Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Common anorectal disorders can produce one or more of the following symptoms: pain, protrusion, pruritus, bleeding or discharge. The cause may be cryptitis, anal fissure, hemorrhoids, anorectal abscess, fistula in ano, neoplasm, condylomata acuminata, pilonidal cyst or inflammatory bowel disease. Each disorder is suggested by its characteristic history. Adequate examination by proctosigmoidoscopy will usually confirm the presence of the suspected disease.
 ...
PMID:Anorectal disorders. 742 60

Due to controversial evaluation of the contribution of clinical signs for the diagnosing of non-specific inflammatory bowel disease, as well as due to the lack of similar data, we tried to find our own answer to the question as to whether the clinical signs of ulcerative colitis (UC) and Crohn's disease (MC) are helpful, unhelpful, or even confusing for the diagnosis. A group of patients with MC and UC was analyzed from this aspect. Individuals in their twenties and thirties prevailed in the sample, mostly intellectual workers, the number of males and females was equal. Our attempt to analyze all the available diagnostic methods originated in an observation that a long period of health problems precedes the diagnosis of MC, namely 1.5 y in males and as long as 4 y in females. Other striking information was that surgery represented the initial treatment in 66% of cases and the correct diagnosis was made peroperatively only in 56% of cases. We compared our results with those of the OMGE study, one of the largest projects which evaluated positively the contribution of clinical signs to the diagnosing of MC and UC. We found that the main signs of CU have not changed in the last century, and some additional signs occur rather due to complications than due to the disease per se. Frequency of pain increased by 25% in our patients, and approximately 1/3 of it represented intermittent pain caused by tenesms. Pain in MC must be properly analyzed in order to discriminate acute appendicitis. Other indicators did not differ from the OMGE study. In accordance with its results, we confirmed the importance of correct evaluation of clinical signs for the diagnosis and differential diagnosis of UC and MC. The number of diagnostic methods still increases. Their validity must be continuously re-evaluated, however the clinical examination in the dynamic process stays to be of crucial value.
 ...
PMID:[What is the value of clinical symptoms in the diagnosis of nonspecific inflammatory bowel disease?]. 763 12

We sought to prospectively characterize and compare the symptoms of children > or = 5 years of age with recurrent abdominal pain to previously established criteria for irritable bowel syndrome (IBS) in adults. For all eligible subjects, a detailed questionnaire concerning characteristics of abdominal pain and defecatory pattern was completed at presentation. In addition, a battery of screening tests was performed and additional evaluation was done at the discretion of their physician. In all, 227 subjects fulfilled the entrance criteria, but 56 were subsequently excluded because of diagnoses of inflammatory bowel disease (nine cases), lactose malabsorption (46 cases), or celiac disease (one case). Of the remaining 171 patients, 117 had IBS symptoms. In the IBS subjects, lower abdominal discomfort (p < 0.001), cramping pain (p < 0.0009), and increased flatus (p < 0.0003) were more common, whereas dyspeptic symptoms such as epigastric discomfort (p < 0.003), pain radiating to the chest (p < 0.009), and regurgitation (p < 0.02) were more common in the non-IBS subjects. Our study not only confirms the clinical heterogeneity of children with recurrent abdominal pain but also concomitantly demonstrates that most children with this disorder have symptoms that fulfill the standardized criteria for IBS in adults. The identification of subgroups of children with recurrent abdominal pain can provide a framework for the diagnosis of functional bowel disease as well as establish the need for invasive and expensive tests.
 ...
PMID:Characterization of symptoms in children with recurrent abdominal pain: resemblance to irritable bowel syndrome. 913 90

A 19 year old man with a history of Crohn's disease treated with azathioprine and prednisone, died after a primary infection with Epstein-Barr virus. He had the characteristics of the virus associated haemophagocytic syndrome, a rare complication of viral infections, which consists of fever, constitutional symptoms, hepatosplenomegaly, liver function and coagulation abnormalities, and hypertriglyceridaemia. Additionally, there was pain, cytopenia, and histiocytic hyperplasia in the bone marrow, spleen, or lymph nodes. This severe complication has been reported previously in renal transplant patients, but not in those with inflammatory bowel disease taking azathioprine. The immunosuppressive therapy may have contributed to this fatal complication of infectious mononucleosis, and this complication should be considered when treating a patient with inflammatory bowel disease with azathioprine.
 ...
PMID:Fatal infectious mononucleosis: a severe complication in the treatment of Crohn's disease with azathioprine. 788 36

Omeprazole, a proton pump inhibitor, was added to the treatment regimen of seven patients with biopsy proven inflammatory bowel disease. Six of the seven patients showed a marked clinical improvement in symptoms, especially pain and diarrhea after starting omeprazole. One of the six is using omeprazole as her sole medication for her colitis currently. Others have been able to decrease steroid doses. A possible mechanism of action relates the similar chemical structure of omeprazole to metronidazole which is efficacious in colitis.
 ...
PMID:Is omeprazole helpful in inflammatory bowel disease? 807 18

Intestinal involvement of endometriosis requiring treatment is 5%, but only 0.7% needs intestinal resection. The authors report two cases of colic endometriosis and illustrate problems in diagnosis and management of this disease. Usually intestinal endometriosis takes the form of asymptomatic superficial serosal implants, encountered incidentally at laparotomy for other diseases, but it can also result in obstruction and occasionally bleeding. Any premenopausal woman with episodic bowel symptoms associated with gynecologic complaints should be suspected of endometriosis of the colon. Diagnosis can be suspected by double-contrast enema examination and colonoscopy with biopsy, although neither is likely to establish the diagnosis with certainty. In fact there are no radiologic or diagnostic imaging findings that are specific for endometriosis and unequivocal diagnosis requires microscopic examination. Differential diagnosis includes primary carcinoma of the colon and other benign diseases (pelvic inflammatory disease, diverticulitis, inflammatory bowel disease, pelvic abscess, polyps, etc.). The treatment of patients with uncomplicated, but symptomatic gastrointestinal endometriosis depends on the age of the patient and her childbearing attitude. Resection of the affected bowel should be done in patient with pain, bleeding, changes in bowel habits and intestinal obstruction and it is necessary to avoid neglecting a malignant tumor. Total abdominal hysterectomy and bilateral oophorectomy is the treatment of choice in the perimenopausal and menopausal women. In symptomatic women desiring children the only resection of involved colon may be appropriate treatment. In these subjects hormonal therapy can be useful.
 ...
PMID:[Endometriosis of the large intestine. A report of 2 clinical cases]. 825 7

Functional disorders mainly occur in young, anxious hyperactive, sometimes obsessional patients and involve all parts of digestive tract: feeling of obstruction the upper oesophagus or dysphagia; aerophagia related to a slow gastric emptying or gastric fullness relieved by eructation; biliary vomiting and pain in right abdominal upper quadrant which might correspond to a form of migraine without headache; irritable bowel, characterized by abdominal discomfort and constipation. Obviously, the diagnosis of functional disorders required elimination of an organic disease by appropriate endoscopic investigations. Psychosomatic disorders mainly comprise gastroduodenal ulcers and inflammatory bowel diseases. Although psychologic profiles have been associated with gastro-duodenal ulcer, these are not necessary for the development of the disease. The role of emotional factors has decreased since very efficient anti-secretory drugs are available. Inflammatory bowel diseases, in particular ulcerative colitis is frequently associated to behaviour disorders. The patient is usually a young woman brought up by an overprotective family. It is generally recognized that attacks of ulcerative colitis may be triggered by emotional factors. Thus, Stress may interact with digestive tract. In some cases, as in patients with irritable bowel or distal ulcerative colitis, psychotherapy such as Schultz's Autogenous Training, improves the patient's condition.
 ...
PMID:[Stress and the digestive system]. 828 96

A controlled, randomized trial with blind assessment of end points is described comparing ceftriaxone (1 g) given at induction of anesthesia with gentamicin (2 mg/kg) and metronidazole (500 mg) (GM), three times, every eight hours starting at induction, in preventing wound, chest, and urinary tract infections following bowel operations. Patients with inflammatory bowel disease received prophylaxis for five days. Two hundred sixty patients were randomized, and 196 were studied after exclusions. Ninety-four were given ceftriaxone, and 102 were given GM. Chest infection was defined as pyrexia plus clinical or radiologic signs of consolidation or the production of purulent sputum. Wound infection was diagnosed on the basis of purulent wound discharge or pyrexia plus swelling, redness, and pain around the wound, and urinary tract infection was diagnosed from microbiologic results. There was a significant reduction in wound infection (17 percent to 6 percent; P < 0.05) and in urinary tract infection (8 percent to 1 percent; P < 0.05) in the ceftriaxone group compared with the GM group. Chest infection occurred in 16 percent of the ceftriaxone group compared with 25 percent of the GM group, but this difference was not statistically significant. Infected patients were in the hospital more than four days longer than uninfected patients, a statistically significant difference (P < 0.01). It is concluded that ceftriaxone is superior to GM in reducing postoperative sepsis and that this effect is likely to be due to the sustained bactericidal blood levels achieved by ceftriaxone.
 ...
PMID:Ceftriaxone is more effective than gentamicin/metronidazole prophylaxis in reducing wound and urinary tract infections after bowel operations. Results of a controlled, randomized, blind clinical trial. 837 23

To determine the current indications and referral patterns for routine gastrointestinal radiology examinations, 1000 consecutive patients were prospectively analyzed. The following specialties were the largest sources of referral: general internal medicine (38%), gastroenterology (21%), and general and colorectal surgery (17%). Referrals from gastroenterologists were weighted toward areas not well evaluated by endoscopy, such as suspected small bowel disease. The major indications for upper gastrointestinal (GI) examinations were dysphagia and swallowing disorders (32%), hiatus hernia/reflux (14%), and ulcer (14%). Small bowel series were predominantly performed for inflammatory bowel disease (37%), obstruction (25%), and occult blood loss (18%). The majority of combined upper GI/small bowel studies were performed for indications primarily relating to the small bowel. Forty percent of barium enemas were performed for detection of neoplasms and polyps, with pain/irritable colon (14%) and exclusion of leak (14%) the next most common indications. Traditional indications, such as peptic ulcer disease and neoplastic disease, continue to be sources of referral for gastrointestinal radiology. However, more specialized applications, particularly in areas not well suited to endoscopy, such as swallowing disorders, inflammatory disease of the small bowel, and evaluation of surgical anastomoses, are also being commonly used. The changing indications, along with the previously documented decreased volume of gastrointestinal radiologic procedures, should be kept in mind when planning a radiology resident educational curriculum.
 ...
PMID:Gastrointestinal radiology: current indications and referral patterns. 843 86

Being the final pathway for chyme and digestive residues, the colorectum influences bowel function critically. The most important and relevant symptoms of colonic dysfunction are diarrhea, constipation, urgency, and pain. Despite the effects of many investigators, over several decades, the motor physiology of the human colon is still relatively obscure. Most is known about patterns of colonic transit. In practice, measurements of transit are the best characterized and most widely available tests of colonic motor function. Colonic hypersensitivity, implying an abnormality of afferent signaling, is assuming greater importance in the pathophysiology of conditions as common as IBS and inflammatory bowel disease.
 ...
PMID:Colonic motility in health and disease. 868 70


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>