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

In the present double-blind placebo-controlled study the effect of cisapride on functional dyspepsia was evaluated in patients with and without histological gastritis. Patients with functional dyspepsia and whose symptoms persisted after a 2 week run-in period with antacid treatment were randomized to receive cisapride (10 mg) or matching placebo three times daily for 4 weeks. Symptoms of epigastric pain, bloating, nausea, belching, early satiety and heartburn were graded on a four-point scale based on patients' feedback and diary card recording. A global response was also formulated by the investigators. One hundred and four patients entered the study and 76 completed the trial, comprising 36 patients with histological gastritis and 40 patients without gastritis. Symptom scores in both gastritis and non-gastritis groups were significantly improved by both cisapride and placebo; however, the improvement was not statistically different between the two treatment groups. Cisapride produced a good or better global response in 58% of subjects with histological gastritis and in 53% of subjects without gastritis compared with 47% and 52%, respectively, of patients on placebo; this difference was not statistically significant. Gastric histology did not influence the effect of cisapride on the symptoms of functional dyspepsia.
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PMID:Effect of cisapride on functional dyspepsia in patients with and without histological gastritis: a double-blind placebo-controlled trial. 907 16

Cisapride is a substituted benzamide with gastrointestinal prokinetic effects presumed to be due to the enhancement of the physiological release of acetylcholine at the myenteric plexus. In a multicentre study, 189 patients with nonulcer dyspepsia (NUD) received single-blind placebo treatment for two weeks. A total of 123 patients with no or minimal response to placebo and epigastric pain of at least moderate severity and frequency were randomly assigned to one of the three parallel double-blind treatments for six weeks: cisapride 10 mg tid, cisapride 20 mg tid or placebo. The severity and frequency of individual symptoms (epigastric pain, heartburn, nausea, vomiting anorexia, postprandial discomfort, regurgitation, lower abdominal pain, bloating and constipation) were assessed on a four- and five-point categorical scale, respectively, by the investigator at three on treatment visits and by patients in a daily diary. Analysis of investigator and patient assessments for differences in symptom severity x frequency composite scores among the three treatment groups showed no statistically significant differences for individual symptoms or symptom clusters. As assessed by the investigator, and compared with baseline, cisapride 20 mg tid significantly (P < 0.05) improved epigastric pain, bloating and early satiety as well as improved the total symptom cluster. Investigator evaluation of the five most severe and frequent symptoms for each patient showed statistically significant improvement in each treatment group. For patient diary assessments, statistically significant within-treatment improvement of the total symptom cluster, the five most severe symptoms cluster, bloating and early satiety was observed for both cisapride 20 mg and placebo, whereas epigastric pain significantly (P < 0.05) improved in all three treatment groups. Investigator evaluation of global response (good+excellent) rate at the end of the six week treatment period was 38% for cisapride 20 mg, 47% for cisapride 10 mg and 33% for placebo. No statistically significant difference in this parameter among treatments was noted. Cisapride was well tolerated at both doses with a side effect profile comparable with that of placebo. It is concluded that in this double-blind multicentre study with a single-blind two-week placebo run in phase, cisapride 10 mg tid and 20 mg tid were not effective compared with placebo in improving symptoms in NUD patients. This study re-emphasizes the good prognosis of patients with NUD, with 14% of patients improving in the two-week placebo run-in phase and a further 33% improving in the next six weeks while on placebo. Within-treatment analysis of investigator assessments showed improvement for cisapride 20 mg tid suggesting a trend of efficacy at this dose.
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PMID:A double-blind randomized study of cisapride in the treatment of nonulcer dyspepsia. The Canadian Cisapride Nud Study Group. 911 11

The effect of long-term cisapride therapy (20 mg orally three times daily for 2 years) on gastric emptying and gastrointestinal symptoms was investigated in 30 patients with severe gastroparesis (24 idiopathic, 6 diabetic). Symptoms were assessed every 2 months, using an overall symptom score based on six symptoms (anorexia, nausea, vomiting, pain, early satiety and bloating), and a 2-year mean overall symptom score was used for analysis. Gastric emptying was measured at 0, 6, 12, 18 and 24 months. Of the 24 patients who completed the study, 10 showed a significant improvement in gastric emptying (P < 0.05) and felt improved on therapy, seven patients showing a > 20% improvement in overall symptom score compared to baseline. Results for 15 patients who underwent at least one follow-up gastric-emptying test showed only a weak correlation between individual symptom score and gastric emptying (r = 0.40). Thus long-term cisapride therapy at the study dose produced long-term symptomatic improvement in 42% of patients with severe gastroparesis, with sustained acceleration of gastric emptying for up to 2 years.
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PMID:Cisapride in the long-term treatment of chronic gastroparesis: a 2-year open-label study. 928 90

Chronic constipation is a common clinical condition that frequently does not respond to routine therapeutic measures. We hypothesized that colchicine would be effective in this condition because we reported that it stimulates intestinal motility in rats and commonly causes diarrhea in patients taking the drug for either gouty arthritis or Familial Mediterranean fever. We prospectively studied seven patients with chronic constipation who were refractory to medical therapy and treated them with oral colchicine 0.6 mg per os three times a day for eight weeks in an open-label pilot study. During the study, the mean number of spontaneous bowel movements significantly increased (P < 0.05) from 1.7 +/- 0.5 noted during routine therapy of constipation with laxatives and enemas to 6.4 +/- 0.7 per week; mean colonic transit time significantly (P < 0.05) decreased from 58.1 +/- 2.5 to 47.1 +/- 5.0 hr; and symptoms of abdominal pain, nausea, and bloating significantly (P < 0.05) improved during therapy with colchicine. Oral colchicine (0.6 mg three times a day) therapy appears to be an a promising treatment for chronic constipation and a placebo-controlled trial is indicated to confirm these findings.
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PMID:Colchicine is an effective treatment for patients with chronic constipation: an open-label trial. 933 Nov 62

The purpose of this study was to investigate whether sublingual glyceryl trinitrate influences the size of the proximal stomach and postprandial symptoms in patients with functional dyspepsia. Twenty patients with functional dyspepsia were included in a double-blind, placebo-controlled crossover study with sublingual glyceryl trinitrate. All patients were scanned twice on consecutive days, receiving either placebo or 0.5 mg glyceryl trinitrate randomly 5 min prior to ingestion of 500 ml meat soup. Total symptoms, pain, nausea, and bloating were scored on a visual analog scale before and after the meal. Standardized ultrasonograms were obtained 1, 10, and 20 min postprandially of the proximal and distal stomach. The proximal stomach was larger in the sagittal section at 1 min postcibally (26.5 +/- 3.9 vs 24.8 +/- 4.9 cm2, P = 0.036) and 10 min postprandially (22.0 +/- 5.1 vs 19.8 +/- 5.3 cm2, P = 0.009) after administration of glyceryl trinitrate compared with placebo, whereas a tendency was observed after 20 min (18.7 +/- 5.5 vs 17.3 +/- 5.7 cm2, P = 0.076). The corresponding changes in the frontal diameters were 8.3 +/- 1.1 vs 7.8 +/- 1.2 cm (P = 0.067) after 1 min, 7.2 +/- 0.9 vs 6.4 +/- 0.8 cm (P = 0.001) after 10 min, and 6.3 +/- 1.1 vs 5.6 +/- 1.2 cm (P = 0.016) after 20 min. The area of the distal stomach was not different (P > 0.31) in the two groups. After administration of glyceryl trinitrate, the patients reported less pain (P = 0.048) and nausea (P = 0.023) 5 min postprandially, but this effect was reduced 15 min later. Total symptom score was improved by glyceryl trinitrate treatment (P < 0.042). Sublingual glyceryl trinitrate improves accommodation of the proximal stomach to a meal and reduces postprandial symptoms in a group of patients with functional dyspepsia.
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PMID:Effect of glyceryl trinitrate on gastric accommodation and symptoms in functional dyspepsia. 936 47

This study investigated whether domperidone could improve gastrointestinal symptoms in patients with Parkinson's disease who were receiving levodopa therapy. A total of 11 patients were studied. Following a baseline gastric emptying test, patients were treated with a starting dose of domperidone 20 mg p.o. q.i.d. A follow-up gastric emptying test was repeated at least 4 months after starting domperidone therapy. At the beginning and at each 3-month follow-up visit, symptoms of nausea, vomiting, anorexia, abdominal bloating, heartburn, regurgitation, dysphagia, and constipation were evaluated and scored on a scale of 0-3. The overall mean follow-up period was 3 years. Compared with their baseline evaluation, patients experienced a significant improvement in all symptoms (p < 0.05) except dysphagia and constipation. Gastric emptying of an isotope-labeled solid meal was significantly faster, with a baseline result of 60.2 +/- 6.4% retention of isotope 2 h after the meal compared with 37.0 +/- 2.2% retention during domperidone therapy (p < 0.05). Patients' global assessment of Parkinson's disease remained stable or improved. Serum prolactin was elevated in all patients after domperidone therapy (p < 0.05). Domperidone therapy significantly reduces upper gastrointestinal symptoms and accelerates gastric emptying of a solid meal, but does not interfere with response to antiparkinsonism treatment.
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PMID:Effect of chronic oral domperidone therapy on gastrointestinal symptoms and gastric emptying in patients with Parkinson's disease. 939 20

Dyspepsia is a vague term for the nonspecific symptoms of upper abdominal discomfort, prolonged postprandial fullness or early satiety, nausea, vomiting, and upper abdominal bloating. Many common and accepted diseases and disorders such as gastroesophageal reflux and irritable bowel syndrome cause dyspepsia symptoms; these disorders should be identified and treated. However, many patients with dyspepsia symptoms have normal radiographic and endoscopic evaluations; in these patients, neuromuscular of functional disorders of the stomach ranging from gastric dysrhythmias to gastroparesis may be the cause of dyspepsia symptoms. A practical approach to the evaluation and treatment of dyspepsia symptoms attributed to gastric neuromuscular dysfunction of unknown origin is described.
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PMID:Dyspepsia of unknown origin: pathophysiology, diagnosis, and treatment. 943 96

Previous studies have shown that up to 40 per cent of patients have symptoms after cholecystectomy or laparoscopic cholecystectomy (LC). There are concerns, however, that these symptoms reflect those of the general population and are not a specific post-operative phenomenon. Abdominal symptoms of 212 patients following LC were compared to a healthy acalculous control population (n = 62). Patients and controls were assessed by questionnaire. Age and sex profiles were similar in both groups. There was no significant difference in the incidence of abdominal pain, bloating or nausea between the 2 groups. Frequent heartburn was a symptom in 19.3 per cent of patients following LC as compared to 3.2 per cent of control patients (p = 0.004, chi-squared 9.39, 1 d.f.). Furthermore 11.3 per cent of post-operative patients complained of dysphagia versus 6.4 per cent of the control group (p = 0.08, chi-squared 1.245, 1 d.f.). One hundred and twenty (57.1 per cent) patients judged their operation to be a complete success, while 9 (4.3 per cent) were dissatisfied. Five of the latter group cited frequent heartburn as the cause of their dissatisfaction. We conclude that abdominal pain, bloating and nausea occur as frequently in the general population as in patients following LC. Patients are more likely to suffer from heartburn and dysphagia following LC than a normal population supporting a link between cholecystectomy and lower oesophageal dysfunction.
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PMID:Symptoms of oesophageal reflux are more common following laparoscopic cholecystectomy than in a control population. 954 Feb 90

The expectation that cholecystectomy is effective treatment for symptomatic gallstones is not always achieved in surgical practice. The impact of cholecystectomy on the relief of gastrointestinal symptoms was evaluated in 92 patients followed up after surgery for a mean of 31.1 months (range 12-83 months). Abdominal pain continued to be present, or arose de novo, in 28 (30.4%) patients. Pain-free outcome after cholecystectomy was associated with a preoperative clinical diagnosis of biliary colic, fatty food intolerance, and a thick-walled gallbladder on ultrasound (P = 0.02). Logistic regression associated a thick-walled gallbladder, elevated gamma-glutamyl transpetidase, body mass index < 26, fat intolerance, and normal bowel habit with good postoperative results (P = 0.001). Application of each of these five factors to a clinical index failed to predict long-term pain-free outcome after cholecystectomy. Abdominal bloating (P = 0.03), dyspepsia (P < 0.001), heartburn (P < 0.007), fat intolerance (P < 0.001), nausea (P = 0.001) and vomiting (P < 0.001) were significantly improved after cholecystectomy, but diarrhoea, constipation and excessive flatus were not. Outcome benefit ratios confirmed that vomiting (0.96), nausea (0.87), dyspepsia (0.67), fat intolerance (0.57) and heartburn (0.51) were relieved by surgery. Cholecystectomy improved symptoms compared with a matched control group, suggesting that surgery remains the gold standard treatment of symptomatic gallstones.
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PMID:Is cholecystectomy effective treatment for symptomatic gallstones? Clinical outcome after long-term follow-up. 984 45

With the advent of minimally invasive techniques, the surgical treatment of gastroesophageal reflux disease has received renewed interest. The efficacy of laparoscopic Nissen fundoplication in eliminating reflux has been documented. This study was undertaken to determine changes in quality of life and cost of antireflux medications after laparoscopic Nissen fundoplication. One hundred patients undergoing laparoscopic Nissen fundoplication between 1992 and 1997 completed questionnaires assessing changes in pre- and postoperative cost and number of antireflux medications, reflux symptoms, and quality of life. The average number of antireflux medications was significantly reduced (1.8 versus 0.3, P < 0.0001) as was the average monthly cost ($170 versus $30, P < 0.0001). Patients reported significant (P < 0.05) symptomatic improvement in postprandial heartburn, nocturnal heartburn, postprandial nausea, postprandial vomiting, dysphagia, and gas/bloating. Patients in this series noted fewer symptoms and used fewer antireflux medications at less cost after laparoscopic Nissen fundoplication. Symptoms commonly thought of as complications of fundoplication (vomiting, dysphagia, gas/bloating) were less common after fundoplication. This report documents the efficacy of laparoscopic fundoplication in improving quality of life and reducing use and cost of antireflux medications.
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PMID:Quality of life and antireflux medication use following laparoscopic Nissen fundoplication. 961 70


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