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

Gastroduodenal Crohn's disease usually, but not always, occurs in patients with previously established ileal and/or colonic Crohn's disease. Symptoms include postprandial epigastric pain accompanied by nausea and sometimes vomiting, weight loss, anorexia, bloating, and diarrhea. Obstruction is the most common complication. Diagnosis can usually be made radiographically or endoscopically. Certain radiographic patterns are almost diagnostic, eg, obliteration of a distinct pyloric channel and a rigidly narrowed antrum tapering into a diseased duodenal bulb. Endoscopic mucosal biopsy of abnormal areas almost always shows chronic inflammation, although granulomas are not common. In patients with symptoms other than intractable obstruction, medical management, such as intermittent corticosteroid therapy, should be attempted. Surgery is usually indicated for refractory obstruction; gastrojejunostomy is the preferred approach.
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PMID:Gastroduodenal Crohn's disease. Differential diagnosis and treatment. 664 59

The benefits, equipment used, commercially available sources, and the indications and techniques for administration of enteral nutrients are reviewed. In many malabsorption states, enteral feeding is preferable and parenteral nutrients are seldom indicated. Transitional enteral nutrient support usually is indicated after parenteral nutrient therapy. Enteral tube-feeding formulas should be matched to the patient's needs; formulas using blenderized natural foods or intact isolated nutrients are appropriate for patients with intact gastrointestinal tracts. Patients should be monitored for glucosuria and hyperglycemia, bloating, nausea, dehydration, and renal, hepatic and hematologic status. Formula dilution, and a reduced flow rate or use of continuous-drip feeding, will reduce the incidence of osmotic diarrhea. The effectiveness, low cost and low potential for serious complications make enteral feeding preferable to parenteral nutrient therapy for many patients.
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PMID:Enteral feedings. 676 98

A low-lactose milk was evaluated for taste acceptance and clinical symptomatology by means of a double-blind control study in two groups of individuals. One group consisted of nine milk intolerant individuals, while the other consisted of five milk tolerant individuals. Each week for 9 wk the participants were given a coded sample of skim milk, lactose hydrolyzed milk, skim milk plus glucose, or sweet acidophilus milk. Each participant was asked to consume four liters of milk during a week and keep a daily log of symptoms (pain, bloating, nausea, flatus, emesis, bowel frequency) along with taste acceptability. After assigning a numerical value to the intensity of symptomatology a X2 analysis was performed on the data. In the milk intolerant population lactose hydrolyzed milk produced significantly milder (p < 0.05) pain and gas symptoms than the nonhydrolyzed milks. Bowel frequency was not altered between the types of milk in both groups. The lactose hydrolyzed milk did not reduce the symptoms of lactose intolerance in the milk intolerance population to the response of the control group. Although both study populations found decreased taste acceptability to the lactose hydrolyzed milk, a taste panel assessment did not show any significant differences in the milks.
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PMID:Clinical studies with low-lactose milk. 689 87

A tracer condition, to be used for clinical epidemiologic examination of psychosociogenic illness, must be common and clearly identifiable, distinguishable from concomitant physical problems, and found in general care. These criteria are met by couvade syndrome, the seeking of care for pregnancy-related symptoms by the mates of expectant women. Records of the mates of 267 postpartum women, representing a systemic sample of all births in a health maintenance organization of 36,000, were rated for the presence of nausea, vomiting, anorexia, abdominal pain, abdominal bloating, and other symptoms. Each patient was his own control. Sixty men (225 of 1000) sought care for couvade syndrome; they had a twofold increase in visits (p less than 0.001); had four times more symptoms than during control periods (p less than 0.001); and received twice as many prescriptions for medication as the men without this syndrome (p less than 0.05). The health care providers did not tend to recognize the "expectant" status of these patients or note the presence of the syndrome.
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PMID:The couvade syndrome: an epidemiologic study. 719 85

We describe a patient with symptoms of severe nausea, vomiting, epigastric bloating and pain, and marked weight loss due to a gastrointestinal motility disturbance. Motility abnormalities were characterized by uncoordinated high pressure (as high as 300 mm Hg) contractions and uncoordinated interdigestive motor complexes in the duodenum and small intestine, and tachygastria often associated with tachyarrhythmia in the gastric myoelectric activity recordings. Uncoordinated interdigestive myoelectric complexes again were found in the duodenum and small intestine. These abnormal myoelectric activities observed in the in-vivo study were confirmed in the in-vitro study. After distal hemigastrectomy and gastrojejunostomy, the symptoms of nausea, vomiting, and epigastric pain decreased considerably. Thus, the motility abnormality found in the study appears to be responsible for the symptoms described. This is probably a new clinical entity. The importance of manometric and myoelectric study of a gastrointestinal motility for unexplained nausea and vomiting is emphasized.
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PMID:Gastric and small intestinal myoelectric dysrhythmia associated with chronic intractable nausea and vomiting. 728 95

A method of recording gastric myoelectric activity with a peroral suction electrode was evaluated, and the recording was compared with that obtained by implanted electrodes on the serosal surface of the stomach of laparotomized humans. In a group of patients with unexplained nausea, epigastric bloating, and vomiting, abnormal antral myoelectric activities were found by a peroral electrode, in contrast to a regular pacesetter potential (frequency: 3-4/min) in control subjects. These abnormalities were confirmed by the recordings from the implanted electrodes in the same subjects. The study indicates that peroral recording of gastric myoelectric activity is a useful diagnostic method for the detection of gastric myoelectric activity abnormalities in humans.
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PMID:Electrogastrographic study of patients with unexplained nausea, bloating, and vomiting. 739 35

Fifty-five patients with delayed gastric emptying and the symptoms of nausea, vomiting, postprandial bloating and early satiety were treated with metoclopramide. Obstruction was excluded by upper endoscopy and standard upper gastrointestinal series. None were on medication known to retard gastric emptying. All patients had an abnormal barium burger radiologic study. Twenty-one patients had had previous vagotomy and drainage procedure, five had diabetic gastroparesis and 29 had idiopathic delayed gastric emptying. Metoclopramide significantly decreased the symptom scores of the surgical and idiopathic patients. When all patients were analyzed together, there was a significant improvement in both the metoclopramide and placebo treated patients. When, however, the improvement on metoclopramide was compared to the improvement on placebo, there was a significant metoclopramide effect beyond the placebo effect. Thus, metoclopramide is an effective agent in treating the symptom-complex of patients with delayed gastric emptying.
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PMID:Metoclopramide therapy in fifty-five patients with delayed gastric emptying. 746 58

Several studies, using pH monitoring with event markers, have identified patients with normal oesophageal exposure to acid despite an apparent relation between symptoms and reflux episodes. In this series of 771 consecutive patients referred for 24 hour oesophageal pH monitoring, a probability calculation was used to evaluate the relation between symptoms and reflux episodes. Oesophageal exposure to acid was normal in 462 of 771 recordings (59.9%); despite this, 70.8% (327 of 462) of these patients used at least once the event marker. In 96 patients (12.5% of total patients) with normal oesophageal exposure to acid, there was a statistically significant association between symptoms and reflux episodes. The symptom cluster of such patients was similar to that usually seen in patients with gastro-oesophageal reflux disease, but symptoms like belching, bloating, and nausea were common thus overlapping with the symptom pattern of functional dyspepsia. In these patients both the duration and the minimum pH of reflux episodes (either symptom related or asymptomatic) were significantly shorter and higher, respectively, when compared with those of patients with gastro-oesophageal reflux disease. These results are consistent with the idea that oesophageal hypersensitivity to acid is the underlying pathophysiological feature of this syndrome.
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PMID:Reflux related symptoms in patients with normal oesophageal exposure to acid. 888 28

Treatment of chronic intestinal pseudoobstruction with prokinetic agents has been disappointing. Our study was designed to determine if octreotide and erythromycin would provide sustained relief from nausea, abdominal pain, and bloating in pseudoobstruction. Using gastrointestinal manometry, quantitative parameters of the activity front of the migrating motor complex at baseline and after prokinetic therapy with erythromycin and octreotide were determined in 14 patients with intestinal pseudoobstruction who had nausea, abdominal pain, and bloating. Patients were treated with erythromycin and octreotide for 20-33 weeks. Octreotide increased the frequency, duration, and motility index of activity fronts (AFs) from 1.2 +/- 0.3 AFs/4 hr, 2.7 +/- 0.7 min, and 85 +/- 23 min mm Hg to 4.1 +/- 0.8 AFs/4 hr, 5.5 +/- 0.7 min, and 152 +/- 24 min mm Hg, respectively (P < 0.05). Antral activity was decreased from 63 +/- 14 to 23 +/- 8% by octreotide (P < 0.05). Erythromycin induced antral activity; however, small intestinal motor activity was suppressed. While on erythromycin and octreotide, five patients had long-term improvement of nausea and abdominal pain. All responders had at least 5 AFs/4 hr induced by octreotide. We conclude that octreotide and erythromycin relieve abdominal pain and nausea in pseudoobstruction. Patients who have at least 5 AFs/4 hr after octreotide administration are most likely to clinically respond.
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PMID:Effect of octreotide and erythromycin on idiopathic and scleroderma-associated intestinal pseudoobstruction. 755 39

The role of Helicobacter pylori infection in the pathogenesis of functional dyspepsia is debated. It is known that a substantial fraction of dyspeptic patients manifest a low discomfort threshold to gastric distension. This study investigated the symptomatic pattern in 27 H pylori positive and 23 H pylori negative patients with chronic functional dyspepsia, and potential relations between infection and gastric hyperalgesia. Specific symptoms (pain, nausea, vomiting, bloating/fullness, early satiety) were scored from 0 to 3 for severity and frequency (global symptom scores: 0-15). The mechanical and perceptive responses to gastric accommodation were evaluated with an electronic barostat that produced graded isobaric distensions from 0 to 20 mm Hg in 2 mm Hg steps up to 600 ml. Gastric compliance (volume/pressure relation) and perception (rating scale: 0-10) were quantified. Standard gastrointestinal manometry and recorded phasic pressure activity at eight separate sites during fasting and postprandially were also assessed. H pylori positive and H pylori negative patients manifested similar severity and frequency of specific symptoms and global symptom scores (mean (SEM)) (severity: 9.5 (2.0) v 9.0 (2.1); frequency: 10.8 (2.0) v 9.7 (2.2)). No differences were seen either in gastric compliance (53 (4) ml/mm Hg v 43 (3) ml/mm Hg) or in gastric perception of distension (slope: 0.50 (0.05) v 0.53 (0.06)). Postprandial antral motility was significantly decreased in H pylori positive patients (two hours motility index: 10.4 (0.6) v 12.6 (0.5); p < 0.05). It is concluded that H pylori infected patients with functional dyspepsia present no distinctive symptoms by comparison with H pylori negative counterparts and H pylori infection is associated with diminished postprandial antral motility but it does not increase perception of gastric distension.
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PMID:Does Helicobacter pylori infection increase gastric sensitivity in functional dyspepsia? 767 80


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