of total symptom score (p2 = 0.09). No side effects were reported during the study.
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PMID:Effect of chronic administration of cisapride on gastric emptying of a solid meal and on dyspeptic symptoms in patients with idiopathic gastroparesis. 355 6

Using a gastric barostat we have studied interdigestive variations in gastric tone and its response to gastric distention in 17 healthy volunteers and 5 patients with postsurgical gastroparesis. The barostat measures tone by monitoring the volume of air within a flaccid intragastric bag, maintained at a constant, preselected pressure level by an electronic feedback mechanism. In healthy individuals, inter-digestive variations in gastric tone were phase-locked in advance of duodenal interdigestive motor activity and consisted of three sequential periods; a quiescence period, an intermediate period, and a period of activity. In contrast to controls, gastroparetic patients presented significantly larger intragastric volume at low intragastric pressure (6 mmHg). Gastric distention (14 mmHg) resulted in significantly reduced extension ratio and phasic motor response in the gastric remnant. Furthermore, distention elicited a symptomatic response that resembled their postcibal syndrome (epigastric fullness, pain, nausea). These data suggest that postsurgical gastroparesis is associated with impaired tone of the residual gastric pouch.
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PMID:Gastric tone measured by an electronic barostat in health and postsurgical gastroparesis. 355 99

Several studies concerning the relationships between gastroesophageal reflux (GOR), gastric emptying and esophageal motility are available. So far, results have been contradictory. The purpose of this work was to study gastric emptying in patients with GOR; to search for simultaneous esophageal motility disorders and to specify their type and frequency; to establish a potential relationship between motor disorders of the esophagus and the stomach in these patients. Thirty-two consecutive patients were selected according to clinical criteria, i.e. presence of at least two of the three characteristic symptoms of GOR, and the data of a three-hour post-prandial pH-metry. Gastric stasis related clinical manifestations (nausea, post-prandial vomiting, sensation of abdominal distension or of post-prandial epigastric fullness) were also searched for in all patients. A gastroscopy allowed to score esophagitis in each case. All patients, including adult controls underwent an esophageal manometry as well as a radionuclide determination of gastric emptying, after isotopic labelling of the solid (S) and liquid (L) phases of a test meal. The results showed that there was no significant modification of gastric emptying of the S and L phases of the meal in the group of patients with GOR whatever the intensity of the reflux, judged on the pH-metry results and the endoscopic data. Thus the average time of gastric half-emptying of S and L was respectively 115 and 52 min for the patients vs 111 and 51 min for the control group. As well, no correlation was found between the gastric emptying parameters and the presence or absence of clinical signs of gastric stasis or the amplitude of esophageal contraction waves. On an individual basis, two patients showed a significant decrease in gastric emptying of either the S or L phases without any attendant modification in the kinetics of the other. These results suggest that, in the adult, gastric emptying cannot be considered to be a determining factor of GOR and there are no diffuse motility disorders of the upper digestive tract during this illness.
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PMID:[Gastric emptying of a solid-liquid meal in gastroesophageal reflux in adults]. 372 Nov 14


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