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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Antral webs and diaphragms are considered a rare cause of gastric outlet obstruction in infants and children. A radiographic diagnosis of antral web was made in 28 children during a 26-mo period. Nonbilious, often projectile vomiting was the predominant presenting symptom in 24 infants who were less than 6 mo of age. The older children complained of pain, vomiting, fullness after eating, and eructation. The characteristic radiologic finging was a wirelike transverse septum 1--2 cm proximal to the pylorus. Poor antral filling was an important early clue in the radiographic search for the webs. Pyloroplasty was performed in 20 patients, frequently after failure of medical management of symptoms. Coexistent congenital abnormalities were present in 28% of patients. A search for environmental and familial factors has failed to elucidate any teratogenic influences in this population.
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PMID:Prepyloric gastric antral web: a puzzling epidemic. 67 Nov 96

The indication field of Nortase, a combination of microbial lipolytic and proteolytic enzymes, comprises the replacement therapy of maldigestion and insufficiency of pancreas. Its efficacy and tolerance were tested in 100 patients in an open study under the conditions of general practice. During the 15-day treatment the following symptoms were evaluated: anorexia, flatulence, pressure and pain in the epigastrium, nausea after the meals, belching, pyrosis, the quality of feces and the body weight. 96% of the patients showed relief of the symptoms after treatment, 65% a therapeutic result ranging from very good to good. In 53% an improvement of the quality of feces was observed and 76% reached an increase in weight. 6 patients had some small side effects, in 1 case the treatment had to be interrupted. The altogether good results confirmed the results of former investigations on the acid stability and the high lipolytic activity of lipase from Rhizopus arrhizus.
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PMID:[Experiences with substitution therapy using a new pancreatic enzyme of plant origin]. 70 May 83

Patients with functional bowel disease commonly complain of abdominal pain, bloating, and excessive flatulence and eructation. Pain and bloating may be primarily caused by abnormal intestinal motility rather than by excessive intestinal gas. As yet there are no data available that prove excessive flatulence is actually caused by the presence of excessive intestinal gas. A study of the composition of intestinal gas provides insight into whether it is derived from swallowed air or from intraluminal metabolism. Therapy aims primarily at excluding the presence of organic disease as a cause and reassuring the patient that the disorder is functional in nature. Dietary manipulation, changing the habit of aerophagia, exercise, and pressure and heat applied to be abdominal area are all possibilities to be tried.
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PMID:Intestinal gas. 110 99

Classic diaphragmatic flutter, a rare disorder associated with dyspnoea, thoracic or abdominal wall pain, and epigastric pulsations, is caused by involuntary contractions of the diaphragm with a frequency of 0.5-8.0 Hz. We have seen three patients with diaphragmatic flutter of higher frequency not associated with respiratory disease. The patients presented with longstanding oesophageal belching, hiccups, and retching, respectively. The diagnosis was established by the presence on electromyography of the diaphragm and scalene and parasternal intercostal muscles of repetitive discharges of 9-15 Hz. Spirographic tracings, especially those of volume or flow vs time, showed similar high-frequency oscillations superimposed on tidal respiratory movements. Treatment with carbamazepine 200-400 mg three times daily led to disappearance or great improvement of flutter and clinical symptoms in all three patients. The phenomenon was not seen in other patients with chronic hiccups or oesophageal belching or in patients without these symptoms who had undergone electromyography or spirography for other reasons. Thus, high-frequency diaphragmatic flutter seems to be a new disease entity. The response to carbamazepine, which suggests that the flutter causes the symptoms, requires further study.
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PMID:High-frequency diaphragmatic flutter: symptoms and treatment by carbamazepine. 134 81

The most certain symptomatic manifestation of gallstones is episodic upper abdominal pain. Characteristically, this pain is severe and located in the epigastrium and/or the right upper quadrant. The onset is relatively abrupt and often awakens the patient from sleep. The pain is steady in intensity, may radiate to the upper back, be associated with nausea and lasts for hours to up to a day. Dyspeptic symptoms of indigestion, belching, bloating, abdominal discomfort, heartburn and specific food intolerance are common in persons with gallstones, but are probably unrelated to the stones themselves and frequently persist after surgery. Many, if not most, persons with gallstones have no history of pain attacks. Persons discovered to have gallstones in the absence of typical symptoms appear to have an annual incidence of biliary pain of 2-5% during the initial years of follow-up, with perhaps a declining rate thereafter. Gallstone-related complications occur at a rate of less than 1% annually. Those whose stones are symptomatic at discovery have a more severe course, with approximately 6-10% suffering recurrent symptoms each year and 2% biliary complications. The far higher rates of symptom development reported in a few studies raise the possibility that these incidence estimates may be too low. The best predictors of future biliary pain are a history of pain at the time of diagnosis, female gender and possibly obesity. The risk of acute cholecystitis appears to be greater in those with large solitary stones, that of biliary pancreatitis in those with multiple small stones, and that of gallbladder cancer in those with large stones of any number. Drugs that inhibit the synthesis of prostaglandins may now be the treatment of choice in patients with gallstones who are suffering acute pain attacks. Persistent dyspeptic symptoms occur frequently following cholecystectomy. A prolonged history of such symptoms prior to surgery and evidence of significant psychological distress appear to be the best predictors of unsatisfactory outcome.
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PMID:Symptoms of gallstone disease. 148 6

Fistulization to the duodenum or stomach from a diseased segment of bowel in Crohn's disease is rare, with only 63 cases reported. We report an additional two cases of Crohn's disease with recurrent fistulization to the duodenum. Although one or both patients complained of pain, diarrhea, and/or weight loss at presentation, neither of them experienced vomiting or feculent eructation. A review of 46 of the 63 reported cases of gastric and duodenal fistulization indicated that patients with gastric fistulas commonly present with vomiting (39%), and with histories of feculent eructations or frank feculent vomiting (44%), but that patients with duodenal fistulas rarely present with vomiting (3.6%), and never have feculent vomiting or eructations. This difference is an important clue to the diagnosis and localization of upper gastrointestinal fistulas in Crohn's disease.
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PMID:Symptomatic differentiation of duodenal from gastric fistulas in Crohn's disease. 232 89

Gastric motor dysfunction and concomitant gastric stasis have been implicated in the pathogenesis of nonulcer dyspepsia, but a cause-and-effect relationship is not established. Essential dyspepsia refers to a subgroup of nonulcer dyspepsia patients who have no evidence of irritable bowel syndrome, gastroesophageal reflux, or pancreaticobiliary disease. In 32 patients with essential dyspepsia, and 32 randomly selected dyspepsia-free community controls of similar age and sex, we measured gastric emptying of solids using Tc99m-Sulphur Colloid in a fried egg sandwich. Subjects with neuromuscular or other diseases that may alter gastric emptying were excluded. Symptoms were assessed by a standard questionnaire. Data processing was carried out "blinded" to the subjects' clinical status. Female patients took significantly longer to empty half the initial stomach activity (mean 90 min) than female controls (mean, 73 min; p = 0.02). The rate of emptying at 25 min was also significantly less in female patients than in controls. Female and male controls, and male patients, had similar emptying times. Delayed emptying was not associated with the occurrence of postprandial pain, belching, or nausea; there was a trend for the half-time rate of emptying to be greater in patients with abdominal distention. While gastric emptying of solids is slightly delayed in females with essential dyspepsia as a group, this may not explain their symptoms.
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PMID:Lack of association between gastric emptying of solids and symptoms in nonulcer dyspepsia. 258 62

Low pressure or inappropriate relaxation of the lower esophageal sphincter, disturbances in esophageal peristalsis and delayed gastric emptying are the most important pathogenetic factors of reflux disease. In general, retrosternal and also epigastric and pharyngeal burning or pain are the leading symptoms, but in mild disease eructation may become the major complaint. Diagnosis is usually made on the basis of a typical history and the results of endoscopy. 24-h-pH-recording is indicated in inconclusive endoscopy, chest pain of unknown origin and preoperative evaluation. Manometry may be indicated to exclude systemic sclerosis.
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PMID:[Pathophysiology, clinical aspects and rational diagnosis of gastroesophageal reflux disease and axial hiatal hernia]. 332 34

Symptoms experienced by 227 consecutive patients before their admission to the coronary care unit were identified by questionnaire and those associated with myocardial infarction (98) compared with those occurring with ischaemia (53) and chest pain or discomfort of unknown cause (29). The diagnosis of myocardial infarction by the nature of the resultant pain or discomfort was unreliable in contrast to the associated symptoms sweating, nausea, belching and vomiting. The predictive value of the latter was 91%. Nausea was associated with inferior site of infarction and development of Q waves on the electrocardiogram. Morphine administration was not followed by an increased incidence of vomiting. Back pain or discomfort during infarction was experienced twice as often by women.
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PMID:Symptoms associated with myocardial infarction: are they of diagnostic value? 345 80

Peptic ulcer disease is a less common cause of gastrocolic fistula than either carcinoma of the stomach or colon. However, use of steroids or aspirin appear to make this a more common complication of benign disease. The typical symptoms are pain, diarrhea, weight loss, foul eructation, and feculent vomiting. The most accurate method of diagnosis is with barium enema. The treatment is surgical.
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PMID:Gastrocolic fistula. 371 71


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