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

On the basis of 4 adult population samples subsequently gathered into one sample of 567 healthy subjects, we determined: (1) the annual prevalence of symptoms suggestive of intestinal functional disorders (30.5 per cent); (2) the elements which prompted subjects with symptoms to request medical attention (we found that the request was significantly correlated with the duration of pain, the intensity and chronicity of constipation, the number of symptoms and the triggering of disorders by stress), and (3) an estimate of the "cost" of intestinal functional disorders.
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PMID:[Epidemiology of intestinal functional disorders]. 252 31

A high percentage of adults and children with advanced cancer suffer from pain. Strong opioids for pain control, e.g. morphine, slow-released morphine or buprenorphine, should be administered early according to the intensity of pain. The analgesics should be given orally whenever possible. They must be given at fixed intervals based on the duration of their action. The dose must be titrated to the needs of the patient. Sometimes more than 1000 mg morphine orally per day is necessary. Correctly used strong opioids produce only a few side-effects, especially constipation and vomiting. Many studies in adult cancer patients all over the world demonstrate the effectiveness of strong opioids for pain control. Children should be treated in the same way and comparable data in children with cancer pain must be collected.
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PMID:[Use of strong opioids in the treatment of cancer pain in adults and children]. 257 Aug 83

Six-hundred sixty-seven patients with endoscopically proven peptic ulcer were included in a randomized, multicenter trial to assess the comparative efficacy of sucralfate and cimetidine. One hundred eighty-seven patients with gastric ulcer and 480 patients with duodenal ulcer completed the study. Ulcer healing was evaluated endoscopically at six weeks for duodenal ulcer and at eight weeks for gastric ulcer. Patients with unhealed ulcer at this time were assigned to the other therapy for a second period of six or eight weeks of treatment (crossover). In patients with duodenal gastric ulcer, pain relief and healing were not significantly different in the two groups. Eighty-eight percent of duodenal ulcers and 73 percent of gastric ulcers healed with six weeks of sucralfate treatment. Reported side effects and symptoms, pooled together for duodenal and gastric ulcer, were more significant in the sucralfate group (7.5 percent) than in the cimetidine group (3.7 percent). Constipation was the most frequent symptom recorded. In conclusion, sucralfate and cimetidine are both excellent healing agents for short-term treatment of duodenal and gastric ulcer. Both give rapid relief of symptoms without severe side effects.
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PMID:Comparative study of sucralfate versus cimetidine in the treatment of acute gastroduodenal ulcer. Randomized trial with 667 patients. 266 May 53

The control mechanisms of gastrointestinal motility are complex. Extrinsic neurohormonal effects modulate an intrinsic system, often called the "gut brain," composed of nervous and neuropeptide components. To exert pharmacologic influence on GI motility, use is made of agents that mimic the external control system. Agents that stimulate opioid receptors, block adrenoceptors, block or facilitate acetylcholine action, or antagonize the action of prostaglandins are used to effect changes in GI motility. The major indications for pharmacologic intervention are to increase motility in constipation, to reduce it in most cases of diarrhea, and to restore propulsive coordination in postoperative ileus. In cases of clinical colic the primary requirement is control of pain. Agents used for this purpose may adversely affect motility, and choice requires knowledge of their actions in this respect. In addition, drugs used for other purposes, anthelmintics for instance, may also influence gut motility. A synopsis of the actions of the agents commonly employed in GI motility control and some associated drugs are displayed in Table 3. Recent advances in the understanding of drug action on the gut should help in the selection of drugs for clinical use.
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PMID:Effects of pharmacological agents on gastrointestinal motility. 267 Jan 8

Internal intussusception of the rectum is the funnel-shaped infolding of the rectum during straining to defecate. Patients present with multiple symptoms; most commonly rectal pressure and pain in association with constipation and straining. Defecography (videofluoroscopy during defecation) is the method of choice for diagnosing this problem. Rectal mobility from the sacrum, infolding of the rectum and sphincter relaxation can be used to grade the findings on defecography (Grade I-IV). The optimal therapy for internal intussusception of the rectum is unknown because the cause of the problem is unknown. Conservative management is recommended in all but the most severely symptomatic patients.
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PMID:Internal intussusception of the rectum: a changing perspective. 269 21

Rubber band ligation was used in 160 patients with internal hemorrhoids; 43 of them also had rectal anterior mucosal prolapse; 13 had prolapse alone. Two thirds of the patients underwent a single rubber band ligation and one third a double rubber band ligation in one session without anesthesia. Ninety-four required repeated ligations. A follow-up of 25 +/- 16 months (mean +/- SD) was carried out in 153 of them. Rubber band ligation was followed by prolonged bleeding in six patients and severe pain requiring removal of the rubber band in 12 patients. The complication rate decreased significantly (P less than .05) in the last 80 patients. Compared with multiple ligation, single rubber band ligation in one sitting was followed by a lower complication rate (P less than .01). Long-term results were good in 71 percent of the patients. (A formal hemorrhoidectomy was needed within two years in 6 percent.) A significantly lower recurrence rate of 9 percent was noted in those with normal bowel habits, when compared with constipated subjects whose symptoms recurred in 85 percent (P less than .001). Constipation seems to be a predictable factor in worsening the outcome of rubber band ligation. Rubber band ligation is followed by a lower complication rate when performed in a single ligation.
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PMID:Rubber band ligation of hemorrhoids and rectal mucosal prolapse in constipated patients. 271 26

Urinary incontinence affects up to 43 per cent of acute care patients. Toileting is a function of intact bladder, sphincters, and nervous system. Five types of incontinence are stress, urge, reflex, total, and functional. Problems affecting patients in acute care are: 1. Diagnostic studies 2. Treatments--for example, intravenous fluids, hyperalimentation, medications, catheters 3. Bedrest 4. Restraints 5. Pain 6. Iatrogenic conditions 7. Environment Assessment includes a specific history and physical examination, focused on previous episodes of incontinence, functional ability, and cognitive status. Management includes scheduled fluid intake and toileting, manipulation of the environment, and attention to orientation and psychological factors. The treatment of fecal incontinence in the hospital elderly includes: 1. Assessment of incontinence and contributing factors; 2. Bowel regimen and environmental assists for persons with periodic incontinence; 3. Treatment of diarrhea or constipation; and 4. Protection of perineal skin from stool exposure.
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PMID:Continence issues in acute care. 277 95

Bowel necrosis in the critical trauma patient without abdominal involvement or preexisting vascular disease is a known but rare complication. During 1977-1986 we observed 31 cases in 2530 patients. Symptoms were unspecific, and since most of the patients were artificially ventilated, pain and tenderness were of little diagnostic value. Twenty-three patients presented with paralytic ileus, fifteen with diarrhea, and four with melena. In eleven patients diagnosis was made clinically, and in twenty patients at autopsy. Twenty-three patients died from septic shock, six from cerebral complications, and one from myocardial infarction. Risk factors for bowel necrosis were fluid restriction, hypotension, hypoxemia, venous congestion, vasoconstrictive drugs, paralytic ileus, and constipation.
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PMID:[Intestinal necroses in severely injured patients without abdominal trauma]. 277 21

A modified version of the McCorkle & Young Symptom Distress Scale, based on a linear analogue self-assessment scoring system, was used to assess symptom distress in a heterogeneous sample of 53 cancer patients. The scale was simultaneously completed by the nurses caring for those patients, who were asked to rate the patient according to how they perceived he was feeling with regard to each particular symptom. The scores were compared for congruency. This preliminary study suggests that, although nurses appear able to estimate the degree of distress due to changes in mobility and appearance or the presence of diarrhoea, constipation and tiredness, they are less effective in perceiving the degree of distress due to the less 'visible' symptoms such as pain, nausea, anorexia, sleeping disturbances, concentration and mood. Perhaps surprisingly, the trend was for nurses to overestimate the degree of distress when this was compared with the patients' self-assessment.
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PMID:Patients' and nurses' perceptions of symptom distress in cancer. 280 38

Twenty patients suffering from irritable bowel syndrome, 14 patients with pain and constipation and 6 patients with pain and diarrhoea, were studied in order to: a) Evaluate the symptomatic response to a Plantago Ovatae fiber medicine. b) Study with radio-opaque markers the colonic transit modifications that could explain the therapeutic responses. There were observed the following results: 1) Pain decreased or disappeared in 80% of the patients. 2) Constipation decreased or disappeared in 78.6% of the patients. 3) Diarrhoea decreased or disappeared in 5 of the 6 patients that were studied. 4) There was a significative increase of the feces weight without changes of the dry residue. 5) Taking all the patients as a whole the number of the retained radio-opaque markers was the same before and after the active treatment. If we evaluate the patients with constipation and the patients with diarrhoea separately the first group shows an acceleration of the colonic transit (fewer retained markers) and the second group shows a decrease of the colonic transit (more retained markers). We draw the conclusion that the Plantago Ovatae fiber regulates or moderates the colon motility and enables a physiological balance of the colonic transit.
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PMID:[Effects of medicinal fiber on colonic transit in patients with irritable colon syndrome]. 284 50


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